Researchers hope that a person who has so far lived for a week with a genetically modified pig heart will provide a trove of data on the possibilities of xenotransplantation.
Surgeons at the University of Maryland Medical Center transplanted a genetically altered pig heart into David Bennett.The first person to receive a transplanted heart from a genetically modified pig is doing well after the procedure last week in Baltimore, Maryland. Transplant surgeons hope the advance will enable them to give more people animal organs, but many ethical and technical hurdles remain.
Aside from that, most research has so far taken place in non-human primates. But researchers hope that the 7 January operation will further kick-start clinical xenotransplantation and help to push it through myriad ethical and regulatory issues.“From 4 patients, we’d learn a lot that we wouldn’t learn from 40 monkeys,” says David Cooper, a transplant surgeon at Massachusetts General Hospital in Boston. “It’s time we move into the clinic and see how these hearts and kidneys do in patients.
But 57-year-old David Bennett gave Mohiuddin’s team a chance to jump straight to a human transplant. Bennett had been on cardiac support for almost two months and couldn’t receive a mechanical heart pump because of an irregular heart beat. Neither could he receive a human transplant, because he had a history of not complying with doctors’ treatment instructions. Given that he otherwise faced certain death, the researchers got permission from the FDA to give Bennett a pig heart.
Chapman likens the process to the use of experimental cancer drugs that are too dangerous to test in people with other options. Regulators and ethicists will need to decide what chance of success outweighs the risk of making a person wait for a human organ, he says.For now, transplantation is limited by the supply of pigs as well as regulatory hurdles.
Mohiuddin says that because each transplant into a baboon costs approximately US$500,000, testing multiple combinations would be prohibitively expensive. Cooper and others say that the future of xenotransplantation probably includes tailoring the modifications to suit particular organs and recipients. Cooper’s own research, for example, has found that in baboons that receive pig kidneys, the growth-hormone modification causes problems with urine transport.
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