By Dennis Thompson HealthDay Reporter<\/b><\/p>\n
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WEDNESDAY, April 24, 2024 (HealthDay News) — New Jersey native Lisa Pisano was staring down the end of her days.<\/p>\n
The 54-year-old had heart failure<\/a> and end-stage kidney disease, but several chronic medical conditions excluded her as a candidate for heart and kidney transplants.<\/p>\n All I want is the opportunity to have a better life, Pisano said in a news release. After I was ruled out for a human transplant, I learned I didn t have a lot of time left. <\/p>\n But Pisano has gotten a new lease on life, thanks to a combined transplant of a mechanical heart pump and a gene-edited pig kidney.<\/p>\n It s the first time the two vastly different medical technologies have been performed on one patient, said surgeons at NYU Langone Health in New York City.<\/p>\n There are no documented instances of anyone with a mechanical heart pump receiving an organ transplant of any kind, they added.<\/p>\n What s more, this is only the second known transplant of a gene-edited pig kidney into a living person, they said.<\/p>\n The first occurred in March, with doctors at Massachusetts General Hospital placing a genetically tweaked pig kidney<\/a> into Rick Slayman, 62, of Weymouth, Mass.<\/p>\n It is incredible to consider the scientific achievements that have led to our ability to save Lisa s life, and what we are endeavoring to do as a society for everyone in need of a life-saving organ, said Dr. Robert Montgomery<\/a>, director of the NYU Langone Transplant Institute.<\/p>\n Nearly 104,000 people are on the waiting list for a transplant, including more than 89,000 waiting for a kidney, the doctors said in background notes.<\/p>\n About 808,000 people in the United States have end-stage kidney disease, but only about 27,000 received a transplant last year, they added.<\/p>\n Surgeons first implanted the heart pump into Pisano, and days later followed up by implanting the gene-edited pig kidney and the pig s thymus gland to help ward off rejection.<\/p>\n Without the heart pump, Pisano s life expectancy would have been measured in days or weeks, researchers said.<\/p>\n But Pisano was stuck in a Catch-22, as patients with chronic kidney disease typically aren t allowed to get a heart pump.<\/p>\n Without the possibility of a kidney transplant, she would not have been eligible as a candidate for [a heart pump], due to the high mortality in patients on dialysis with heart pumps, said Dr. Nader Moazami<\/a>, chief of heart and lung transplantation at NYU Grossman School of Medicine.<\/p>\n This unique approach is the first time in the world that [heart pump] surgery has been done on a dialysis patient with a subsequent plan to transplant a kidney, Moazami added in an NYU Langone news release.\u00a0<\/p>\n The pump was implanted on April 4, and the pig kidney transplant occurred on April 12.<\/p>\n Pisano had high levels of harmful antibodies that would have attacked any transplanted human kidney, doctors noted. It likely would have taken years to find an appropriate human match.<\/p>\n But Montgomery found that an experimental gene-edited pig kidney developed by United Therapeutics Corp. was not only available, but also was a good match for Pisano.<\/p>\n The kidney was engineered to block a gene responsible for producing a sugar known as alpha-gal. Previous studies have shown that removing alpha-gal can prevent an antibody reaction that can trigger rejection of the pig kidney.<\/p>\n Pisano also received the donor pig s thymus gland, which is responsible for educating the immune system and will further lower the risk of rejection.<\/p>\n Other experimental gene-edited pig organs have included many different genetic alterations intended to ward off rejection, but Montgomery thinks simple could be better.<\/p>\n By using pigs with a single genetic modification, we can better understand the role one key stable change in the genome can have in making xenotransplantation a viable alternative, Montgomery said.<\/p>\n Since these pigs can be bred and do not require cloning like more-complex gene edits, this is a sustainable, scalable solution to the organ shortage, Montgomery added. If we want to start saving more lives quickly, using fewer modifications and medications will be the answer. <\/p>\n More information<\/strong><\/p>\n Harvard Medical School has more on the first gene-edited pig kidney transplant<\/a>.<\/p>\n SOURCE: NYU Langone Health, news release, April 24, 2024<\/p>\n <\/i><\/p>\n