There are probably a few women who exclaimed, “I told you so.” But all jokes aside, a 57-year-old heart disease patient now gets a second chance at life as the first human recipient of a genetically modified pig heart.
“It was either die or do this transplant. I want to live,” David Bennet, an American handyman said in a statement issued by the Maryland University early this week.
Bennett is a terminal heart patient from the state of Maryland in the United States of America. He said he knew there was no guarantee that the surgery would work, but said that he was dying and ineligible for a human heart.
Currently, 110 000 people like Bennett are awaiting organs for transplant in the United States alone.
“I know it’s a shot in the dark, but it’s my last choice,” said Bennett. “I look forward to getting out of bed after I recover.”
The historic *xenotransplant surgery was conducted by University of Maryland School of Medicine (UMSOM) faculty at the University of Maryland Medical Center (UMMC), together known as the University of Maryland Medicine.
The U.S. Food and Drug Administration (FDA) granted emergency authorization for the surgery on New Year’s Eve through its expanded access (compassionate use) provision – a protocol only used when experimental medical products are the only option left for terminally patients.
Groundbreaking surgery
Bennett is currently being carefully monitored to determine whether the transplant has potentially lifesaving benefits, said Professor Muhammad Mohiuddin, director of surgery at the University of Maryland’s School of Medicine cardiac xenotransplant programme.
In a video statement he said, “We are excited to see this pig heart beating in his this human [chest]. This pig heart has performed so far very well even beyond our expectations. We have not seen any signs of rejections.”
Bennett had been deemed ineligible for conventional heart transplant at the UMMC and several other transplant centres in the country.
“This was a breakthrough surgery and brings us one step closer to solving the organ shortage crisis. There are simply not enough donor human hearts available to meet the long list of potential recipients,” said Dr Bartley Griffith.
Griffith is the transplant surgeon who conducted Bennett’s surgery. He is also a professor in transplant surgery at the University of Maryland’s School of Medicine.
“We are proceeding cautiously, but we are also optimistic that this first-in-the-world surgery will provide an important new option for patients in the future.”
Transplant surgeon, Dr Bartley Griffith
Mohiuddin added, “This is the culmination of years of highly complicated research to hone this technique in animals with survival times that have reached beyond nine months. The successful procedure provided valuable information to help the medical community improve this potentially life-saving method in future patients.”
But are animal-human transplants a thing?
The concept of transplants have been the most challenging area of modern medicine, and xenotransplants are not an entirely new solution to the crisis of global organ shortages. “To achieve xenotransplantation and it is now personally gratifying to me to see this long-sought goal clearly in view. It is a spectacular achievement,” said transplant surgeon, Dr Bruce Jarrell.
Here is a brief history of the practice:
1667: French doctor Jean-Baptiste Denys tapped the veins of farm animals to perform human blood transfusions. His patient, a boy (15) survives surgery likely due to a small amount of sheep blood. The practice of xenotransfusion is abandoned as two patients of Denys die following other attempts.
1800: Skin xenografts become popular. Surgeons begin to use species including rabbits, dogs, and pigeons as donors. According to medical historians none of these experimental grafts ever became permanent.
1900: In the 1980’s xenotransplant surgery abandoned once more following the death of Stephanie Fae Beauclair, a terminally ill infant who became the first recipient of a baboon heart. It is believed that Beauclair died due to complications with her immune system in 1984.
Dr Muhammad Mohiuddin and team. Photo: University of Maryland Pig heart before removal. Photo: University of Maryland Dr’s hold the pig heart of David Bennett Sr. Photo: University of Maryland Surgeons conduct David Bennett’s surgery. Photo: University of Maryland Surgeons await to transplant heart to David Bennett. Photo: University of Maryland Dr Bartley Griffith performs surgery. Photo: University of Maryland
A giant leap
Xenotransplantation could potentially save thousands of lives, said Dr Albert Reece who is the dean at the school of medicine at the University of Maryland. He said, “We hope it will one day become a standard of care for patients in need of organ transplants.”
Organs from genetically modified pigs have been the focus of much of the research in xenotransplantation in part because of physiologic similarities between pigs, human, and primates.
Dr Bert O’Malley added, “I couldn’t be more proud to say the future is now. Our skilled team of UMMC and UMSOM physician-scientists will continue to advance and adapt medical discovery for patient care that could offer a lifeline for more patients in dire need.”
Bennett was repeatedly informed of the risks associated with the experimental surgery explained head anaesthetist, Dr Peter Rock.
“We carefully considered the unique needs of this patient in preparing him for surgery and the intricacies involved in modifying our anaesthetic techniques for this xenotransplant procedure. Our planning paid off, and the surgery could not have gone better thanks to the herculean efforts of the medical team involved in this landmark event.”
Dr Peter Rock, anesthesiologist
Dr Mohan Suntha said, “We appreciate the tremendous courage of this live recipient, who has made an extraordinary decision to participate in this ground-breaking procedure to not only potentially extend his own life, but also for the future benefit of others.”