The recent report of a case of a genetically engineered six-gene-edited pig-to-human lung xenotransplantation into a 39-year-old brain-dead male human recipient following a brain hemorrhage, has demonstrates the feasibility of pig-to-human lung xenotransplantation. Nevertheless, substantial challenges relating to organ rejection and infection remain, and further preclinical studies are necessary before clinical translation of this procedure.
The lung xenograft maintained viability and functionality over the course of the 216 hours of the monitoring period, without signs of hyperacute rejection or infection, but severe edema resembling primary graft dysfunction was observed at 24 hours after transplantation. Antibody-mediated rejection appeared to contribute to xenograft damage on postoperative days 3 and 6, with partial recovery by day 9. Immunosuppression included rabbit anti-thymocyte globulin, basiliximab, rituximab, eculizumab, tofacitinib, tacrolimus, mycophenolate mofetil and tapering steroids, with adjustments made during the postoperative period based on assessments of immune status.
All these advances bring us ever closer to a not-too-distant future in which we will be able to have an "in vivo" organ bank, at the expense of genetically engineered pigs, and even our “own autologous organ bank”, with autologous vitrified organs obtained from genetically engineered pigs with organs created with our own cells, without the subsequent need for immunosuppression in the absence of rejection.
Javier Cabo, MD,PhD.
Cardiothoracic Surgeon. Clinica Cardiologica Internacional of Madrid. Former Chief Section Cardiovascular Surgery. Hospital La Paz in Madrid who performed the first successfull neonate heart transplantation in 1984 in Spain and Fellow and visitor profesor in the Cardiothoracic Surgery Department at Loma Linda University International Heart Institute. Loma Linda , Ca. EEUU, where in 1984 the first successful xenotransplantation in the world of a baboon’s heart into a newborn human baby was performed.