Kidneys are one of the organs most in demand in transplant units in the United States, where there are regarding 800,000 people in need.
Kidney transplant. Photo: Unsplash.
In 2024, the USA began to venture into genetically edited pig kidney transplantation because many patients spend years on waiting lists, and some of them die without obtaining the organ they need.
However, the first results are not encouraging. Richard Slayman, 62, received a kidney from a genetically modified pig in Massachusetts last March but died two months later.
The first pig kidney transplant. Photo: Reuters.
Adding to this, a woman who received a pig kidney transplant on April 12 in a New York hospital had to have it removed 47 days later, and she has just died.
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Who was the woman who received a kidney transplant and died in New York?
Lisa Pisano was the second person to receive a pig kidney transplant designed to increase compatibility between the pig graft and its human recipient. In the surgery, she also received a mechanical heart pump to keep her heart beating.
Kidneys. Photo: Unsplash
The 54-year-old woman was also the first to receive a transplant and a heart pump since she suffered from kidney and heart failure. Less than two months later, her new kidney had to be removed because it was affected by irregular blood flow related to the heart pump. This forced her to return to dialysis.
“Lisa’s contributions to medicine, surgery, and xenotransplantation (which involves the use of organs from other species) cannot be underestimated. Her bravery gave hope to thousands of people living with end-stage kidney or heart failure who might soon benefit from an alternative organ supply,” according to her surgeon Robert Montgomery.
Pig Kidney Transplants: Hope and Heartache in the Search for Solutions
The demand for kidneys in the United States is at a critical point, with over 800,000 individuals awaiting life-saving transplants. This dire shortage has prompted scientists and medical professionals to explore novel solutions, including xenotransplantation, the transplantation of organs from animals to humans. While the concept holds great promise, the recent passing of two recipients of pig kidney transplants, including Lisa Pisano, highlights the ongoing challenges and underscores the urgent need for further research and development.
The Complexities of Xenotransplantation: A Balancing Act
The pig, specifically, has emerged as a potential source for organ transplants due to its biological similarities with humans. However, the process of xenotransplantation is fraught with complex scientific and ethical considerations. The main challenges include:
- Immune Rejection: The human immune system readily identifies pig organs as foreign and attacks them. This immune rejection is a significant hurdle that researchers are actively trying to overcome using genetic engineering and immunosuppressant therapies.
- Porcine Endogenous Retroviruses (PERVs): These viruses are naturally present in pigs, posing a potential risk of transmission to humans during transplantation. Extensive research has been dedicated to developing pigs that are free of PERVs or have their viral activity minimized.
- Ethical Concerns: The use of animals for organ transplantation raises ethical questions regarding animal welfare and the potential for creating new infectious agents. It is crucial to consider these ethical implications and develop clear guidelines for responsible xenotransplantation research and practice.
The Promise of Genetic Modification: A Breakthrough in Compatibility
Significant strides have been made in genetic engineering to enhance the compatibility between pig organs and human recipients. Researchers have successfully modified pig embryos to eliminate genes that trigger immune rejection and create pigs that produce human proteins that further reduce the risk of immune attack.
The Case of Lisa Pisano: A Tragic Loss, Yet a Valuable Lesson
Lisa Pisano’s case highlights both the potential and the perils of xenotransplantation. While she initially showed signs of improvement following the pig kidney transplant, complications arose due to the simultaneous use of a mechanical heart pump. Her death underscores the need for more comprehensive protocols and strategies for managing the interplay of xenotransplantation with other interventions aimed at addressing multi-organ failure.
Looking Ahead: The Future of Xenotransplantation
Despite the challenges and setbacks, the scientific community remains optimistic regarding the future of xenotransplantation. Ongoing research is focused on refining genetic modification techniques, developing new immunosuppressant medications, and optimizing surgical procedures. The goal is to create a safe and effective xenotransplantation approach that can provide much-needed organs for countless individuals in need.
The efforts of scientists and medical professionals in this field are commendable, and their commitment to finding solutions for the organ shortage crisis is inspiring. As research progresses, the hope remains that xenotransplantation will eventually become a viable and ethical option for patients battling end-stage organ failure.
Further Research and Collaboration: The Key to Progress
To advance xenotransplantation and make it a truly viable solution, significant investment in research and collaboration is critical. This includes:
- Funding for research: Increased funding is needed to support ongoing research efforts focusing on overcoming immune rejection, minimizing PERV risks, and developing comprehensive clinical protocols.
- Collaboration between researchers: Collaborative efforts between scientists, clinicians, ethicists, and animal welfare experts are essential to address the complex scientific and ethical aspects of xenotransplantation.
- Public awareness and education: Public education and open discussions regarding xenotransplantation are crucial to garnering societal support and fostering informed decision-making.
It is through these combined efforts that we can usher in a new era of xenotransplantation where the potential to save lives becomes a reality.
**Note:** The article includes a mix of general information regarding xenotransplantation and specific details regarding Lisa Pisano’s case. The article also encourages further research and collaboration as key factors in achieving a successful outcome for xenotransplantation.
