Pig kidneys transplanted into brain-dead man work

Chronic kidney disease (CKD) affects around 10% of adults in Spain, a figure that reaches 20% in the population over 60 years of age, according to the Spanish Society of Nephrology (SEN), from which they also warn , that it is an underdiagnosed health problem. Patients in advanced stages need renal replacement therapy (RRT), whose prevalence has increased by 30% in our country in a decade (2009 to 2020), which gives an idea of ​​the importance of this serious public health problem.

Chronic kidney failure affects more men and people who are elderly or have cardiovascular disease, and many of the latter end up developing end-stage renal disease (ESRD). A Kidney transplantation is the indicated treatment for patients with ESRDbut despite the fact that Spain is a world leader in transplants, there are not organs available for all those who need them, and for this reason scientists continue to explore the possibilities of xenotrasplante or transplantation of animal organs to humans.

Xenotransplantation could be a solution for these patients and studies have been carried out on pig-to-human kidney transplants using a preclinical model of human brain death, which have shown that the xenograft produces urine, but does not eliminate creatinine, a necessary function. for life. Now, however, a clinical team in the United States has succeeded in transferring pig kidneys to a brain dead manand these organs have demonstrated their functionality.

“This study confirms that genetically modified pig kidneys can correct kidney failure and work with standard kidney transplant drugs”

This is not the first time that an intervention of this type has been carried out, but it is the first to demonstrate the ability of the xenograft to perform a function that is essential to sustain life. The findings have been published in JAMA Surgery. The patient was a male in his 50s with brain death and “an acute kidney injury superimposed on a history of CKD (stage 2) and hypertension” who had his kidneys removed and transplanted with pig kidneys that had been genetically modified to prevent rejection by his immune system.

Genetically edited pig kidneys can function normally

The results of the study showed that the transplanted organs were functional – they were able to produce urine and clear creatinine– seven days after the operation. These organs functioned immediately and showed no signs of rejection for a period of seven days, during which biopsies and blood tests confirmed normal kidney function. Therefore, the researchers believe that this type of transplant could help solve the shortage of donor organs.

Toby CoatesProfessor of Medicine at the University of Adelaide and director of Transplants at the Royal Hospital of Adelaide (Australia) has told SMC Spain that “this case represents one of the first functional kidney transplants from a pig to a human being, and shows the proof principle that organs from a genetically modified animal can replace human kidney function for one week without rejection and using conventional drug therapy for kidney transplants.”

“The key advance in this case -he continues- is the genetic deletion of four porcine genes that previously represented a barrier to the success of transplants between species, and the insertion of six human genes that prevent coagulation and ‘humanize’ the porcine kidney to make it look more human (the pig donor modified with 10 genes)”. “This study confirms that genetically modified pig kidneys can correct kidney failure and work with standard kidney transplant drugs.”

In statements to the same medium, Roger Lord, Senior Lecturer in Medical Sciences at Australian Catholic University, notes, “Historically, xenografts have largely failed due to hyperacute rejection after surgery, even with the use of immunosuppressive drugs to control this process. To address this failure of kidney xenografts, researchers have removed four genes of porcine (pig) origin and added six transgenic insertions to regulate the rejection process and maintain normal kidney function.

“The current study involved only one brain-dead patient with chronic renal failure as a first step in demonstrating that gene-edited porcine kidneys can function normally when transplanted to remove creatinine over a 7-day period, and provides important preliminary evidence of that these genetically modified kidneys can function normally after xenotransplantation and offers hope to those on the waiting list for a kidney transplant”.

Source: www.webconsultas.com

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