SURGEONS in China have performed the world’s first combined transplant of a whole pig liver and both kidneys into a braindead human recipient, achieving nearly five days of organ function without hyperacute rejection.
The procedure, led by a team at the Second Affiliated Hospital of Guangxi Medical University, located in south China, used a six-gene-edited pig with a body size and physiological characteristics highly similar to those of humans as the donor, according to the university’s announcement on Monday. To combat the fundamental scarcity of organs globally, xenotransplantation, or the transfer of animal organs into humans, leveraging gene-edited pigs, has arisen as the most revolutionary solution. Yet, the varying rejection patterns in multi-organ grafts still pose a critical obstacle. The team’s editing strategy, three knockouts and three insertions, is designed to reduce immune responses and improve compatibility, noted the study published in the journal MED.
They transplanted the liver and both kidneys in their natural positions through a single incision. The total cold ischemia time, which is the duration the organ is kept chilled outside the body, was controlled at 281 minutes from donor procurement to reperfusion. The recipient, a 53-year-old brain-dead man, was monitored for about 106 hours in the ethically accepted clinical study conducted after his organs had been donated for clinical use.
For roughly five days, the transplant showed promising physiological outcomes, including largely normal organ blood supply, as well as observed bile secretion and urine production. Examination of metabolites revealed that the pig liver was shifting its behaviour to resemble a human liver rather than a pig one. This indicated that the organ managed to use the body’s own resources and might even be able to completely “reprogramme” its metabolism to match a human host.
This study has provided initial evidence for the feasibility of pig-to-human orthotopic whole-liver plus bilateral-kidney transplantation, and identified early immune and metabolic features that may inform perioperative management and future clinical translation, the researchers said. Transferring multiple organs is more complex than moving one, and transplanting pig kidneys and a liver in the same procedure is also unique, commented Leonardo Riella, a physician scientist at Massachusetts General Hospital in Boston.
Xinhua
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