Good news!
What are the ethical considerations when a brain-dead human recipient is involved? Was that necessary?
"Researchers in China say they performed the first transplant of a genetically modified pig liver into a brain-dead human recipient ...
The recent transplant was carried out on 10 March 2024 at Xijing Hospital of Fourth Military Medical University in China.
The researchers say once in place, the organ secreted bile and produced porcine albumin, part of the process a normal functional liver performs. ...
Why test brain-dead patients?
Hawthorne [Dr Wayne Hawthorne, Immediate Past President of the International Xenotransplantation Association (IXA)] says that its safer, in some ways, to test xenotransplantation in a deceased patient before proceeding to a live recipient.
It gives surgeons the ability to take large biopsies and many samples from the organ and the recipient over a short period of time, which they cannot necessarily do in a live recipient who will recover. ..."
From the abstract:
"The shortage of donors is a major challenge for transplantation; however, organs from genetically modified pigs can serve as ideal supplements. Until now, porcine hearts and kidneys have been successively transplanted into humans.
In this study, heterotopic auxiliary transplantation was used to donate a six-gene-edited pig liver to a brain-dead recipient.
The graft function, haemodynamics, and immune and inflammatory responses of the recipient were monitored over the subsequent 10 days. Two hours after portal vein reperfusion of the xenograft, goldish bile was produced, increasing to 66.5 ml by postoperative day 10. Porcine liver-derived albumin also increased after surgery. Alanine aminotransferase levels remained in the normal range, while aspartate aminotransferase levels increased on postoperative day 1 and then rapidly declined. Blood flow velocity in the porcine hepatic artery and portal and hepatic veins remained at an acceptable level. Although platelet numbers decreased early after surgery, they ultimately returned to normal levels. Histological analyses showed that the porcine liver regenerated capably with no signs of rejection. T cell activity was inhibited by anti-thymocyte globulin administration, and B cell activation increased 3 days after surgery and was then inhibited by rituximab. There were no significant peri-operative changes in immunoglobulin G or immunoglobulin M levels. C-reactive protein and procalcitonin levels were initially elevated and then quickly declined. The xenograft remained functional until study completion."
Gene-modified pig-to-human liver xenotransplantation (open access)
Extended Data Fig. 2: The heterotopic auxiliary liver xenotransplantation procedure.
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