The story behind a historic transplant

Also: Who defines a famine? [Donate ❤️]( [View in Browser](  March 26, 2024 Hi CommonHealth reader, Every once in a while, a headline stops us in our tracks. That’s certainly how I felt a few days ago when doctors at Massachusetts General Hospital announced they had transplanted a genetically modified kidney from a pig into a living human man. This is the first operation of its kind in the world, and a milestone in the field of xenotransplantation, when an organ from an animal is transplanted into a human. Building on years of research, surgeons on March 16 transplanted a pig's kidney into 62-year-old Richard Slayman, a Weymouth resident with severe kidney disease. His medical team said the operation was successful, and Slayman is still recovering at the hospital. The rationale for xenotransplants There simply aren’t enough human organs available for all the people who desperately need them. In fact, [17 people die]( every day while waiting for an organ transplant. More than 103,000 people are on the waitlist for organ transplants nationwide; the vast majority of them need kidneys. It turns out pigs' organs — Yucatan minipigs, to be precise — are similar in size and physiology to human organs. “We picked that breed on purpose,” said Mike Curtis, chief executive of eGenesis, which provided the pig kidneys for the operation at Mass General. Not just any pig The pigs are raised on farms in the Midwest, and produced by cloning, in a process similar to the one that made [Dolly the sheep](. Using CRISPR gene-editing technology, scientists made 69 changes to the pig kidneys to prevent rejection in a human body and to prevent the transmission of pig viruses. (Earlier research showed monkeys could survive two years with a genetically modified pig organ.) Eventually, eGenesis plans to have the pigs breed, so their organs can help many more patients. “We have millennia of learning how to breed pigs, and we can breed them at a very large scale,” Curtis said. What’s next? This all may seem a bit surreal at the moment. And as NPR has reported, some experts are [concerned about the ethics]( of slaughtering pigs for their organs. But many doctors are hoping pig organ transplants could someday become a routine treatment option for people with failing kidneys. Slayman’s transplant at Mass General was done under the FDA’s compassionate use protocol, which gives seriously ill patients access to experimental treatments. The next step is to conduct a clinical trial to test the treatment in more patients. Dr. Leonardo Riella, medical director of kidney transplantation at Mass General, said he hopes long-term kidney dialysis treatment — now the norm for many thousands of Americans — eventually will become obsolete. “Dialysis will be like a ventilator for a patient with respiratory failure,” Riella said. “You use it for a period of time, and hopefully, if they're healthy enough, they could have a more permanent solution, which could be a human transplant — or a xenotransplant.” You can read and listen to more of [our coverage here](. Priyanka Dayal McCluskey Senior Health Reporter [Follow]( Support the news  This Week's Must Reads [There's already 'catastrophic' hunger in Gaza. Who decides when to call it a 'famine?']( A report out this week says hunger, malnutrition and even starvation are widespread in Gaza, but stopped short of declaring it a 'famine.' Here's a primer on what that means, and who gets to decide. [Read more.]( [There's already 'catastrophic' hunger in Gaza. 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