I have a photo of my dad that I think about a great deal when it comes to advances in medical technology. That picture was taken in 1943 when my Dad was 3. Sitting next to my Dad in this picture is one of my Aunts, Gertrude Ann. She was about 18 months old. Unfortunately, I have never met Gertrude Ann, because she died a week after that picture was taken. She died of croup.
My Dad made my brothers and I learn CPR at an early age because of Gertrude Ann.
He said, “If your grandparents or anyone else in the house had known CPR, Gertrude Ann wouldn’t have died.”
Unfortunately, in 1943 no one knew CPR. It didn’t exist. My list is much longer than my Dad’s on the “If we had knowns” that could have saved Gertrude Ann. Antibiotics, ventilators, cricothyroidotomies, the EMS system, 911, none of those existed back then, any of them could have made a huge difference for her. Since their invention, those technologies have saved millions of lives. Gertrude Ann is why I get so excited when medicine takes a big leap forward because I know firsthand the positive impact that medical advances make on patients and their families.
You may have seen in the news over the last few days another big leap forward. The successful transplantation of a pig kidney into a human being. Xenotransplantation is the term used for organ transplants between species.
This is not the first time we have tried xenotransplantation between pigs and humans or other animals and humans. There have been several failed attempts since as early as the 17th century to use animal blood and organs to save humans.
To date, the longest surviving attempt was in 1984 when in a desperate attempt to save the life of an infant “Baby Fae” doctors transplanted a baboon heart into her at 12 days old. She survived for an additional 21 days, but eventually the heart rejected and failed, and Baby Fae died.
Since then the work has focused mostly on pig organs because we do use pigs successfully for many other medical advances like medications like heparin, tissues like heart valves, other tissues like pig skin is used in burn treatment, and in some countries pig corneas are used for transplant to restore sight. Pigs are also numerous, and they reproduce rapidly. The reason until now that pig organs haven’t worked well is there is a sugar in pig cells that basically causes instant rejection of any organ transplanted from a pig.
That sugar, or more accurately the elimination of that sugar is what has made this one surgery work. The genes in the pig that donated the kidney were edited so the pig didn’t produce that sugar. Once they successfully were able to eliminate the sugar, they started looking for a human recipient. But, unlike with Baby Fae, this group of scientists did not want to decide based on desperation, and they didn’t want to take the risk of someone losing their life. So, they approached a family who had a loved one who was brain dead and wanted to donate their organs for transplant, but unfortunately that person’s organs were not viable for donation. They asked if they could transplant the kidney from their gene-edited pig and see if it would work. The family consented.
The pig kidney was transplanted into the brain-dead person, and they observed both the kidney and the person for 2 days. After 2 days, there was no sign of rejection and the kidney worked well. They limited it to 2 days because pig kidneys reject almost instantly in attempts done decades ago, and so they could also let the family who allowed for the transplant experiment on their loved one lay that person to rest. That it worked is a big step in a very positive direction. But there is still a great deal more research to be done before this is something we could do routinely.
Each year there are 100,000 people in the US alone waiting for a kidney transplant, but there are only about 21,000 organs available for transplant each year. That means about 12 people in the US die every day waiting for a kidney transplant. This technology could save so many people. If we could expand that out to hearts, livers, lungs, pancreases, and all the other organs we transplant the number of lives saved would be enormous! It is very exciting to think about.
