Researchers of the
University of Alabama at Birmingham (USA) present today the first peer-reviewed research describing the successful transplantation of genetically modified pig kidneys into a brain-dead human individual, replacing the recipient’s native kidneys. These positive results demonstrate how xenotransplantation might address the global organ shortage crisis.
In the study published in
«American Journal of Transplantation», researchers tested the first human preclinical model for transplanting genetically modified pig kidneys into humans. The recipient of the study had two pig kidneys transplanted genetically modified in your abdomen following his kidneys were removed. The organs were obtained from a genetically modified pig. The key to
The success of this transplant lies in the genetic edition of 10 key genes in the pig.
“Today’s results are a remarkable achievement for humanity and they advance xenotransplantation to the clinical field”, highlights Selwyn Vickers, from the aforementioned university.
For the first time, transplanted pig kidneys were obtained from pigs that in those who had edited 10 key genes that can make kidneys suitable for transplantationsa human. This process demonstrates the long-term viability of the procedure and how the transplant might work in the real world. transplanted kidneys filtered blood, produced urine And what is more important, they were not immediately rejected: remained viable until the end of the study, 77 hours following transplantation.
“We are at a revolutionary moment in the history of medicine and it represents a paradigm shift and an important milestone in the field of xenotransplantation, which is possibly the best solution to the organ shortage crisis,” explains Jayme Locke, principal surgeon at the study.
With this step, “we have overcome critical knowledge gaps and obtained the necessary safety and feasibility data to begin a clinical trial in living humans with end-stage renal disease.”
The key has been gene editing in pigs to reduce immune rejection, which has made organ transplants from pigs to humans possible.
The natural life of a pig is 30 years, they are easily raised and may have organs similar in size to humans.
Genetically modified pig kidneys had been tested on non-human primates. In addition to testing in nonhuman primates, evaluation of genetically modified pig kidneys in a human preclinical model investigation may provide important information regarding the potential safety and efficacy of kidneys in human transplant recipients, including in clinical trials.
“Our study demonstrates that the main barriers to human xenotransplantation have been overcome, identifies where new knowledge is needed to optimize xenotransplantation outcomes in humans, and lays the groundwork for establishing a new preclinical human model for further study,” Locke says. ».
This discovery has the support of the pioneer in biotechnology United Therapeutics Corporation, which awarded a grant to the
University of Alabama to launch the innovative xenotransplantation program. revivicor, Inc., a subsidiary of United Therapeutics, provided the genetically modified pig that was the source of the investigational xenotransplant kidneys called UKidney.
“At Revivicor we are amazed by the historical achievements at the UAB with our 10-gene research xenon kidney or UKidney”, highlights David Ayares, adding that they are confident that “UKidney can become a solution that saves the lives of thousands of people in dialysis”.
Kidneys were harvested from a donor pig housed in a surgically clean, pathogen-free facility. The kidneys were then stored, transported and processed for implantation, just like human kidneys.
Before surgery, the recipient brain dead and the donor animal underwent a cross-match test to determine if genetically modified pig kidney and its intended receiver had a good match.
The pig kidneys were placed in the exact anatomical locations used for human donor kidneys, with the same attachments to the renal artery, renal vein, and the ureter that carries urine from the kidney to the bladder.
The receptor brain dead received the standard immunosuppression therapy used in person-to-person allogeneic kidney transplantation.
The transplant recipient, the late Jim Parsons, thus becomes a key player in the future of organ transplantation. This scientific and medical breakthrough would not have been possible without Jim Parsons, the recipient, or his family, the researchers acknowledge.
The Chronic Kidney Disease (CKD) is a serious and progressive condition that consists of a decrease in kidney function and is characterized by being a silent disease, since it generally no symptoms until very advanced stages.
The CKD can significantly reduce life expectancy as kidney function declines, because the risk of suffering cardiovascular events increases, and can evolve into its most severe form, known as End-Stage Renal Disease, in which kidney damage and deterioration of kidney function progress to the point of requiring dialysis or kidney transplant.
CKD in Spain has a prevalence of 15,1%3, affects approximately 47 million people in the EU and more than 850 million people worldwide. An increase in these figures is expected, mainly due to the aging of the population, as well as the increase in the prevalence of hypertension and diabetes, its main risk factors. In addition, it accuses a high underdiagnosis.
“CKD has become a serious public health problem, with prevalence and incidence rates that continue to grow every year in our country. In addition, it has a strong impact on the quality of life of the people who suffer from it and their families, and more importantly, it entails high mortality, which has increased by 30% in the last decade. In fact, CKD is the second disease whose mortality and disability increased the most between 2006 and 2016, following Alzheimer’s», says Patricia de Sequera, president of the
Spanish Society of Nephrology (SEN).
And he adds that to this «we must add that according to the last report of the
World Health Organization Of the 55.4 million deaths that occurred in 2019 in the world, more than half (55%) are due to 10 pathologies, among which kidney disease is ranked for the first time.
