Loading ...

A genetic-modified lung transplanted from a pig into a brain-dead adult man lasted for 9 days, demonstrating the feasibility of the procedure, according to a new report published in Nature Medicine.

Fewer patients remain on the waiting list for lung transplants than in the past, thanks to improved scoring systems to predict who will derive the most benefit, said Kartik V. Shenoy, MD, professor of thoracic medicine and surgery at the Lewis Katz School of Medicine at Temple University, Philadelphia, in an interview.

However, the risk for death while on the waiting list remains at about 10%-13%, said Shenoy, who was not involved in the pig research.

The lung from a genetically-engineered pig was transplanted into a 39-year-old brain-dead male recipient, according to the abstract.

The researchers reported severe edema 1 day after the transplant, which they described as possibly caused by ischemia-reperfusion injury. “Antibody-mediated rejection appeared to contribute to xenograft damage on postoperative days 3 and 6, with partial recovery by day 9,” they wrote.

Overall, the lung maintained both viability and functionality, with no signs of hyperacute rejection or infection through the 216-hour monitoring period.

The current case shows the feasibility of pig-to-human lung xenotransplantation, but more preclinical work is needed to address the challenges of infection and organ rejection, the researchers noted.

The results of the transplant were not unexpected, Shenoy told Medscape Medical News. “Though the researchers tried to do some gene editing to make the organ more compatible with humans, our understanding and ‘treatment’ of the differences between pig and human immunologically is still in its infancy,” he noted.

Xenotransplantation is not currently a mainstream option but may become one in the future with additional research and improved understanding of the immune system, said Shenoy. “Further understanding of optimal gene editing and posttransplant immunosuppression would be of paramount importance for xenotransplant to work in the future,” he said. 

Shenoy disclosed advisory work within the past year for AstraZeneca.