Reacción a "A modified pig liver was transplanted into a living person for the first time"

In the race established in recent years by researchers in the United States and China to take the lead in the field of xenotransplantation, the team at Anhui University Hospital in eastern China has taken a very important step forward with this study by demonstrating for the first time in a living human being that it is feasible to perform a genetically modified pig liver transplant.

A few months ago, another Chinese team demonstrated that this type of transplant was possible in a brain-dead patient. This time, however, the patient was alive and suffering from cirrhosis caused by the hepatitis B virus and a large tumour in the right lobe of the liver, which made resection unfeasible without a replacement liver. The transplant was carried out using a pig liver with 10 genetic modifications, achieving good function for 31 days, during which time it produced bile and was able to manufacture albumin and coagulation factors typical of a well-functioning graft. It had to be removed after this period due to the onset of thrombotic microangiopathy, a serious complication that can also be seen in some transplant patients with human grafts, and he finally died after 171 days from gastrointestinal bleeding.

The experience is very relevant because the fact that it has been demonstrated that the porcine liver can function without rejection or major complications, at least for a month, opens the door to its use in clinical trials as a “bridge organ” in patients with fulminant liver failure, awaiting a human liver for transplantation that does not always arrive in time. This is the approach of a trial already approved in the United States (although none have been carried out yet) and also the one proposed to the ONT by the University of Murcia, and this article demonstrates that they are perfectly possible.

An added value of this research is the fact that genetic modifications have been successfully introduced into the pig litter, including the elimination of potentially pathogenic viruses, which will greatly favour future production.

As with other pig organs transplanted to date, long-term survival is still a long way off, something that Chinese researchers are pursuing but which, for the moment, is not a near-term goal in the United States, where the focus is more on maintenance liver replacement until definitive transplantation.

As in other xenotransplantation experiments, there are more questions than answers, but a giant step forward has been taken with a possible immediate practical application as a bridge organ, something that had not been achieved in a credible way with other transplanted pig organs until now.