In the USA, a patient with a pig kidney died two months after the transplant


By John

He survived two months Rick Slayman62 years old, the first living patient to receive a genetically modified pig kidney, which was transplanted last March in the USA. One possibility, that of the transplant of genetically modified animal organs, which could potentially represent a great additional opportunity in the future for the many patients on the waiting list for an organ, but the road is still long even if Slayman's death does not indicate, according to experts, a failure of the program. The Massachusetts general hospital where the transplant was carried out, reports the Guardian newspaper, however declared that it had no indication that the cause of death was the transplant. Surgeons had said they believed the organ could last at least two years.

That of xenotransplantation, or the transplantation of organs from animals to humans, is «a complex and long path, but at the same time the message to be given is that the death of the American patient does not indicate a failure of the xenotransplantation program, but highlights that there is still a path to go. Potentially, xenotransplantation can in fact represent a great additional opportunity for certain categories of patients on the waiting list for an organ”, he explains to Ansa Giuseppe Feltrin, director of the National Transplant Center (Cnt). The patient, Feltrin notes, «was already severely compromised in his health conditions and with a previous transplant he received and failed, however the fact that he survived for two months is a positive element and gives hope for future developments. However, we are awaiting more information from US doctors since there may be many factors that led to the death.” The novelty in this intervention, clarifies the director of the CNT, «is twofold: for the first time a genetically modified pig kidney was used and the transplant was done on a living patient, while previously similar pig kidney transplants have been carried out only on brain-dead patients for research purposes and to understand the compatibility of the organ and the risk of possible rejection. Previously, again in the USA, two genetically modified pig heart transplants were also carried out on patients who were alive but died after a few weeks. This is therefore the third case of a genetically modified pig organ transplanted to a living patient.”

The genetic modification of the pig organ represented «a step forward of fundamental importance: this in fact allows – he clarifies – to limit the risk of rejection of the organ and also to limit the risk that the pig's organ could transport infections to humans through DNA”. Even if xenotransplantation continues to be a potential for the future, today, however, Feltrin warns, “we still need to strongly encourage cadaveric organ donations and also living donations, for example for kidney, liver and lung. In 2023 donations have fortunately increased, with a +15% between organ donations and transplants, but even more must be done since – remember – there are currently still around 8 thousand patients in Italy on the waiting list to receive an organ 24 years since Thomas Starzl, the American doctor who pioneered liver transplantation, indicated xenotransplantation as the frontier for solving the problem of organ scarcity. And the ideal candidate for xenotransplantation was, Starzl stated, the genetically modified pig. A path that will still require efforts, but which could represent a turning point in the future. Currently, in Italy alone, there are 685 patients on the waiting list to receive a heart, 933 for the liver, 194 for the pancreas, 254 for the lung, 5,894 for the kidney and 6 for the intestine.