Pig Kidney Transplanted Into Brain-Dead Man Sustains Normal Function For Over A Month

In a groundbreaking medical achievement, surgeons have successfully transplanted a pig’s kidney into a brain-dead human recipient, and the organ has continued to function normally for over a month.

This accomplishment represents a significant stride toward potentially performing similar operations on living patients. The recent experiment, unveiled by NYU Langone Health, stands as a pivotal development in the ongoing race to harness animal organs to save human lives.

“Is this organ really going to work like a human organ? So far it’s looking like it is,” says Dr. Robert Montgomery, director of NYU Langone’s transplant institute.

“It looks even better than a human kidney,” he added on July 14, as he replaced a deceased man’s kidneys with a single kidney from a genetically modified pig — and watched it immediately start producing urine.

The experimental procedure involved replacing a deceased man’s kidneys with a single kidney sourced from a genetically modified pig. The operation demonstrated immediate functionality, with the transplanted pig kidney promptly producing urine.

The endeavor hinges on the modification of pig organs to better align with the human immune system, thereby circumventing the historical challenge of immune rejection in cross-species transplants.

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The possibility that pig kidneys might one day help ease a dire shortage of transplantable organs persuaded the family of the 57-year-old Maurice “Mo” Miller from upstate New York to donate his body for the experiment.

“I struggled with it,” his sister, Mary Miller-Duffy, told the AP. But he liked helping others and “I think this is what my brother would want. So I offered my brother to them.”

“He’s going to be in the medical books, and he will live on forever,” she added.

Attempts at animal-to-human transplants have failed for decades as people’s immune systems attacked the foreign tissue. Now researchers are using pigs genetically modified so their organs better match human bodies.

Last year with special permission from regulators, University of Maryland surgeons transplanted a gene-edited pig heart as a last-ditch attempt to save a dying man. He survived only two months before the organ failed for reasons that aren’t fully understood but that offer lessons for future attempts.

Now, the Food and Drug Administration is considering whether to allow some small but rigorous studies of pig heart or kidney transplants in volunteer patients.

NYU Langone’s experiment is one of a string of developments aimed at speeding the start of such clinical trials. Also Wednesday, the University of Alabama at Birmingham reported another important success — a pair of pig kidneys worked normally inside another donated body for seven days.

Kidneys don’t just make urine — they provide a wide range of jobs in the body. In the journal JAMA Surgery, UAB transplant surgeon Dr. Jayme Locke reported lab tests documenting the gene-modified pig organs’ performance. She said the weeklong experiment demonstrates they can “provide life-sustaining kidney function.”

These experiments are critical to answer more remaining questions “in a setting where we’re not putting someone’s life in jeopardy,” said Montgomery, the NYU kidney transplant surgeon who also received his own heart transplant — and is acutely aware of the need for a new source of organs.

A long waiting list for transplants

More than 100,000 patients are on the nation’s transplant list and thousands die each year waiting.

The surgery itself isn’t that different from thousands he’s performed “but somewhere in the back of your mind is the enormity of what you’re doing … recognizing that this could have a huge impact on the future of transplantation,” Montgomery said.

The operation took careful timing. Early that morning Drs. Adam Griesemer and Jeffrey Stern flew hundreds of miles to a facility where Virginia-based Revivicor Inc. houses genetically modified pigs — and retrieved kidneys lacking a gene that would trigger immediate destruction by the human immune system.

As they raced back to NYU, Montgomery was removing both kidneys from the donated body so there’d be no doubt if the soon-to-arrive pig version was working. One pig kidney was transplanted, the other stored for comparison when the experiment ends.

“You’re always nervous,” Griesemer said. To see it so rapidly kickstart, “there was a lot of thrill and lot of sense of relief.”

How long should these experiments last? Alabama’s Locke said that’s not clear -– and among the ethical questions are how long a family is comfortable or whether it’s adding to their grief. Because maintaining a brain-dead person on a ventilator is difficult, it’s also dependent on how stable the donated body is.

In her own experiment, the donated body was stable enough that if the study wasn’t required to end after a week, “I think we could have gone much longer, which I think offers great hope,” she said.

The University of Maryland’s Dr. Muhammad Mohiuddin cautions that it’s not clear how closely a deceased body will mimic a live patient’s reactions to a pig organ — but that this research educates the public about xenotransplantation so “people will not be shocked” when it’s time to try again in the living.