Xenotransplantation — here’s how a gene-edited pig cures humans

KV Prasad Jun 13, 2022, 06:35 AM IST (Published)

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The early success of the transplant of a pig kidney into a human being marks a major milestone in the quest to lessen the critical shortages of human kidneys for patients with kidney failure. This has raised hopes for the researchers that large clinical trials involving pig organs could be a reality. It could also bring the process of xenotransplantation which involves use of animal organs into the clinic.

The need for transplantation of organs is growing. While some scientists feel that animal organs can help in reducing the demand, there is a critical component which  discusses on how this could lead to dangerous infections.

Transplanting a whole organ from a pig has been difficult because of genetic differences that causes the human body to reject them. There are also concerns on being infected by a latent virus inside the pig. This virus could then spread to other humans. 

These kind of efforts will soon lead to a surge in small clinical trials of animal for human transplantation in extremely sick people. If successful, this could help many who have been waiting for organ transplants. 

What is Xenotransplantation  

Xenotransplantation is a process that involves the transplantation, implantation or infusion into a human recipient from a non-human animal source.  Despite several potential benefits, there is a risk of an infection of the recipients. This process called as cross species organ transplantation is still in a nascent stage. There are no human clinical trials that have been approved by the US Food and Drug Administration. 

Transplants from animals have a higher risk because animals have a different genetic code. To lower this risk, researchers make small changes to the animal’s DNA to match better with the human genes. It is very important to find the right genetic code  cells. The genes are edited so that the cells do not  produce a particular sugar that is foreign to the human body and triggers immediate organ rejection. The immune systems of humans were reacting mainly to one sugar molecule on the surfaces of pig cells, called α-Gal.

Xenotransplantation can just be a short-term solution that will reduce the organ shortage in the next five to seven years.

The Risks

There are ethical issues and many animal supportive groups strongly feel that the animals should not be genetically modified. A spokesperson for Animal Aid, a UK-based animal rights group, had told the BBC it was opposed to modifying animal genes in any circumstances. “Animals have a right to live their lives, without being genetically manipulated with all the pain and trauma this entails, only to be killed and their organs harvested,” the organisation said.   The other potential risks are that of organ rejection and virus infection which could be fatal.

The Trajectory 

Lisa Pisano, a 54-year-old woman from New Jersey last month became the second living person to receive a transplant of a gene-edited pig kidney. Doctors also implanted a mechanical heart pump, making Pisano the first person to receive both a heart pump and an organ transplant, according to a statement from NYU Langone Health, where the surgery was performed.

In March this year, a patient at the Massachusetts General Hospital received the first pig kidney transplant. 

The NYU team has earlier experimented with transplanting gene edited pig organs into brain dead patients. They have also twice transplanted pig hearts into deceased human patients. 

In 1984, the heart of a young baboon was transplanted into an infant born with a fatal heart defect. The infant lived for three weeks but died because of heart failure that was caused by the organ rejection. Before this there were other experimental non human heart transplants, the earliest in 1964 using a chimpanzee heart.

The animal to human transplant needs a lot more collaboration, scientific  and clinical trials before they can actually be categorised as a medical success.

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KV Prasad Journo follow politics, process in Parliament and US Congress. Former Congressional APSA-Fulbright Fellow