A US transplant patient had a genetically engineered pig kidney removed last week after it started losing function – 47 days after the surgery – due to challenges in managing both her cardiovascular health and kidney function, said doctors.
The patient, 54-year-old Lisa Pisano, is stable and has started dialysis, said the team at NYU Langone Health.
CNN reports that Pisano first received a mechanical heart pump, called an LVAD, on 4 April, and on 12 April, received a kidney and thymus gland from a gene-edited pig.
Her case is the first reported organ transplant in a person with a mechanical heart pump, NYU Langone said, and the second known transplant of a gene-edited pig kidney into a living recipient as well as the first transplanted along with the thymus.
“However, there were multiple episodes where the blood pressure she could generate from the left ventricular assist device (LVAD) was not adequate to provide optimal perfusion to the kidney, causing cumulative reduction in her kidney function,” said Dr Robert Montgomery, director of the NYU Langone Transplant Institute.
“On balance, the kidney was no longer contributing enough to justify continuing the immunosuppression regimen.”
There were no signs of rejection after a recent biopsy of the kidney, he added, but there was “significant injury to the kidney from episodes of insufficient blood flow”.
Pisano’s heart pump is continuing to function
The kidney came from a pig genetically engineered to disrupt a gene responsible for the production of a sugar, called alpha-gal. It’s found on the surface of animal cells and can be recognised and attacked by human antibodies.
The pig’s thymus gland, which plays a role in immunity, was placed under the cover of the kidney in an attempt to help Pisano’s immune system recognise the organ.
While the kidney ultimately had to be removed from Pisano, Montgomery said the kidney would be studied for further insights and stressed the importance of her contribution to the larger goal.
“Lisa knew the world would learn a great deal through her altruism, and we will apply what she has taught us as we seek to make xenotransplantation a solution for the inadequate supply of human organs.”
See more from MedicalBrief archives:
First combined heart pump and pig kidney transplant
First pig kidney transplant patient dies
Genetically engineered pigs put xenotransplantation back in the spotlight