[Doctors during Surgery. Photo Credit to Pexels]

This past April, NYU Langone Health made headlines by successfully performing a procedure involving the first gene-edited pig kidney, marking a significant leap forward in  xenotransplantation. 

Led by pioneering surgeon Robert Montgomery, MD, the procedures involved an innovative two-step approach: first implanting a heart pump, followed by transplanting pig thymus tissue to minimize rejection of the gene-edited kidney.

This procedure represented several firsts in the field: the first organ transplant case for a patient with a mechanical heart pump, the second pig kidney transplant, and the first thymus-combined case.

“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,” Dr. Montgomery explained.

The procedure offers hope amid a critical shortage of donor organs.

According to the American Kidney Fund, over 106,000 people are currently on the transplant waiting list, with 87 percent awaiting kidney transplants. 

Patients are listed on this waiting list, and surgeries are prioritized based on their ranking. 

The historic surgery was performed on Lisa Pisano, who suffered from severe heart dysfunction and end-stage kidney disease. 

Her unique condition made her ineligible for human organ transplants, but notably, she showed no antibody reaction to engineered pig organs. 

“All I want is the opportunity to have a better life,” Pisano stated in an interview with NYU Langone. 

However, the story took a tragic turn when Pisano passed away in July.

Medical professionals attributed the kidney transplant failure to necessary blood pressure medications that could not be discontinued, ultimately requiring removal of the xeno-kidney. 

The science behind the procedure involves sophisticated gene editing techniques, particularly CRISPR-Cas9 technology.

Key modifications include removing the alpha-gal gene in pigs to reduce immune reactions and inserting human genes to enhance organ compatibility.

Despite the promise of this technology, there are substantial challenges.

Ethical concerns include animal rights, human-animal identity distinctions, and equitable organ distribution.

Medical experts also worry about the potential introduction of novel viruses, citing a previous patient death linked to porcine cytomegalovirus.

Nevertheless, the medical community remains optimistic.

In a recent interview published by the National Kidney Foundation, specialists emphasized xenotransplantation's potential to help more than  90,000 Americans awaiting kidney transplants.

Healthcare institutions maintain that each clinical trial refines immunosuppressive regimens and surgical procedures, advancing patient outcomes.

With constant research and development, xenotransplantation technology is expected to evolve, bringing unprecedented reform to medical technology in human society.