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Medicine

Woman Who Received Pig Kidney Transplant Has It Removed (wired.com) 40

Due to complications with a mechanical heart pump, surgeons in New York removed a pig kidney from Lisa Pisano less than two months after transplanting it. The genetically engineered pig kidney did not show signs of rejection but suffered from inadequate blood flow. Wired reports: Pisano was facing heart and kidney failure and required routine dialysis. She wasn't eligible to receive a traditional heart and kidney transplant from a human donor because of several chronic medical conditions that reduced the likelihood of a good outcome. Pisano first received a heart pump at NYU Langone Health on April 4, followed by the pig kidney transplant on April 12. The heart pump, a device called a left ventricular assist device or LVAD, is used in patients who are either awaiting heart transplantation or otherwise aren't a candidate for a heart transplant.

In a statement provided to WIRED, Pisano's medical team explained that they electively removed the pig kidney on May 29-47 days after transplant -- after several episodes of the heart pump not being able to pass enough blood through the transplanted kidney. Steady blood flow is important so that the kidney can produce urine and filter waste. Without it, Pisano's kidney function began to decline. "On balance, the kidney was no longer contributing enough to justify continuing the immunosuppression regimen," said Robert Montgomery, director of the NYU Langone Transplant Institute, in the statement. Like traditional transplant patients, Pisano needed to take immunosuppressive drugs to prevent her immune system from rejecting the donor organ.

The kidney came from a pig genetically engineered by Virginia biotech company Revivicor to lack a gene responsible for the production of a sugar known as alpha-gal. In previous studies at NYU Langone, researchers found that removing this sugar prevented immediate rejection of the organ when transplanted into brain-dead patients. During Pisano's surgery, the donor pig's thymus gland, which is responsible for "educating" the immune system, was also transplanted to reduce the likelihood of rejection. A recent biopsy did not show signs of rejection, but Pisano's kidney was injured due to a lack of blood flow, according to the statement. The team plans to study the explanted pig kidney to learn more.

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Woman Who Received Pig Kidney Transplant Has It Removed

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  • I've been hearing about Thymokidney transplant for I think decades from xenotransplant nerds, it's like fusion energy. Anyway it looks like it might finally work? Would be nice to get rid of immunosuppression entirely someday so I guess this is a start on that path? I guess by then we'd know how to regrow entire kidneys from the patient's cells.

    • by gweihir ( 88907 )

      I would not say that it already works. But 47 days means one major hurdle, namely fast rejection seems to be off the table. Definitely a great step and definitely means there will be significant research on this in the future.

  • So 4 of the 6 people who have gotten pig organs, 4 in China with the liver guy still living 2 weeks after transplant, have died 1-2 months after receiving the organs, and this one failed before they could implant a second pig organ. I'm thinking the pig organs have something to do with it, regardless of the protestations of the doctors involved.

    • by SuperDre ( 982372 ) on Tuesday June 04, 2024 @02:54AM (#64521769) Homepage
      Do a reality check, even with human organ transplants, a lot of transplants fail. So it isn't for sure this one wouldn't have the same problems if she had gotten a human kidney transplant.
      • TFS sounds like there were a lot of other health issues.

        • by Luckyo ( 1726890 ) on Tuesday June 04, 2024 @06:37AM (#64521913)

          That is the only way to get approved for this kind of transplant in the West right now. You need to have life threatening condition with no alternative viable treatment available.

          Essentially they only get permissions to experiment with people who have a lot of other problems and are on the verge of dying from them.

          • Since only the sickest get transplants, it means the expected outcomes will be worse. For experimental transplants the patients are even sicker and cannot have traditional transplnts. One doesn't do these experimental techniques on a healthy 30 yer old patient.

            • by Luckyo ( 1726890 )

              To be fair it would be rather pointless to do a kidney transplant on a healthy 30 year old, because people who actually need a new kidney aren't healthy 30 year olds.

              And you don't test experimental medical procedures on people for lulz. You test them to see how it would work in a typical use case. People with many problems on the verge of dying are much, much closer to that than a healthy 30 year old.

            • the Nazi's did. And look at all the valuable human research we got from them! (sarcasm, for those who can't smell it)
      • My reality check is that the failure rate of the kidneys transplanted is currently 100%. The status of the liver is still on the table.

        • Better on the table than on the BBQ!
        • by SuperDre ( 982372 ) on Tuesday June 04, 2024 @04:33AM (#64521815) Homepage
          Again, it's not clear if it's actually the kidney that is the real problem here. They removed it because it was failing due to not enough blood being pumped into it, so the problem might be something else like the heartvalve not strong enough to pump the blood through.
        • My reality check is that the failure rate of the kidneys transplanted is currently 100%. The status of the liver is still on the table.

          Wait until you find out that non transplanted kidneys fail with 100% failure rate too given enough time ;-)

      • by sjames ( 1099 )

        In fact, she was so likely to have problems like this, she wasn't even allowed on the human transplant list.

    • Its more like if you're desperate enough to let someone put a pig organ in you, you're not doing so well. As with other experimental treatments, if you're volunteering to take a new cancer drug under a compassionate use protocol that so far has its best claim to fame being that most of the rats that took it didn't die immediately, a successful outcome can still be that you die a year later because it may well have worked decently but you were already too far gone. You're not going to test the pig organ on
      • Its more like if you're desperate enough to let someone put a pig organ in you, you're not doing so well. As with other experimental treatments, if you're volunteering to take a new cancer drug under a compassionate use protocol that so far has its best claim to fame being that most of the rats that took it didn't die immediately, a successful outcome can still be that you die a year later because it may well have worked decently but you were already too far gone. You're not going to test the pig organ on some 20 year old that had a falling accident and will have another 60 years under them with a good human organ.

        I'm probably a minority, but if I am figuring if I have a heart pump and kidney failure, and the option is a pig kidney - I'm going to check out. No one lives forever, and it appears that her options were living in a hospital full time. Another year of that? I'll pass on that, my bros.

        There are some fates far worse than a dignified shifting of this mortal coil.

        • Nah I agree with you. Like now with little kids I'd do what needed done to stay alive to see them into adulthood but if I was in decline I'd rather wander off into the permafrost than get frankensteined.
          • Nah I agree with you. Like now with little kids I'd do what needed done to stay alive to see them into adulthood but if I was in decline I'd rather wander off into the permafrost than get frankensteined.

            Whoah! Wild you should mention that. My instructions to the SO is that if I become incapacitated and especially if I become senile, she is put me on a flight to somewhere above the Arctic circle, and have them set me outside for the evening. And here you say pretty much the same thing!

          • Well, I am looking into being Frankensteined all the way! A Gorilla Heart, Pig Kidneys, horse lungs, Giraffe liver, etc. But, ya gotta remember to put the bolts in my neck also, so I can get juiced up on the go.
        • the article says, “We are hoping to get Lisa back home to her family soon,” So, she wouldn't need to live in a hospital 24/7, however she will need access for dialysis in some schedule that they will set up. She wouldn't have qualified for the heart valve assist device if she had not gotten the pig kidney transplant according to the article and it is doing just fine. The pig kidney showed no sign of being rejected, once again, according to the article.
          • the article says, “We are hoping to get Lisa back home to her family soon,” So, she wouldn't need to live in a hospital 24/7, however she will need access for dialysis in some schedule that they will set up. She wouldn't have qualified for the heart valve assist device if she had not gotten the pig kidney transplant according to the article and it is doing just fine. The pig kidney showed no sign of being rejected, once again, according to the article.

            They are hoping - that doesn't mean it will happen. It isn't my idea of life to be tied to a heart assist pump which appears to not be working all that well, and having to live life doing dialysis. And she also will be likely to end up with dementia - there is a connection between dialysis and Alzheimer's. But anyhow, different people have different outlooks. Some will attempt to hang onto life until there is nothing left. Others like myself, understand that a few months more and the extraordinary expense

    • by nashv ( 1479253 )

      I will assume you are uninformed instead of a moron. In this particular case, the patient has multiple complications - no proper heart function and no proper kidney function. The pig kidney seems to work, but it seems likely that the heart problems are causing kidney problems , irrespective of what kidney is in there. Here is a report that explains this. [bhf.org.uk]

    • by sjames ( 1099 )

      Not really. What you're seeing is that the pig transplants are only being done on the very sickest patients that would otherwise surely die. Not people actually waiting on a transplant list, people too far gone to even be on the list. It's kinda like in basketball when the buy throws the ball across the court at the buzzer. Nobody expects it to go in but why not try?

    • by gweihir ( 88907 )

      It likely is the simple fact that these are people too sick to get regular transplants or the whole thing would never pass an ethics board (even in China). There probably is no life-shortening effect at all.

  • by flyingfsck ( 986395 ) on Tuesday June 04, 2024 @06:37AM (#64521915)
    I am not pulling weeds in my garden - I am explanting invasive flora.
  • Another story of ultimately unsuccessful xenotransplantation. This one is a little better than average on the information front, in that at least they sort of explained that all the science was inconclusive at this point. They implanted a pig kidney and a pig thymus in a patient whose system was too effed to rate a human kidney. They added a pig thymus to make immunological introductions for the kidney. The kidney stopped getting blood flow and basically choked to death, which may or may not have been w
    • the pig kidney did not die, sure, if left in place it may have, but it was removed not because it was dead, but because it wasn't getting enough blood from the heart for it to do its job as well as they needed it to.

      What do you propose to do instead of research on xenotransplantation?

      • I have no problem with research on xenotransplantation. Well, I have problems, but I guess they're unavoidable. No, my real problems are with the state of xenotransplantation journalism. And science/medicine journalism in general. Generally, the stories end up saying nothing, and leave extremely obvious questions unanswered. So you have to ask around on web forums for what the story means. I understand that some expertise is required to understand these things, but they're erring way on the side of va
        • well, there are always the actual scientific journals, The Lancet, The New England Journal of Medicine, etc. Those mostly have papers written by the actual authors who did the research. that does not guarantee you will have 100% comprehension, but at least they are written by the people that did the work.

          Just out of curiosity, not that it is any of my business, but what are your problems with xenotransplantation? I can think of several issues one could have, but I am betting if I can think of it, it may

  • by nuckfuts ( 690967 ) on Tuesday June 04, 2024 @09:55AM (#64522203)
    Learned a new word there :)

An adequate bootstrap is a contradiction in terms.

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