The man with the pig kidney transplant died two months after the operation

Rick Slayman, 62, survived for two months, the first living patient to receive a genetically modified pig kidney, which was transplanted to him last March in the USA. One possibility, that of the transplant of genetically modified animal organs, which might potentially represent a great additional opportunity in the future for the many patients on the waiting list for an organ, but the road is still long even if Slayman’s death does not indicate, according to experts, a failure of the program.

The Massachusetts General Hospital in Boston, where the transplant was performed, reports the Guardian newspaper, however declared that it had no indication that the cause of death was the transplant. Surgeons had said they believed the organ might last at least two years. That of xenotransplantation, or the transplantation of organs from animals to humans, is «a complex and long path, but at the same time the message to be given is that the death of the American patient does not indicate a failure of the xenotransplantation program, but highlights that there is still a path to go. Potentially, xenotransplantation can in fact represent a great additional opportunity for certain categories of patients on the waiting list for an organ”, explains Giuseppe Feltrin, director of the National Transplant Center (Cnt). The patient, Feltrin notes, «was already severely compromised in his health conditions and with a previous transplant he received and failed, however the fact that he survived for two months is a positive element and gives hope for future developments. However, we are awaiting more information from US doctors since there may be many factors that led to the death.”

The novelty in this intervention, clarifies the director of the CNT, «is twofold: for the first time a genetically modified pig kidney was used and the transplant was done on a living patient, while previously similar pig kidney transplants have been carried out only on brain-dead patients for research purposes and to understand the compatibility of the organ and the risk of possible rejection. Previously, once more in the USA, two genetically modified pig heart transplants were also carried out on patients who were alive but died following a few weeks. This is therefore the third case of a genetically modified pig organ transplanted to a living patient.” Precisely the genetic modification of the pig organ represented «a step forward of fundamental importance: this in fact allows – he clarifies – to limit the risk of rejection of the organ and also to limit the risk that the pig organ might carry infections to the ‘man through DNA’.

Even if xenotransplantation continues to be a potential for the future, today, however, Feltrin warns, «we still need to strongly encourage cadaveric organ donations and also living donations, for example for kidney, liver and lung. In 2023, donations have fortunately increased, with a +15% between organ donations and transplants, but even more must be done as – remember – there are currently still around 8 thousand patients in Italy on the waiting list to receive an organ”. 24 years have passed since Thomas Starzl, the American doctor who pioneered liver transplantation, indicated xenotransplantation as the frontier for solving the problem of organ shortage. And the ideal candidate for xenotransplantation was, Starzl stated, the genetically modified pig. A path that will still require efforts, but which might represent a turning point in the future. Currently, in Italy alone, there are 685 patients on the waiting list to receive a heart, 933 for the liver, 194 for the pancreas, 254 for the lung, 5,894 for the kidney and 6 for the intestine.