For the first time in history, a pig kidney was successfully transplanted into a human patient this month. Massachusetts General Hospital (MGH) revealed Thursday that the medical milestone surgery was performed March 16.
“Seventy years after the first kidney transplant and six decades following the advent of immunosuppressive medications, we stand on the brink of a monumental breakthrough in transplantation,” said Leonardo V. Riella, the hospital’s medical director for kidney transplantation.
According to the United Network for Organ Sharing, there were more than 27,000 kidney transplants last year, another first. A study published in the JAMA Surgery journal last year that an organ shortage continued to be a “crisis” for people with end-stage kidney disease.
“At MGH alone, there are over 1,400 patients on the waiting list for a kidney transplant,” said Riella. “Some of these patients will unfortunately die or get too sick to be transplanted due to the long waiting time on dialysis. I am firmly convinced that xenotransplantation represents a promising solution to the organ shortage crisis.”
Xenotransplantation refers to organ transplantation of non-human animal cells into humans.
In a press release, MGH said the recipient of the pig kidney is 62-year-old Richard ‘Rick’ Slayman of Weymouth, Mass. As of Thursday, he was “recovering well at MGH,” after the four-hour surgery and was “expected to be discharged soon.”
“The real hero today is the patient, Mr. Slayman, as the success of this pioneering surgery, once deemed unimaginable, would not have been possible without his courage and willingness to embark on a journey into uncharted medical territory,” said Dr. Joren C. Madsen, director of the MGH Transplant Center.
Slayman lived with Type 2 diabetes and hypertension for many years and previously received a kidney transplant from a human donor in late 2018. Prior to that transplant, he was on dialysis. After around five years, the human kidney transplant failed and he went on dialysis again last year.
“My nephrologist, Dr. Winfred Williams, and the Transplant Center team suggested a pig kidney transplant, carefully explaining the pros and cons of this procedure,” Slayman explained. “I saw it not only as a way to help me, but a way to provide hope for the thousands of people who need a transplant to survive.”
Riella and the transplant team applied for an FDA Expanded Access Protocol (EAP), known as compassionate use, to perform the surgery. This protocol is granted for patients with serious, life-threatening illnesses or conditions so they can access experimental treatments. Along with the transplant, Slayman also received infusion of novel immunosuppressant drugs, tegoprubart, provided by Eledon Pharmaceuticals, Inc., and ravulizumab, provided by Alexion Pharmaceuticals, Inc.
Scientists worked to eliminate viruses that could potentially hinder the success of the transplant. The pig donor that provided the kidney was also genetically-edited using CRISPR-Cas9 technology to remove harmful pig genes and add certain human genes to improve its compatibility with humans, said the hospital. It was obtained through eGenesis of Cambridge, Mass.
Mass General Brigham has a history of groundbreaking transplant operations. These include the world’s first successful human organ transplant (a kidney) performed at Brigham and Women’s Hospital in 1954 and the nation’s first penile transplant, performed in 2016.
“The success of this transplant is the culmination of efforts by thousands of scientists and physicians over several decades. We are privileged to have played a significant role in this milestone. Our hope is that this transplant approach will offer a lifeline to millions of patients worldwide who are suffering from kidney failure,” said Dr. Tatsuo Kawai, Director of the Legorreta Center for Clinical Transplant Tolerance.