The patient, Richard Slayman, no longer requires dialysis. “Today marks a new beginning not just for me, but for them as well,” he said, referring to other kidney patients. Credit.Michelle Rose/Massachusetts General Hospital via NYT
Richard Slayman, 62, the first person to receive a kidney transplanted from a genetically modified pig is getting on so well that he was discharged from the hospital on Wednesday, just two weeks after the groundbreaking surgery, NYT reported.
The transplant and its encouraging outcome represent a remarkable moment in medicine, scientists say, possibly heralding an era of cross-species organ transplantation.
Two previous organ transplants from genetically modified pigs failed. Both patients received hearts, and both died a few weeks later. In one patient, there were signs that the immune system had rejected the organ, a constant risk.
But the kidney transplanted into Richard Slayman, 62, is producing urine, removing waste products from the blood, balancing the body’s fluids and carrying out other key functions, according to his doctors at Massachusetts General Hospital.
“This moment — leaving the hospital today with one of the cleanest bills of health I’ve had in a long time — is one I wished would come for many years,” he said in a statement issued by the hospital. “Now it’s a reality.”
He said he had received “exceptional care” and thanked his physicians and nurses, as well as the well-wishers who reached out to him, including kidney patients who were waiting for an organ.
“Today marks a new beginning not just for me, but for them as well,” Mr. Slayman said.
The procedure brings the prospect of xenotransplantation, or animal-to-human organ transplants, significantly closer to reality, said Dr. David Klassen, the chief medical officer for the United Network for Organ Sharing, which manages the nation’s organ transplant system.
“Though much work remains to be done, I think the potential of this to benefit a large number of patients will be realized, and that was a question mark hovering over the field,” Dr. Klassen said.
Whether Mr. Slayman’s body will eventually reject the transplanted organ is still unknown, Dr. Klassen noted. And there are other hurdles: A successful operation would have to be replicated in numerous patients and studied in clinical trials before xenotransplants become widely available.
Mr. Slayman exhibited signs of rejection on the eighth day after surgery, according to Dr. Leonardo V. Riella, medical director for kidney transplantation at Mass General. (The hospital’s parent organization, Mass General Brigham, developed the transplant program.)
The rejection was a type called cellular rejection, which is the most common form of acute graft rejection. It can happen at any time but especially within the first year of an organ transplant. Up to 25 per cent of organ recipients experience cellular rejection within the first three months.
The rejection was not unexpected, though Mr. Slayman experienced it more quickly than usual, Dr. Riella said. Doctors managed to reverse the rejection with steroids and other medications used to tamp down the immune reaction.
Mr. Slayman is taking several immunosuppressive drugs, and he will continue to be closely monitored with blood and urine tests three times a week, as well as with doctor visits twice a week.
移植豬腎的男子從醫院回到家
根據《紐約時報》報道，62 歲的理查德·斯萊曼(Richard Slayman) 是第一個接受基因改造豬腎臟移植的人，他的情況非常好，以至於他於週三出院，此時距離突破性手術僅兩週後。
科學家表示，這次移植及其令人鼓舞的結果代表了醫學界的一個非凡時刻，可能預示著跨物種器官移植時代的到來。
之前兩次基因改造豬的器官移植都失敗了。 兩名患者均接受了心臟移植，但均在幾週後死亡。 在一名患者身上，有跡象顯示免疫系統已經排斥該器官，這是一個持續的風險。
但根據馬薩諸塞州總醫院的醫生介紹，62 歲的理查德·斯萊曼 (Richard Slayman) 的腎臟移植後能夠產生尿液、清除血液中的廢物、平衡體液並執行其他關鍵功能。
他在醫院發表的聲明中說：“今天帶著我很長一段時間以來最乾淨的健康狀況離開醫院的這一刻，是我多年來一直希望能出現的時刻。” “現在這已成為現實。”
他說他得到了“特殊的護理”，並感謝他的醫生和護士，以及向他伸出援手的祝福者，包括正在等待器官的腎臟病患者。
「今天不僅對我來說是一個新的開始，對他們來說也是如此，」斯萊曼先生說。
負責管理美國器官移植系統的器官共享聯合網絡的首席醫療官大衛·克拉森博士表示，這項手術使異種移植（即從動物到人類的器官移植）的前景更加接近現實。
克拉森博士說：“儘管還有很多工作要做，但我認為這將使大量患者受益的潛力將會實現，這是一個懸而未決的問號。”
克拉森博士指出，斯萊曼先生的身體最終是否會排斥移植的器官仍不得而知。 還有其他障礙：在異種移植廣泛應用之前，必須在大量患者中複製成功的手術並進行臨床試驗研究。
麻省總醫院腎臟移植醫學主任 Leonardo V. Riella 博士表示，斯萊曼先生在手術後第八天就出現了排斥反應的跡象。 （該醫院的上級組織麻省總醫院布里格姆總醫院制定了移植計劃。）
這種排斥是一種稱為細胞排斥的類型，是急性移植排斥最常見的形式。 它可以隨時發生，尤其是在器官移植的第一年。 高達 25% 的器官接受者在前三個月內經歷細胞排斥。
里埃拉博士說，這次拒絕並不出人意料，儘管斯萊曼先生比平常經歷得更快。 醫生設法用類固醇和其他抑制免疫反應的藥物來逆轉排斥反應。
斯萊曼先生正在服用多種免疫抑制藥物，他將繼續受到每週三次血液和尿液檢查的密切監測，並每週兩次就診。
Source: NYT
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