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For 66-year-old Tim Andrews, it was a matter of life and death.
Andrews spent most of his two years on dialysis due to end-stage kidney disease. He was on the waiting list for a new kidney transplant, but his blood type made finding donor organs particularly difficult.
The average wait time for kidneys is 3-5 years at most centers, but studies have found that you can wait ten years to receive your kidneys. His chances of living for another five years on long-term dialysis is about 35%. His doctors estimated there was about a 9% chance that he would ingest organs over the next five years.
Andrews said there was a “lack of time.”
“It really makes me very depressing,” he recalls the thought. “This is how I’m going to end my life. I’m going to be dialysis and tired.”
So Andrews didn’t hesitate when doctors at Massachusetts General Hospital asked if they would consider an experimental transplant using donor pig kidneys.
“All of a sudden, I’m not in the dark. I’m going to get better, Andrews said in a hospital interview she shared with a journalist.
On Friday, doctors at Massachusetts General Hospital announced that Andrews had received a pig’s kidney normally. The January 25th procedure took place through the US Food and Drug Administration’s expanded access route. He was the first in a study of three patients and the second person currently living in the world.
The Massachusetts General’s team used an organ developed by Cambridge of Massachusetts-based biotechnology company Egenesis.
“This year’s three patient studies provide important insight into the long-term viability of xenotransplants as a transformational solution for thousands of patients in need of life-saving kidneys,” General Hospital states. stated in.
Dr. Sanjay Gupta of CNN enters a facility where pigs are kept to become organ donors
The practice of transplanting animal organs into humans, known as xenotransplants, has long felt like science fiction. However, in the past three years, half a dozen such procedures have been performed in the US using genetically modified pigs, making organs more compatible with humans.
Scientists can use CRISPR, a gene editing technology, to modify pig DNA. Egenesis workers make over 60 compilations that will help them manage many potential issues, including rejection, organ size, and even pig retroviruses that can infect humans.
Another biotechnology company, United Therapeutics, announced this week that it will move forward in a xenotransplant trial with Pig kidneys, with 10 gene editing, following green light from the FDA. The company hopes to perform the first of six early implants in people with end-stage renal disease in mid-2025, with the aim of expanding the trial to a total of 50 patients.
United Therapeutics expects pig kidney transplantation to become an established option for patients by the end of the decade, spokesman Dewey Strideman said.
For people in the transplant field, approval for clinical trials is a major turning point.
“The whole field has been working towards this clarity and the ability to go to patients,” says Mike Curtis, CEO of Egenesis. “This creates a very clear pathway to bringing this technology to more patients.”
Early in her decades-long career, Dr. Jame Locke said she wasn’t sure she’d see the technology reach the operating table.
“I think this is one of the many holy grails we’ve been trying to achieve in the field of implantation,” said Locke, a transplant surgeon at Nyu Langone Health, who was not involved in the Andrews case.
Locke considers it a benefit to multiple companies with different genetic models taking part in the trial. “We haven’t yet defined what the optimal genetic editing will be,” she said. And there is a high chance that different people will respond differently to genetic editing, some coinciding with one and one.
Until recently, xenograft attempts using pig kidneys have led to approximately two months of life for the patient. However, Locke said these cases are not a true test of xenograft possibilities.
Previous attempts to implant pig kidneys into humans, including last year at Mass General, have been made in people with very serious health problems who were not eligible to be on the organ waiting list. Ta.
“I think it really helps to be able to do this with individuals who are robust and otherwise qualify to register for wait times,” Locke said.
Locke is involved in transplantation and care of Towana Looney, 53, who received a pig kidney from United Therapeutics at Nyu Langone’s Transplant Laboratory in November. A native of Alabama, Rooney has been living in New York ever since and has been subjected to constant surveillance and follow-up. Currently, 74 days after transplant, Rooney holds a record of the longest living recipients of pig organs, making it the best that pig organs could be a viable source of donor organs. It’s proof.
“After that 90-day mark, we can actually say that xenografts helped patients achieve similar survival benefits to what they saw with human transplants,” Locke said.
She spoke with Rooney almost every day, and the patient said, “I’m living her best life.”
“From the moment I saw my kidneys start making urine in the operating room that day, to the time I met her night after the surgery, she was already full of this vibrancy. Her cheeks were rosy. She had it. She was more alive. Her family could see it,” Locke said. “The joy and hope that he had recovered was enormous.”
Hope for thousands of patients
“As soon as I woke up after the surgery, the dialysis cloud disappeared,” Andrews said in an Egenesis statement. “I felt revitalized and revitalized. It was a miracle. The magnitude of what these doctors and nurses accomplished was incredible and I leased my life to me. I would like to thank you for your help.”
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Andrews was discharged just a week after the implantation, but is continuously monitored and returns to the clinic three times a week for blood tests. Additionally, he has multiple devices so that the clinical team can remotely check his vitals and heart rhythms. Like human donor kidneys, he must take medicine for the rest of his life to ensure that the body does not reject the organs.
“But this transplant isn’t about me,” he said. “It’s about all the people I met at a dialysis clinic and I saw what they were going through.”
In the United States, 37 million adults suffer from chronic kidney disease, of which approximately 800,000 suffer from end-stage renal failure.
“We usually have a waiting list between 80,000 and 100,000 (patients) every year, with approximately 25,000 to 28,000 kidney transplants per year,” Locke said. “So when you start backing up it, you understand the size of what this offers, right? Because not everyone with kidney failure can reach the waiting list.”
For patients like Andrews, this new organ has a promise he didn’t expect: “It’s a faint hope,” he said.
