An awe-inspiring gathering of medical professionals filled the hospital corridor, forming an extraordinary show of reverence. For an unprecedented duration of two months, the lifeless body of a man had been functioning with a pig’s kidney implanted within.
The audacious experimental procedure concluded on a Wednesday as doctors at NYU Langone Health delicately extracted the pig’s kidney and reverently returned the donated body of Maurice “Mo” Miller to his family for his final rites.
This experiment set a new milestone, marking the longest period that a genetically modified pig kidney has ever functioned in a human body, although in this case a deceased one. Through this groundbreaking research involving the dead, the scientists gleaned invaluable insights that they intend to present to the Food and Drug Administration, holding out hope for future trials of pig kidneys in living human subjects.
Expressing his mixed feelings of exhilaration and relief, Dr. Robert Montgomery, the pioneer transplant surgeon, said that the condition of the pig kidney even after two months instilled great confidence for future endeavours.
Montgomery, a heart transplant recipient himself, staunchly believes in the potential of animal-to-human transplants to mitigate the critical shortage of organs in the country where over 100,000 people are on the waiting list, most in need of a kidney. Thousands are tragically destined to die while waiting.
Over several decades, attempts at xenotransplantation have been fraught with failure as the human immune system relentlessly attacked and destroyed foreign animal tissue. The innovative approach now revolves around genetically modifying pigs to develop organs that closely resemble those of a human.
In previous short-term trials with deceased bodies, an immediate immune attack was successfully circumvented but provided no insight into the more common type of rejection that could occur over a month. The reasons behind the failure of last year’s attempt by University of Maryland surgeons to transplant a pig heart into a dying man still remain largely ambiguous, casting an array of questions over the performance of pig organs vis-a-vis human ones for the FDA and Montgomery’s team.
Nevertheless, Montgomery was confident that his bold strategy to keep Miller’s body on a ventilator for two months to observe the functioning of the pig kidney could provide some of those answers.
Commending their efforts, Miller’s emotional sister, Mary Miller-Duffy bade a tearful farewell to her brother. Miller’s body was deemed unfit for organ donations due to his cancer-afflicted state, and was hence instead donated for the noble cause of this experimental procedure.
In one humbling instance, Miller-Duffy received a heartfelt message from a stranger in California awaiting a kidney transplant, expressing gratitude for her contribution to such a crucial research.
On Miller’s 58th birthday, surgeons replaced his native kidneys with a pig kidney and its thymus, a gland which plays a crucial role in training immune cells. Gestures of hope prevailed as the kidney functioned seamlessly for the first month with no sign of rejection.
However, as the second month proceeded, doctors noted a minor decrease in urine production which hinted at the early phases of rejection. Encouragingly, with a mere change in the routine immune-suppressing medication, the kidney’s performance rebounded.
Panel experts on transplantation strongly believe in the feasibility of xenotransplantation, expressed NYU transplant immunologist Massimo Mangiola.
Setting a critical precedent, the pig kidney exhibited no major deviations in response to human hormones, antibiotic excretion, or medication-related side effects.
Observing the pristine pig kidney at the 61-day mark, Dr. Jeffrey Stern remarked on its resemblance to normal kidneys, further bolstering the faith in future explorations into xenotransplantation.
The mission did not end here. Around 180 different tissue samples were collected from every major organ, lymph nodes, and the digestive tract, to be holistically examined for any potential complications from the xenotransplant.
However, Karen Maschke, a research scholar from the Hastings Centre cautioned that lessons drawn from deceased bodies cannot be extrapolated to predict how the organs might function in the living. Nevertheless, she stated that it could help identify potential genetic variations impacting the success rate of such procedures.
By embracing the challenges associated with xenotransplantation, these medical experts strive to give those awaiting organ transplants a fighting chance for a second lease at life, concluded Mangiola, the transplantation immunologist.
