The changes are intended to prevent the body from becoming infected with dormant viruses that may be present in the kidney, and in any case the kidney is designed to fit the specific patient
Richard Sleiman's days were numbered. The 62-year-old man already underwent a kidney transplant six years ago, but the transplanted kidney began to falter and fail. Sleiman's blood vessels were filled with toxins and harmful substances that the kidney was supposed to filter and excrete in the urine, without success.
Sleiman entered the waiting list for a new kidney transplant, but his place in the queue did not leave much hope that he would survive until a suitable kidney was found.
In the United States there is an extraordinary procedure for such people, that the sword of Damocles hangs above their heads and may fall at any moment. The "compassionate use" procedure of the United States Food and Drug Administration allows those for whom no treatment helps to also try innovative and unusual treatments. The chances of success for such treatments are considered slim, and the risk of damage is greater than usual, but as Ecclesiastes said - "What do you have to lose?"
And so Suleiman agreed to receive a kidney from a pig. But not just any pig: a pig that has been genetically engineered specifically for the transplant.
Why engineer pigs?
It is easy and pleasant to focus on the success stories of medicine, and to ignore that they are always the end product of many trials and failures that happened along the way. One such failure took place at the beginning of 2022, when another patient - who is not the hero of our story - won a heart transplant. Like Suleiman, he also relied on the "merciful use" procedure, and hoped for the best.
And it was indeed good, for the 46 days after the operation. On the 47th day, the transplant recipient suffered a severe heart attack and died shortly after. One of the causes of heart failure Demonstrates how great the hidden is over the known in medicine: the pig's heart contained dormant viruses, which were released after the transplant and caused the human immune system to attack the foreign heart.
How can you prevent such dormant viruses from waking up? This is a particularly complicated problem. There are many genes in the pig cells that can lead to the creation of viral proteins inside the cells, which will be released from them as whole or partial viruses. To face this challenge, you need to silence and damage dozens of genes at the same time. This is a task that in the early 2000s would have been considered almost impossible. Genetic engineering of just one gene twenty years ago in a complex mammal like a pig could have taken whole years. If a doctor of genetics was asked to engineer dozens of genes at the same time, he would probably quit his job at that moment.
But we are no longer in the early 2000s.
eGenesis was founded by one of today's greatest geneticists, Professor George Church - a man who became a legend in the world of genetic engineering. In the last five years, the company has engaged in extensive genetic engineering of pigs using revolutionary technology that Church was involved Inventing it and known as Crisper-Kaz9. CRISPR-Kaz9 allows genetic changes to be made in cells with extraordinary ease, and Church decided to apply it to make pig tissues safer for transplantation.
During work that lasted five long years, eGenesis researchers went through the genetic code of the pig and decided which genes to focus on. They identified 59 genes that were a source of danger for viruses to break out of the pig cells, and silenced and disrupted them all. They didn't stop there. They knocked out three genes that caused the pig's cells to display markers… well, porcine… that would cause Sleiman's immune system to attack the new kidney.
And that's it? Definately not. They were not content with paralyzing or removing genes from the pig, but They added strictly human genes to it. They chose to add, for example, human anticoagulants to reduce the risk of blood vessel blockage during the transplant. Along with them, they also inserted five genes that are supposed to signal to the human immune system that it should not attack the pig's heart.
In short, they created a pig with one clear overarching goal: to donate its tissues to humans who need them, like Suleiman.
The surgery and its results
In March 2024, Richard Sleiman was euthanized, and his body was rolled into the operating room at Massachusetts General Hospital. The surgeon held the engineered kidney in awe. After that he He declared That -
"It was truly the most beautiful kidney I have ever seen."
Regardless of the surgeon's aesthetic preferences, the operation took four hours and ended successfully. When Sleiman's blood vessels were connected to the blood vessels in the kidney, the new organ "immediately turned pink," as one of those involved in the operation described. That is, Suleiman's blood managed to saturate the pig's kidney, and it began to perform its function and filter the toxins from the blood. As described in a press release from Harvard Medical School -
"She produced urine. The operating room was filled with applause. It was a pretty amazing experience.”
Although Sleiman was unconscious throughout the operation, it is likely that he shared the enthusiasm. More than twenty days have passed since the operation, and on the first weekend of April he was released from the hospital to his home. It would be an exaggeration to say that he is completely healthy, but he recovered quickly from the operation, and the kidney is currently functioning as expected. In the meantime she is holding on.
But for how long?
A kidney and a thorn in it
It takes time for viruses to wake up in the transplanted pig tissues. In the pig heart transplant surgery I described at the beginning of the article, it took about six weeks for the heart to be irreversibly damaged by the immune system's action against those viruses. It is likely that Sleiman, along with his doctors and everyone involved in the surgery, look at the calendar every morning on their knees, and hope for the best. True, they silenced the genes that were supposed to allow viruses to come to life inside the cells. But it is very difficult to reach absolute certainty in biology and medicine. And so, everyone waits.
But there is optimism in the air.
Sleiman was the first human to receive the eGenesis engineered kidney, but he was not the first primate (ie, a member of the cashier series). This dubious honor was won by the long-tailed macaque monkeys, along with a pig-engineered kidney that was implanted in their bodies around 2020. Most of the monkeys survived several months after the transplant. Some of them succeeded Survive two whole years.
Say now - all this mess just for two more years of life?
well yeah. Also because every extra minute of life is precious, and also because the kidney may extend life beyond what is expected in Sleiman's body. But let's face it: Sleiman didn't really have many options open to him, and like him many others. More than 17 people are waiting for organ donation in the United States alone, and XNUMX of them die Every day While waiting for a new member to become available for them. A huge number of 800,000 people In the United States, people suffer from severe kidney disease or kidney failure, and the only solution for them is a kidney transplant or painful dialysis treatments in the hospital, several times a week, for the rest of their lives.
If the new genetically engineered pigs can provide a lifeline - even a temporary one - to some of those drowning-to-death people, they will do a great service to humanity.
But let's be realistic for a moment: they won't stop there.
Science and technology in the last two hundred years continue to move forward without stopping. We have already seen that achievements that were considered science fiction only twenty years ago, today become self-evident. Medical science also continues to run forward, among other things when it is supported by the superpower of artificial intelligence. In this situation, every addition of a few years to the human lifespan can provide another opportunity for life, thanks to new inventions and developments that will emerge during this time.
The new engineered kidney may only survive two years in Sleiman's body. maybe less. But at this time, eGenesis will already launch the more advanced kidneys: Kidneys 2.0. And if not her, then another company. And the same process is expected to occur for many other organs: heart, lungs, liver and more.
Therefore, we wish Suleiman the best of luck with all our hearts and minds, and hope that he ends this particular medical treatment as a hero - and not as a victim.
More on the subject on the science website:
Comments
Thanks for the update.
He died in mid-May 2024, two months after the operation
Interesting article. But the question arises why millions of people strive to destroy the body so efficiently.
Kidney is a reliable organ. You only need to drink a lot of water and not destroy with alcohol, drugs and more. So why do millions insist on destroying, especially with the stupid argument, I didn't know, because everyone knows. Think before you act.