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Failure is the mother of success! The world's first pig heart-to-human transplant experience brings us one step closer to success

Release time:

2023-08-04

The death of the world's first pig heart transplant recipient is extremely regrettable, and people are full of questions about the cause of his death. According to a report on the University of Maryland website on June 30, the famous medical journal "The Lancet" published a study that revealed the possible reasons for the failure of the world's first genetically modified pig heart transplant.

The first pig heart transplant patient died 2 months later, and The Lancet announced the reason for the failure.

This groundbreaking surgery, performed by doctors and scientists at the University of Maryland School of Medicine (UMSOM) in the United States in January 2022, is an important milestone in medical science.

 

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In January last year, doctors at the University of Maryland School of Medicine performed the world's first genetically modified pig heart transplant. A 57-year-old Maryland man received a "gene-edited pig heart transplant." In the first few weeks after the transplant, the man showed no signs of acute rejection. But 2 months after the transplant, the man suddenly died of heart failure.

 

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David Bennett (right) after surgery

 

Since then, transplant teams have studied the causes of heart failure in post-surgery patients. Mohammad Mohideen, professor of surgery at the University of Maryland School of Medicine and director of the cardiac xenotransplantation project, and Bartley Griffiths, a pig heart transplant surgeon, are the principal investigators of the project.

This new study published in The Lancet confirms that there may be multiple causes that lead to heart failure in patients.

First, the patient's poor health before transplantation left his immune system severely compromised, which also limited the use of effective anti-rejection regimens used in preclinical transplantation studies. Researchers found that patients' organs may be more susceptible to rejection by antibodies produced by the immune system.

Then, the patient's use of intravenous immunoglobulin (IVIG), a drug containing antibodies, after a transplant may also result in damage to the heart muscle cells. In the second month after the transplant, the patient received two injections to help prevent infection and possibly trigger an immune response to the pig's heart.

Finally, the new study suggests that a latent virus called porcine cytomegalovirus (PCMV) may be present in pig hearts, which may cause transplant dysfunction. After patients reduce their use of antiviral treatments, the virus may become activated, possibly triggering an inflammatory response that leads to cell damage. However, there is no evidence that the virus infected patients or spread to organs other than the heart.

 

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Griffiths said: “We hope that the next patient will not only survive longer with a transplant, but return to a normal life for months or even years.

There is a serious shortage of transplant organs worldwide, and technical breakthroughs are urgently needed.

Although the world's first pig heart transplant ended in failure, failure is the mother of success! Even so, this is a huge step forward in medical technology. The valuable experience and lessons learned from it will better provide information and basis for future xenogeneic organ transplantation, and open up people's imagination about various types of organ transplantation.

Professor Zhao Qiang, deputy director of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine and a cardiac surgery expert, said that heart transplantation is technically not difficult at all. The success rate of the operation is over 95%, and the survival rate one year after the operation is as high as 95%. . But it faces a shortage of transplant organs. Therefore, scientists turned their attention to animal organs. Relevant reports show that in addition to the heart, transplantation of organs and tissues such as retina, kidney, liver, lung, pig blood, heart valve, and pancreas are all being studied, among which heart valve transplantation is relatively mature. There are millions of clinical application cases of pig and bovine valve transplantation to humans around the world.

"Of course, the pinnacle of the development of transplantation technology, taking heart transplantation as an example, is to use the patient's own cells to create an artificial, flesh-and-blood heart through laboratory culture. Such a heart is ethically, theoretically, and technically A perfect donor. In terms of genomics and immune technology, our country keeps up with the international forefront and is constantly exploring." Professor Zhao Qiang said.

Yinfeng Cryomedicine Research Center is committed to carrying out research on tissue engineering materials and 3D bioprinting. It uses placenta, umbilical cord, etc. as raw materials, and uses methods such as decellularization, freeze-drying, liquid nitrogen grinding, and enzyme treatment to form various types of tissues of different shapes. Engineering matrix materials, and allogeneic decellularized tissue engineering materials are used to prepare bio-inks, and 3D printing is used to achieve rapid, accurate, and customized clinical research and application of soft tissue filling.

 

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We look forward to early breakthroughs in related technologies and the realization of innovative technologies that truly save lives and protect human health.

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