Last Saturday, Richard Slayman made history: He became the first living person to receive a genetically modified kidney from a pig, surgeons at Massachusetts General Hospital in Boston said Thursday.
Slayman, 62, whose kidneys had failed and who had been on dialysis, underwent the four-hour operation Saturday to receive the pig kidney, said his nephrologist, Dr. Winfred Williams, the associate chief of the nephrology division at Mass General.
“It really is a groundbreaking milestone,” William said. “Should the kidney continue to work well and this is a success, I think it represents a breakthrough in a number of different areas.”
The first successful pig kidney transplant in a living recipient — a milestone in the field of so-called xenotransplantation or animal-to-human transplant — could offer hope to the tens of thousands of people in the U.S. on the waiting list for organ transplant as well as countless others worldwide.
More than 100,000 people in the U.S. are on transplant waiting lists, including about 90,000 who need kidneys, according to the United network for Organ sharing, a nonprofit group that manages the U.S. organ transplant system.
But xenotransplantation still comes with significant risks. There have been two pig-to-human heart transplants in the U.S.; in both cases, the patients live for no more than 2 months.
Slayman’s operation was five days ago. He’s still recovering at Mass General, but Williams said his doctors hope to send him home this weekend, as long as no complications come up.
So far, there have been no signs that his body’s immune system is rejecting the kidney, Williams said.
A one-off, for now
Xenotransplantation isn’t approved by the Food and Drug Administration. Though it’s been touted as a potential solution to the worldwide organ shortage, it could be years before the procedure is widely used, as much more data is needed.
“What we really want to do is get to the initial clinical trials, where you have multiple patients that are receiving xenografts and several centers that are participating where you can really test a hypothesis and see how safe this is and how well it works,” said Dr. Robert Montgomery, the director of the NYU Langone Transplant Institute.
“His blood pressure, his vital signs are very stable,” he said. “He looks almost completely on the way to full recovery.”
Still, doctors are collecting samples of Slayman’s blood around the clock, looking for signs of a dangerous virus, which is believed to have killed the man who received the first genetically modified heart from a pig in 2022.
The question of how long the kidney will last remains.
“It will be really interesting to learn whether or not the xenograft is ultimately a bridge, meaning it lasts for a short period of time until a human allograft can be found, or if it’s going to be what we call destination, meaning it will last this individual the rest of his life,” said Dr. Jayme Locke, a transplant surgeon at the University of Alabama Birmingham Heersink School of Medicine.
Even so, “it’s game-changing,” Locke said.
Slayman’s transplant was performed under the FDA’s compassionate use program, which lets patients with serious, life-threatening conditions access experimental treatments when nothing else is available.
“It’s a one-off transplant,” said Karen Maschke, a researcher at the Hastings Center, a bioethics research institute, who studies the ethical, regulatory and policy issues involving the use of new biomedical technologies.
While Slayman was unique in that he was chosen for a pig kidney transplant, his condition was far from rare: About 800,000 people in the U.S. have kidney failure and require dialysis, often a time-consuming process for patients.
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