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| Pig heart pump and kidney transplant |
Hope shines on the medical horizon with the successful completion of a new breakthrough in transplant science. In an unprecedented development, the first transplant surgery combining a mechanical heart pump and a gene-edited pig kidney has been performed at NYU Langone Health, marking a monumental advance in the search for solutions to the chronic organ shortage.
The protagonist of this innovative feat is Lisa Pisano, a 54-year-old woman from New Jersey, who suffered from heart failure and end-stage renal disease, requiring regular dialysis to stay alive.
However, his case presented medical complications that made a standard transplant difficult, and the general lack of donor organs in the United States aggravated the situation.
Faced with this challenging reality, Pisano clung to hope when presented with the opportunity to participate in this innovative procedure. “I have tried everything else and exhausted all other resources. So when this opportunity came, I said, 'I'm going to take advantage of it,'” Pisano said during a press conference from his bed in the intensive care unit.
The stark reality of the organ shortage in the United States is manifested in heartbreaking statistics: Every day, 17 people die while waiting for a transplant, and the waiting list for kidneys is especially long. Although around 27,000 kidney transplants were performed in 2023, around 89,000 people remained on the waiting list.
Experts agree that xenotransplants, which involve transplanting organs from animals to humans, are essential to addressing this crisis. The gene editing technique plays a crucial role in modifying the DNA of pigs to minimize rejection by the human immune system.
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The pioneering procedure performed in Pisano involves the implantation of a mechanical heart pump followed by the transplantation of a genetically modified pig kidney, along with the animal's thymus. This intervention, which constitutes the first reported organ transplant in a person with a mechanical heart pump, represents a significant milestone in the field of medicine.
A combined transplant
The leader of the medical team, Dr. Robert Montgomery, director of the New York University Langone Transplant Institute, described Pisano's case as a medical "catch-22." Despite suffering from heart and kidney failure, she was not a candidate for a combined transplant due to her multiple health conditions.
Approval to perform these innovative procedures was obtained from the US Food and Drug Administration under expanded access or “compassionate use” policies, which allow terminally ill patients with no other options to access investigational treatments.
The kidney used in the transplant came from a pig genetically modified to prevent the production of a specific sugar that could be recognized by the human immune system. Additionally, the pig's thymus was included to help the recipient's immune system recognize the organ.
Despite the challenges, the medical team is optimistic about Pisano's progress in his recovery. His kidney is functioning optimally and his heart is showing significant improvements. However, they remain vigilant against possible complications such as rejection or infections.
For Pisano, this procedure represents an opportunity for hope and a chance to improve his quality of life. Before the procedures, his daily activities were limited by his medical condition, but she now feels better than she has in a long time and is full of optimism about the future.
“Even in the worst-case scenario, if it doesn't work for me, it might work for the next person,” Pisano said humbly. “At least someone will benefit from it.” His bravery and determination serve as an inspiration to all those fighting serious illnesses and seeking new hope in medical science.
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