Sunday, September 24, 2023

Pig kidney works in the donated body for two months

Dozens of doctors and nurses stood respectfully and silently in a hospital hallway: For a record two months, a pig’s kidney had been functioning normally in the body of the brain-dead man who passed by on a stretcher.

The historic experiment ended Wednesday when surgeons at NYU Langone Health removed the kidney and returned Maurice “Mo” Miller’s donated body to his family for cremation.

It was the longest period for which a genetically modified pig kidney functioned in a human, albeit a brain-dead one. And by pushing the boundaries of research with a dead person, scientists learned crucial lessons that they plan to reveal to the Food and Drug Administration (FDA) in hopes of eventually replicating the experiment on a living person.

“It’s a mix of excitement and relief,” said Dr. Robert Montgomery, the transplant surgeon who led the experiment, told the Associated Press. “Two months is a long time to have a pig kidney in such good condition. That gives us a lot of confidence for the future.”

Montgomery, a heart transplant recipient himself, believes animal-to-human transplants are crucial to make up for organ shortages. More than 100,000 people are on the national waiting list, most of them needing a kidney, and thousands will die without receiving a kidney.

Attempts at so-called xenotransplantation have failed for decades: the human immune system immediately destroys the foreign animal tissue. What is new is the attempt to use genetically modified pigs to make their organs more similar to those of humans.

The brief experiments on deceased bodies avoided the immediate immune attack but did not shed light on a common form of rejection that develops over a month. Last year, surgeons at the University of Maryland tried to save a dying man with a pig heart transplant, but he only survived two months when the organ failed for unclear reasons. And the FDA gave Montgomery’s team a list of questions about how the pig heart works compared to the human heart.

Montgomery bet that putting Miller’s body on a ventilator to see how the pig’s kidney worked would answer some of those questions.

Miller was brain dead and could not donate his organs because of cancer. After a moment’s hesitation, his sister Mary Miller-Duffy donated the man’s body for the experiment.

On July 14, just before his 58th birthday, surgeons replaced one of Miller’s kidneys with one from a pig and the thymus, a gland that trains immune cells. In the first month, the kidney functioned without any side effects.

But soon afterwards, doctors noticed a slight decrease in the amount of urine. A biopsy confirmed signs of early rejection and gave doctors a chance to see if it was treatable. And so it happened that the kidney regained its function through a change in the immunosuppressive drugs that patients are currently using.

“We are learning that this is doable,” said NYU transplant immunologist Massimo Mangiola.

Nation World News Desk
Nation World News Desk
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