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Transplantation of a Genetically Modified Porcine Heart Into a Live Human

Thursday, February 27, 2025

Submitted by

Akshay Patel

Source

Source Name: Nature Medicine

Source URL: https://www.nature.com/articles/s41591-024-03429-1

Author(s)

Bartley P. Griffith, Alison Grazioli, Avneesh K. Singh, Andy Tully, Javier Galindo, Kapil K. Saharia, Aakash Shah, Erik R. Strauss, Patrick N. Odonkor, Brittney Williams, Henry J. Silverman, Allen Burke, Cinthia B. Drachenberg, Chris L. Wells, Timm Dickfeld, Susie N. Hong, Albert J. Hicks III, Manjula Ananthram, Anuj Gupta, Robert H. Christenson, Lo Tamburro, Tianshu Zhang, Alena Hershfeld, Billeta Lewis, Erika D. Feller, Kasinath Kuravi, Lori Sorrells, Erwan Morgand, Fariza Mezine, Valentin Goutaudier, Martine Rothblatt, Christine L. Lau, Bradley Taylor, Steve Perrin, Alexandre Loupy, David Ayares, Muhammad M. Mohiuddin

This article presents findings from the second-ever pig-to-human heart xenotransplant. A 58-year-old patient with end-stage heart failure received a 10-gene-edited porcine heart and was maintained on a novel anti-CD40L immunosuppressive regimen. Initially, the graft functioned well, but by day 31, the patient developed severe diastolic heart failure and required ECMO. The xenograft ultimately failed due to endothelial injury and antibody-mediated rejection (AMR), despite aggressive immunosuppression. No evidence of porcine cytomegalovirus was found, ruling out infection as a contributing factor.

This study is crucial for cardiothoracic surgery, highlighting both the progress and ongoing challenges in xenotransplantation. These findings provide insights into improving immunosuppressive strategies, refining donor selection, and overcoming rejection, bringing xenotransplantation closer to clinical viability as an alternative to human heart transplantation.