(UTV | COLOMBO) – A man with terminal heart disease gets a transplant of genetically modified pig heart.
A 57-year-old man with life-threatening heart disease has received a heart from a genetically modified pig, a groundbreaking procedure that offers hope to hundreds of thousands of patients with failing organs. It is the first successful transplant of a pig’s heart into a human being. The eight-hour operation took place in Baltimore on Friday, and the patient, David Bennett Sr. of Maryland, was doing well on Monday, according to surgeons at the University of Maryland Medical Center.
“It creates the pulse, it creates the pressure, it is his heart,” said Dr. Bartley Griffith, the director of the cardiac transplant program at the medical center, who performed the operation. “It’s working and it looks normal. We are thrilled, but we don’t know what tomorrow will bring us. This has never been done before.”
“This is a watershed event,” said Dr. David Klassen, the chief medical officer of the United Network for Organ Sharing and a transplant physician. “Doors are starting to open that will lead, I believe, to major changes in how we treat organ failure.”
But he added that there were many hurdles to overcome before such a procedure could be broadly applied, noting that rejection of organs occurs even when a well-matched human donor kidney is transplanted. “Events like these can be dramatized in the press, and it’s important to maintain perspective,” Dr. Klassen said. “It takes a long time to mature a therapy like this.”
Mr. Bennett decided to gamble on the experimental treatment because he would have died without a new heart, had exhausted other treatments and was too sick to qualify for a human donor heart, family members and doctors said. His prognosis is uncertain. Mr. Bennett is still connected to a heart-lung bypass machine, which was keeping him alive before the operation, but that is not unusual for a new heart transplant recipient, experts said.
The new heart is functioning and already doing most of the work, and his doctors said he could be taken off the machine on Tuesday. Mr. Bennett is being closely monitored for signs that his body is rejecting the new organ, but the first 48 hours, which are critical, passed without incident. He is also being monitored for infections, including porcine retrovirus, a pig virus that may be transmitted to humans, although the risk is considered low.
“It was either die or do this transplant,” Mr. Bennett said before the surgery, according to officials at the University of Maryland Medical Center. “I want to live. I know it’s a shot in the dark, but it’s my last choice.” Dr. Griffith said he first broached the experimental treatment in mid-December, a “memorable” and “pretty strange” conversation.
“I said, ‘We can’t give you a human heart; you don’t qualify. But maybe we can use one from an animal, a pig,” Dr. Griffith recalled. “It’s never been done before, but we think we can do it.’” Dr. Jay Fishman, the associate director of the transplantation center at Massachusetts General Hospital, said that using pig organs provides the ability to perform genetic manipulations, the time to carry out better screening for infectious diseases, and the possibility of a new organ at the time that the patient needs it.
“There are challenges for sure, but also opportunities,” he said. The heart transplanted into Mr. Bennett came from a genetically altered pig provided by Revivicor, a regenerative medicine company based in Blacksburg, Va. The team used a new experimental drug developed in part by Dr. Mohiuddin and made by Kiniksa Pharmaceuticals to suppress the immune system and prevent rejection. It also used a new machine perfusion device to keep the pig’s heart preserved until surgery.
“The anatomy was a little squirrelly, and we had a few moments of ‘uh-oh’ and had to do some clever plastic surgery to make everything fit,” Dr. Griffith said. As the team removed the clamp restricting blood supply to the organ, “the heart fired right up” and “the animal heart began to squeeze.” When Mr. Bennett first told his son, David Bennett Jr., about the upcoming transplant, he was flummoxed.
“At first I didn’t believe him,” the younger Mr. Bennett, who lives in Raleigh, N.C., said. “He’d been in the hospital a month or more, and I knew delirium could set in. I thought, no way, shape or form is that happening.” He said his father had had a pig’s valve inserted about a decade ago, and he thought his father might be confused. But after a while, Mr. Bennett said, “I realized, ‘Man, he is telling the truth and not going crazy. And he could be the first ever.’”