Genetically engineered pig heart successfully transplanted in brain-dead recipients in US
Xenotransplant surgeries were performed on June 16 and July 6 at New York University (NYU) Langone's Tisch Hospital.
FollowSurgeons in the United States have successfully transplanted genetically engineered pig hearts into recently deceased humans, a step toward the long-term goal of performing such surgeries regularly in living patients, according to researchers.
The xenotransplant surgeries were performed on June 16 and July 6 at New York University (NYU) Langone's Tisch Hospital.
The investigational procedures were led by Nader Moazami, surgical director of heart transplantation at the NYU Langone Transplant Institute, who used hearts obtained from a facility hundreds of miles away and transplanted into recently deceased donors who were on a ventilator support.
The transplant surgeries took several hours, and the heart function was monitored for three days. The first heart xenotransplant was completed on June 19, 2022, and the second was completed on July 9, 2022.
According to the researchers, there were no signs of early rejection in either organ, and the hearts functioned normally with standard post-transplant medications and without additional mechanical support.
There was no evidence of porcine cytomegalovirus (pCMV) in either case. According to the researchers, the operating room used for the study has been taken offline and will only be used for future xenotransplantation research.
The hearts were obtained from pigs with ten genetic modifications, including four porcine genes "knockouts" to prevent rejection and abnormal organ growth, and six human transgenes to promote the expression of proteins that regulate critical biologic pathways pig-human incompatibilities can disrupt.
In the study, no other investigational devices or medications were used. The procurement, transportation, transplant surgery, and immunosuppression procedures were all per current clinical standards in heart transplantation.
In a statement, Moazami stated that "our goal is to integrate the procedures utilised in a conventional, everyday heart transplant, but with a nonhuman organ that will function normally without additional assistance from unproven technologies or medications.
With the tried-and-true transplant techniques, we have mastered at the NYU Langone Transplant Institute, "we hope to confirm that clinical studies can advance utilising this new source of organs," Moazami added.
According to Alex Reyentovich, director of the NYU Langone Advanced Heart Failure programme, these most recent developments in xenotransplantation make the field closer to achieving a fresh supply of organs for patients facing a life-threatening disease.
Reyentovich stated that these are the initial steps in gaining a thorough grasp of the mechanical, molecular, and immunologic components of xenoheart transplantation and the viability of doing so using accepted clinical procedures and equipment.
Professor Robert Montgomery of NYU Grossman School of Medicine noted that to develop a discipline that had up until last year, been tested exclusively on nonhuman primates, additional human data must be gathered via xenotransplant trials using recently dead donors.
"Moving this effort ahead depends on the concept of whole-body donation in situations where organ donation is not an option. We are extremely appreciative of the families who volunteered to take part in this study because it will help save countless numbers of additional lives," added Montgomery.
Enhanced porcine virus monitoring, implemented in these most recent procedures, is one of the crucial components of success in advancing this field, according to Montgomery, who led ground-breaking xenotransplant surgeries using single-gene knockout pig kidneys in September and November of last year.
According to other studies, he noted, the success of xenotransplanted organs may be influenced by pCMV.
"To find evidence of pCMV in the donor pigs at low levels, more sensitive screening techniques have been developed. To provide the heart transplant recipient organ with the best chance of long-term survival, we have included that additional screening to the protocol," said Montgomery.
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