Xenotransplant: Are pig kidney transplants in humans sustainable?

It is a known fact that delayed medical procedures can be fatal. Transplants are indeed life-altering.

The need for xenotransplantation, according to Dr Sashi Kiran A, consultant nephrologist, Yashoda Hospitals, Hyderabad stems from:

A) End-stage organ failure is a significant public health problem worldwide. Heart, kidney, lung, and liver failure collectively claim hundreds of thousands of lives each year.
B) Heart failure alone kills more people than HIV infection or breast cancer. Unfortunately, preventive therapies have a limited impact on end-stage organ failure.
C) Demand for organs far exceeds supply.

Risk factors

Considering that Richard Slayman, a US man who became the first recipient of a pig kidney, died 2 months after xenotransplant, experts stress that this process contains lots of risk factors that can be dangerous for the patient and can lead to serious consequences. “One of the major risks is that pigs have certain genes that are not suitable for the human body; hence, they need to be modified before transplantation. Experts are actively screening pigs and their health conditions to make sure they are fit and safe for the transplant before going ahead with the procedure,” said Dr Bhuwania.

It is also important for scientists and experts to make sure the pigs are well taken care of and not harmed or abused in any form, urged Dr Bhuwania.

Dr Sashi Kiran listed the following challenges besides immunological rejection:

Xenotransplantation also raises concerns about interspecific infection risk. “Of particular interest are the porcine endogenous retroviruses,” said Dr Sashi Kiran.

Clinical uncertainty is another concern. “Although considerable progress has been made in kidney xenotransplantation, the transplantation Rick Slayman underwent being a major milestone, it remains uncertain whether xenotransplantation as destination therapy can be successfully applied to humans,” said Dr Sashi Kiran.

For decades, proponents of so-called xenotransplantation have proposed replacing ailing human organs with those from animals. (Reuters Photo)

Is the procedure sustainable?

The big question to ask is whether there is surety about how long pig kidneys can be sustained in the human body.

Genetically engineered pigs could potentially resolve the organ shortage problem, stressed Dr Sashi Kiran. “These pigs might provide tissues and cells not only for transplantation but also for treating conditions like diabetes, Parkinson’s disease, and corneal blindness,” said Dr Sashi Kiran.

According to Dr Sashi Kiran, researchers continue to investigate ways to overcome rejection, control inflammation, and optimise immunosuppressive regimens. Public awareness and recognition are also crucial for the future of xenotransplantation. “Extensive and foolproof data is needed to determine the success of pig kidney transplants. Not everyone will be convinced or comfortable with this option. We have to wait and watch when it comes to the outcome and prognosis of such a transplant,” said Dr Bhuwania.