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Pig kidneys were first transplanted into humans

October 19th USA TodayAn American newspaper reported that a New York surgeon had successfully transplanted a pig kidney into a human subject. The organs were successfully attached for 3 days in the experimental procedure of a brain-dead patient. The procedure was the culmination of many years of work. For decades, scientists have dreamed of xenotransplantation, which involves transplanting animal organs into humans. Successful transplants show how far science has progressed in this process, and how far it must still go.

In 2014, a company called Synthetic Genomics in La Jolla, California began working on a unique and radical project. The idea was to make many genetic changes to the pig so that the pig’s organs would be more suitable for transplantation into humans without being rejected. The goal was to address the growing shortage of organs for transplantation. Synthetic Genomics has partnered with United Therapeutics Corporation, another biotechnology company based in Silver Spring, Maryland. United Therapeutics believes that one million people in the United States alone suffer from end-stage organ disease each year and may need a heart, kidney, or lung transplant.

For years, attempts to advance xenotransplantation have failed, primarily due to problems caused by immune rejection of foreign organs. However, by 2014, when United Therapeutics began working with Synthetic Genomics, the availability of gene editing technologies such as CRISPR had increased, with the goal of creating closer transplantable organs.

Martine Rothblatt, the founder of United Therapeutics, has a personal stake in the results. Her daughter has a rare and incurable lung condition that may require a transplant at some point. Seven years ago, the company began designing a variety of genes in pigs with the goal of allowing organs to function more harmoniously when transplanted into the human body. Pigs have been the focus of most studies on xenotransplantation, especially because the organs are of the right size. Organs taken from cows are too large and organs taken from goats are too small.

There were many issues to solve. The first problem was the spread of inflammation in the pig’s organs after removal. The other is a blood clot. Second, there is a problem with the reaction of human antibodies to T cells, which can quickly cause the recipient’s body to reject organs. Humans lack an enzyme called alpha 1,3-galactosyltransferase. In pigs, this enzyme puts sugar on the surface of cells. This is what the human immune system quickly recognizes as a foreign body and rejects it.

Therefore, those who want to transplant pig organs into humans must first knock out the pig’s enzyme-producing gene. This problem was resolved in 2003, long before gene editing appeared. A company now called Revivicor, a unit within United Therapeutics, created the world’s first pig without these genes and is now called GalSafe.

According to a comment from a surgeon who had surgery yesterday, the transplant was done by simply collecting organs from GalSafe pigs and not genetically modifying them. Many questions remain. United Therapeutics declined the interview request and this work has not been published in the journal. However, if removal of the enzyme-producing gene is the only genetic alteration made to the pig that donated the kidney, this means that much work remains for the future of United Therapeutics and xenograft organs. Suggests.

The company is working on “10 gene pigs”. This probably refers to the number of changes made to the porcine genome. One of the genetic changes it has made is to add to pigs a human gene that produces a human protein called CD46 that relaxes the effects of the immune system. The company also inserts an anticoagulant gene to prevent the formation of blood clots in the transplanted organ and a gene that reduces the likelihood of organ rejection by T cells. The long-term goal is to adapt the pig’s organs to the human body so that the medication required is the same as that currently used for human-to-human organ transplantation. In addition to this, the company is also working on more futuristic ideas, such as manufactured organs that do not require the use of immunosuppressants at all.

These efforts are essential. Organ demand far exceeds supply. While this news will bring hope to many on the waiting list for organ transplants, animal organs will not be used on a daily basis for years to come.

Regulators should focus on how these innovations should be managed. For example, are CRISPR-modified pigs within the existing legal framework of genetically modified organisms to disrupt pig genes or insert human genes? In Europe, these animals will probably qualify as GMOs. China has not yet introduced a regulatory system.

That’s not the only challenge. Koko Kwisda and colleagues at the Center for Life Science and Ethics, Hanover College Leibniz University, wrote: Nature biotechnology In July of this year, “Is the pig as a whole a medical device or a drug? Or is the pig just an incubator for organ transplants?” In addition, regulations may still confuse them. ■■

Pig kidneys were first transplanted into humans

Source link Pig kidneys were first transplanted into humans

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