A man with end-stage kidney disease became the first living human to receive a genetically-edited pig kidney, opening a new frontier in addressing the global organ shortage crisis that leaves thousands of patients waiting for lifesaving transplants.
At a Glance
- Massachusetts General Hospital recently performed the world’s first successful transplant of a genetically-edited pig kidney into a living human recipient
- The pig’s genome underwent 69 precise edits using CRISPR technology to prevent rejection and improve compatibility with human recipients
- Two successful transplants of genetically modified pig organs into humans have been reported, offering hope for patients with organ failure
- This breakthrough aims to address the critical organ shortage, with over 100,000 people in the U.S. currently awaiting organ transplants
- The procedure represents a significant milestone in xenotransplantation after decades of research
Breakthrough in Xenotransplantation
At Massachusetts General Hospital, a 62-year-old man named Richard “Rick” Slayman with end-stage kidney disease received a genetically-edited pig kidney in a groundbreaking four-hour surgery. This procedure, performed under an FDA Expanded Access Protocol for compassionate use, marks the first time a living human has received a pig kidney that was extensively modified using gene-editing technology. The transplant team carefully monitored the patient, who is reportedly recovering well and expected to be discharged soon.
The pig kidney was supplied by eGenesis, a biotechnology company that utilized CRISPR-Cas9 technology to make 69 genetic edits to the pig’s genome. These modifications included disabling pig genes, adding human genes, and removing potentially harmful viruses that could transfer to humans. This extensive genetic engineering was necessary to prevent immune rejection and improve compatibility between the pig organ and the human recipient. The procedure included novel immunosuppressant drugs from Eledon Pharmaceuticals and Alexion Pharmaceuticals to further prevent rejection.
Expanding Horizons in Organ Transplantation
This achievement is not isolated. In China, at Xijing Hospital, researchers recently transplanted a genetically modified pig liver into a patient who was clinically dead. The liver showed promising function by producing bile and exhibited no signs of immune rejection. Similar to the kidney transplant, the pig liver had undergone genetic modifications – three pig genes were disabled and three human genes were added to prevent rejection. These advances demonstrate the potential of xenotransplantation to address the severe shortage of human donor organs.
Massachusetts General Hospital has a long history of innovation in organ transplantation, having performed the first successful human organ transplant in 1954. The hospital has been collaborating with eGenesis on xenotransplantation research for over five years, with significant findings published in Nature in 2023. This recent breakthrough builds on decades of scientific advancement and could potentially transform access to kidney transplants, particularly for underserved populations facing health disparities in organ donation.
Addressing the Global Organ Shortage
The implications of this medical milestone extend far beyond a single patient. With more than 100,000 people in the United States alone waiting for organ transplants, and many dying before receiving one, xenotransplantation offers a potential solution to this critical shortage. Genetically modified pig organs could provide an alternative source that isn’t limited by human donor availability. The kidney is particularly significant as kidney failure affects millions worldwide, with many patients dependent on dialysis while awaiting transplantation.
While these initial successes are promising, researchers acknowledge that long-term studies are still needed to fully understand the durability and safety of xenotransplantation. Questions remain about potential long-term complications, optimal immunosuppression regimens, and the ethical implications of using animals as organ sources. However, the successful gene editing techniques demonstrated in these cases suggest that many historical barriers to xenotransplantation may be surmountable through continued scientific innovation and careful clinical investigation.
