Pig Kidneys Are Transplanted Into Brain-Dead Man

"Doctors in Alabama said that they had successfully transplanted a pair of pig kidneys into the body of a brain-dead person, potentially paving the way for clinical trials of animal-to-human transplants for patients in desperate need of kidneys and other organs.

The first-of-its-kind surgery was performed in late September at the University of Alabama at Birmingham and described in a paper published Thursday in the American Journal of Transplantation. The genetically engineered kidneys weren't immediately rejected by the recipient's body and showed limited function for the duration of the multiday experiment, the doctors said.

The recipient of the genetically engineered organs was James Parsons, a 57-year-old carpenter and motorcycle racer from Huntsville, Ala., who was found to be brain-dead after crashing during a race, members of his family said. In the U.S., brain death is defined as the irreversible cessation of all brain function, even if heart and lung activity can be maintained with machines.

The experimental surgery, which proceeded after discussions with ethicists and after Mr. Parsons' family consented to the experiment, is part of a decadeslong effort to ease the chronic shortage of donor organs by allowing critically ill patients to receive pig organs rather than human ones.

"We couldn't get Jim back for a week," said Julie O'Hara, Mr. Parsons' former wife. "His body had to be maintained," she added. "That was a struggle, but we knew that the benefits of what we were doing with him outweighed those concerns."

The surgery was initiated with the hope that it would show that pig organs can function in humans, as were a pair of operations last year in which doctors at NYU Langone Health attached a pig kidney to the upper leg of a brain-dead person.

Experiments involving the transplantation of an organ from one species to another, known as xenotransplantation, more commonly have involved the placement of genetically modified pig organs into baboons and other monkeys rather than in humans.

More than 100,000 people in the U.S. are on the national waiting list for kidneys, livers, hearts and other organs, according to the United Network for Organ Sharing.

More than 6,000 patients die each year while waiting to get a new organ, according to the network.

A number of xenotransplantation researchers are in talks with the Food and Drug Administration about launching clinical trials, researchers said. So far none has begun, but researchers said they were eager for that to happen.

This month, doctors at the University of Maryland School of Medicine in Baltimore performed the first transplantation of a genetically modified pig heart into a living human. The recipient of the heart, 57-year-old David Bennett, remains hospitalized, according to Muhammad Mohiuddin, director of the university's cardiac xenotransplantation program.

The pig kidneys came from a 13-month-old, 350-pound male pig that was provided by Revivicor Inc. of Blacksburg, Va. The pig had undergone 10 gene edits designed to make its organs more suitable for transplantation into people.

The pig had been kept in a special germ-free facility near the hospital. The kidneys were surgically removed and then transported on ice to the UAB human-transplant center.

After removing Mr. Parsons' kidneys, surgeons placed the pig kidneys into his abdomen and then attached them to blood vessels and connected their ureters to Mr. Parsons' bladder.

The doctors said they monitored the kidneys for about 78 hours. They said they stopped the experiment when mechanical support was no longer sufficient to maintain Mr. Parsons' physiological processes.

Transplant surgeons not involved in the study said the experiment showed clinical trials are feasible. But the supply of genetically modified pigs remains limited, as does the availability of germ-free animal facilities. In addition, the FDA hasn't approved some immunosuppressive drugs shown to improve the survival of baboons that received genetically modified pig organs." [1]

1. U.S. News: Pig Kidneys Are Transplanted Into Brain-Dead Man
Marcus, Amy Dockser. Wall Street Journal, Eastern edition; New York, N.Y. [New York, N.Y]. 21 Jan 2022: A.3.