This week a group of surgeons performed the first-ever heart transplant of a pig to a human. The surgery occurred on January 7, 2022 and a significant milestones for research on transplants between species, known as xenotransplantation.
Although the surgeons are unsure how long or how well the pig heart will last in the human body, the 57-year old patient David Bennett gets to have a second chance at life for however longer because of it. Mr. Bennett suffered advanced heart failure and an arrhythmia called ventricular fibrillation. Because Mr. Bennett hadn’t taken control of his high blood pressure and other related health problems, doctors at University of Maryland Medical Center and other nearby institutions deemed him ineligible for a human heart transplant. A human organ, according to Muhammad Mohiuddin, director of the cardiac xenotransplantation program at UMSOM, “is considered a very precious thing; the main concern was whether to give the heart to a person who may not be able to take care of it.”
Instead of dying because he could not get a human heart, Mr. Bennett consented to a pig’s heart. The team of doctors at UMSOM sought what is called a “compassionate use” authorization from the FDA to allow Mr. Bennett to get a heart from a genetically modified pig created by Revivicor. Revivicor is a privately held company.
Xenotransplantation involves serious risks. There are risk of rejection of the transplanted organ, an immune response in the receiver of the organ that can cause organ failure. A main issue with xenotransplantation is that antibodies produced by humans recognize certain sugars on the surface of a pig’s cells as foreign. Therefore, according to Dr. Joseph Tector, a transplant surgeon at the University of Miami, cautioned “you really need to get rid of as much antibody binding as you can upfront to get the graft to survive longer. “ One interesting thing the surgeons do to prepare the pig’s heart for human implantation is the “heart is bathed in a circulating broth that includes water, hormones, such as adrenaline and cortisol — and dissolved cocaine.”
Mr. Bennett is the only patient that has received the “compassionate use” authorization from the FDA for the pig heart. However, if this transplant gives Mr. Bennett additional time to live, chances are more patients will receive such authorization as well. The team that performed the surgery is hopeful. And they have said that their goal “is to advance the approach into a multicenter clinical trial.” To do that, they will have to do more tests to show long-term survival in baboons to get FDA approval for the trial.
What an amazing opportunity Mr. Bennett have to live more life because of a pig’s heart.
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