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Medical breakthrough could help thousands waiting for kidney transplant

New details reveal UH kidney mistake not noticed until second patient was in operating room
Posted at 6:38 PM, Oct 27, 2021

A recent medical breakthrough could help people get organ transplants faster.

“This is really the first attempt to move this into the clinical realm,” Dr. Robert Montgomery, the director of the NYU Langone Transplant Institute, said.

Dr. Montgomery and the rest of the team at NYU Langone Health recently completed the first investigational transplant of a genetically engineered pig kidney, to a human body.

“We had a genetically-edited pig kidney and a recently deceased human whose family essentially donated her body to participate in this test to see if this pig kidney would work,” he explained.

It’s a process known as xenotransplantation.

“There have been attempts at trying to advance xenotransplantation using animal organs for human use for about 50 years,” Dr. Montgomery explained. He said the process for making this surgery possible started about four years ago. They completed the surgery at the end of September. Doctors kept the donor on a ventilator. For 54 hours after the surgery, they monitored the donor to watch the kidney’s function and check for signs of rejection.

“We’ve been sort of stuck in the preclinical animal studies for a very long period of time and this really gives us the confidence because the kidney worked so well and it wasn't rejected. It gives us the confidence that we can now move to a living human trial. I think that is going to happen in the next year or two,” Dr. Montgomery said. “What this will do is really allow, I think, anyone who needs a transplant to be able to get it. And not have to wait for years and maybe get too sick or die before they get it.”

There are 106,713 patients currently on the national waitlist, according to statistics from the Organ Procurement and Transplantation Network data pulled by the United Network for Organ Sharing on October 20, 2021. About 90,259 are in need of a kidney transplant.

“The 90,000 people on the list, that's really just a fraction of people who need a kidney,” said Dr. Michelle Josephson, a professor of medicine at the University of Chicago. Josephson is also a part of the American Society of Nephrology.

“If you look over time it has increased, and you say well why has it increased? I think the numbers increased one because we’re just not keeping up with demand...the other is that as we’ve gotten more knowledgeable about how to manage transplant recipients, we’re more willing to offer transplantation as a viable option to more people with perhaps more diseases and co-morbidities than we once felt capable or comfortable doing,” Dr. Josephson said.

Dr. Joseph Vassalotti with the National Kidney Foundation said that waitlist could take years.

“In parts of the country it might only be one year to wait for a deceased donor kidney. And in other parts of the country it might be 10 years, so there are some differences based on your blood type and where you live,” he said.

The possibility of xenotransplantation to help reduce wait times doesn’t come without controversy.

“There are barriers, people worried about the possibility of taking an infection from the animal world and bringing it into humans, so that's one big concern. There's been also concern that there's specific antibodies that humans might have against pig kidneys,” Dr. Josephson said.

Dr. Montgomery said he worked with a team of more than 100 people to manage those concerns.

“Everything that we did was really vetted through ethicists, through legal experts, religious experts,” he explained.

And it will be a while before this type of transplant is available to the public.

“It’s probably going to be several years before we can have large-scale clinical trials— to see this forward,” Dr. Vassalotti said.