US surgeons have successfully implanted a heart from a genetically modified pig in a 57-year-old man, a medical first that could one day help solve the chronic shortage of organ donations. The “historic” procedure took place Friday, the University of Maryland Medical School said in a statement on Monday.
While the patient’s prognosis is far from certain, it represents a major milestone for animal-to-human transplantation. The patient, David Bennett, had been deemed ineligible for human transplant a decision that is often taken when the recipient has very poor underlying health.
He is now recovering and being carefully monitored to determine how the new organ performs. “It was either die or do this transplant. I want to live. I know it’s a shot in the dark, but it’s my last choice,” David Bennett said a day before the surgery.
Bennett, who has spent the last several months bedridden on a heart-lung bypass machine, added: “I look forward to getting out of bed after I recover.
The Food and Drug Administration granted emergency authorization for the surgery on New Year’s Eve, as a last-ditch effort for a patient who was unsuitable for a conventional transplant.
“This was a breakthrough surgery and brings us one step closer to solving the organ shortage crisis,” said Bartley Griffith, who surgically transplanted the pig heart.
“We are proceeding cautiously, but we are also optimistic that this first-in-the-world surgery will provide an important new option for patients in the future.” Muhammad Mohiuddin, who co-founded the university’s cardiac xenotransplantation program, added the surgery was the culmination of years or research, involving pig-to-baboon transplants, with survival times that exceeded nine months.
“The successful procedure provided valuable information to help the medical community improve this potentially life-saving method in future patients,” he said.
10 UNIQUE GENE EDITS
Bennett’s donor pig belonged to a herd that had undergone genetic editing procedures.
Three genes that would have led to the rejection of pig organs by humans were “knocked out,” as was a gene that would have led to excessive growth of pig heart tissue.
Six human genes responsible for human acceptance were inserted into the genome, for a total of 10 unique gene edits.
The editing was performed by Virginia-based biotech firm Revivicor, which also supplied the pig used in a breakthrough kidney transplant on brain dead patients in New York in October.
But while that surgery was purely a proof-of-concept experiment, and the kidney was connected outside the patient’s body, the new surgery is intended to save a person’s life.
The donated organ was kept in an organ-preservation machine ahead of the surgery, and the team also used an experimental new drug made by Kiniksa Pharmaceuticals along with conventional anti-rejection drugs to suppress the immune system.
About 110,000 Americans are currently waiting for an organ transplant, and more than 6,000 patients die each year before getting one, according to official figures.
To meet demand, doctors have long been interested in so-called xenotransplantation, or cross-species organ donation, with experiments tracing back to the 17th century
Early research focused on harvesting organs from primates for example, a baboon heart was transplanted into a newborn known as “Baby Fae” in 1984, but she survived only 20 days.
Today, pig heart valves are widely used in humans, and pig skin is grafted on human burn victims.
Pigs make the ideal donors because of their size, their rapid growth and large litters, and the fact they are already raised as a food source.
The team behind the successful transplantation, however, has an India-Pakistan connection.
One of the surgeons who was directly involved in the transplantation was Dr Muhammad M. Mohiuddin, MD, who is scientific and program director of the Cardiac Xenotransplantation Program at the University of Maryland School of Medicine (UMSOM).
Pakistan-born Dr Mohiuddin is also one of the leading experts on transplanting
animal organs, known as xenotransplantation. He also serves as the professor of surgery at the UMSOM.
“This is the culmination of years of highly complicated research to hone this technique in animals with survival times that have reached beyond nine months. The FDA used our data and data on the experimental pig to authorize the transplant in an end-stage heart disease patient who had no other treatment options,” Dr Mohiuddin said according to a statement released by the UMSOM and the University of Maryland Medical
Center (UMMC).
Dr Mohiuddin received his MBBS degree from Karachi’s Dow Medical College in 1989. He
moved to the US and then received his first fellowship in transplantation biology at University of Pennsylvania and later fellowship in bone marrow transplantation at Institute of Cellular Therapeutics, Drexel University.
He further added that the information and findings that the team came across during the operation will benefit the medical community in the future. “The successful procedure provided valuable information to help the medical community improve this potentially life-saving method in future patients,” he said.
Dr Mohiuddin assisted Dr Bartley P. Griffith, MD in transplanting the pig heart into the body of David Bennett, a Maryland resident.
The team’s efforts were lauded by Indian-origin US citizen Dr Mohan Suntha, who serves as the president and chief executive officer of the University of Maryland Medical System(UMMS).
“The University of Maryland Medical System is committed to working with our University of Maryland School of Medicine partners to explore, research, and in many cases implement the innovations in patient care that make it possible to improve quality of life and save lives,” Suntha said, according to a statement. He also lauded the patient for his courage. “We appreciate the tremendous courage of this live recipient, who has made an
extraordinary decision to participate in this groundbreaking procedure to not only potentially extend his own life, but also for the future benefit of others,” he further added
Dr Suntha served the UMMS throughout his entire career. He has served several faculty and clinical appointments throughout his tenure and is a member of the American College of Radiation Oncology and the American Society for Therapeutic Radiology and Oncology. He received his MBA from Wharton School of Business at the University of Pennsylvania and also was responsible for turning around the fortunes of University of Maryland St. Joseph Medical Center in the year 2016 where he served as president and CEO. He received his MD from Jefferson Medical College and his BA from Brown University
