Researchers from NYU Langone Health reported on Tuesday that a surgical team had successfully transplanted the heart of a genetically modified pig into a human patient who had passed away as part of an ongoing research study.
The treatment was the first of its kind and represents a step forward in the investigation into the viability of modifying the organs of non-human animals to successfully transplant them into humans who need such a procedure.
The recipient, Lawrence Kelly, who was from Pennsylvania and was 72 years old, was diagnosed as having brain death. His family generously gave his body to the research team so that they could explore the viability of the modified pig heart in a human body after the person had passed away.
After completing the transplant on Kelly back in June, the research team went on to do the procedure on another deceased victim, this time it was New York City resident Alva Capuano, who was 64 years old.
After an operation in January at the University of Maryland, in which a pig heart was successfully implanted into a living human, these transplants followed suit. That beneficiary passed away in March.
According to Dr. Robert Montgomery, head of the NYU Langone Transplant Institute, the procedures enabled a more in-depth investigation of how well the bodies of the transplant recipients handled the pig hearts.
He stated that “we can undertake much more regular monitoring,” adding that this will allow us to “truly sort of comprehend the biology” and “fill in all of the unknowns.”
He also mentioned that their research was one of a kind since they made an effort to simulate settings that are found in the real world. For instance, they did not employ any experimental equipment or pharmaceuticals.
The investigators are now working on publishing additional information regarding the study.
“He went out a hero,” said people.
Researchers had to travel out of state to obtain the heart, which had genetic modifications aimed at several factors, such as modulating the organ’s growth and reducing the chance that the recipient’s immune system would reject it. To obtain the heart, researchers had to travel out of state.
Dr. Nader Moazami, the surgical director of heart transplantation at NYU Langone Health, commented that because of the trip, the team was able to simulate the conditions that are present during a conventional heart transplant.
“It was around an hour and 15-minute flight from New York, which is typical of the distance that we take hearts for clinical transplantation,” said Moazami, who conducted the transplant. “It is typical of the distance that we take hearts for clinical transplantation.”
Kelly, a former sailor who was involved in an accident that left her brain dead, was the recipient of the heart. Alice Michael, who was engaged to Kelly, gave her consent for his body to be donated for scientific study.
They had planned to remove his liver, but they were unable to locate a suitable recipient. Then, New York University contacted me about this study that they were conducting. And without even thinking about it, I replied in the affirmative, knowing that he would have welcomed the opportunity. “He had a passion for assisting others,” she stated.
“When they asked me, I didn’t have to give it much thought. I immediately said yes. I was aware that it was ground-breaking research, and I knew that he would have wanted to participate in it, so I just immediately responded positively. It was difficult since I had to wait to bury him after he passed away. On the other hand, perhaps in the long term, he will be able to assist a great number of people.
Michael said, “He was a hero in life, and he went out a hero,” referring to the deceased man.
Following the heart transplant, the researchers conducted tests for three days to evaluate how well the recipient’s body absorbed the new heart, all the while the body of the recipient was being kept alive by mechanical means, including breathing.
According to a news statement issued by the medical center, “No symptoms of early rejection were seen, and the heart functioned correctly with routine post-transplant drugs and without further mechanical support.”
In addition, the researchers reported that they could not find any symptoms of infection with porcine cytomegalovirus (pCMV). This virus has been the subject of concern among specialists since there is a possibility that it could be a barrier to the transplantation of pig organs into human recipients.
An innovative approach for the study of transplants
According to Moazami, there is a new procedure that involves testing how well organ transplantation works by using the donated body of a deceased individual. In September, a team at NYU Langone led by Montgomery successfully transplanted a kidney from a genetically modified pig into a human donor who had passed away. This was the first time that this method had been used for research purposes.
According to Moazami, even if the study is a step in the right direction, there is still a lot more work to be done before a method like this can be made widely available outside of the context of research.
According to what he had to say, “there is still a long way to go before we proceed from here to clinical transplantation to maintain a patient for the longer term.” “There are still a great number of questions that need to be answered,” the speaker said.
According to him, one of the most significant limitations of the study was its duration; the organ and recipient were only monitored for 72 hours after the transplant. In addition, there is a possibility that the reaction of human bodies that have already passed away to the process could be very different from that of living people. To have a better understanding of the transplant recipients’ long-term prognosis, additional research is required.
“We thought that in 72 hours, we could learn all the things that we would learn if we had extended this a little bit more,” Moazami said, noting that the short time frame limited the expense of the study and allowed the recipient’s body to be returned to his family more quickly. In addition, Moazami noted that the short time frame allowed for the body of the recipient to be returned to his family more quickly.
“We considered that 72 hours was a sufficient amount of period for our short-term study, to learn all of the things that we required — that three days, versus five days, versus seven days, wouldn’t make a difference.” Would it make a difference if we did it in three days instead of one month? Yes, without a doubt. However, at this point, it would have been quite challenging to accomplish that.”
The practice of transplanting organs from animals into humans raises several additional ethical concerns. One of these concerns is whether or not the potential benefits of using a pig heart that has been genetically modified outweigh the potential dangers that a patient would face if they waited for a human organ to become available.
A connection on a personal level and an uncharted territory
The investigation holds some significance for Montgomery on a personal level. He is a person who has received a human heart transplant, and he has stated that one of the things that drive him to work hard is the fact that it is so difficult to get a transplant.
“As I was recovering from my sickness, it became very evident to me that the current model is flawed. “It’s a broken model, and we need a renewable resource, an alternative source of organs that doesn’t require one person to pass away for another person to have a chance at life,” he added. “It’s a paradigm that’s collapsing.”
“My whole illness was all about informing me about the reality of that and changing the way I think, not that it’s not important to continue doing what we’re doing, but we’ve got to move this in a completely different direction,” she said. “It’s not that it’s not important to continue doing what we’re doing, but we’ve got to move this in a completely different direction.”
In most cases, the demand for organ transplantations in the United States substantially outweighs the number of donor organs that are now available. As of the 7th of July, there were 106,074 people on the waiting list for organ transplants, with 3,442 persons on the waiting list for heart transplants. Daily, there are an average of seventeen persons pass away while waiting for an organ transplant.
Moazami noted that transplants from animals could one day be effective in the pediatric setting, which is a setting in which patients can face even greater obstacles in getting a human organ transplant promptly. It may be possible to employ organs from animals as a “bridge” to purchase more time till a better suitable human organ becomes available.
“Perhaps the best way to study this is maybe to use it as a bridge to a human transplant if you will,” Moazami said. “So that any patient who needs an organ would get this heart with the caveat that when a human heart becomes available that matches the recipient, we swap it out again.” Moazami was referring to the possibility of using the artificial heart as a bridge to a human transplant.