Four people ineligible for transplantation and having liver failure will be connected to an external liver from a genetically modified pig, which will filter their blood. This is the first trial in which pig liver is being tested as a viable option in liver transplants. The process of using non-human organs as transplants is called xenotransplantation. According to Wayne Hawthorne, a transplant surgeon at the University of Sydney, Australia, this is a big leap in xenotransplantation. Serious liver failure has a mortality rate of 50%, which makes this novel method of transplantation all the more significant in increasing the survival rate.
Organ transplantation faces the problem of demand and supply, as there are only a handful of organ donors available for donating organs. To put it in numbers, only 1% of registered donors are able to donate organs after their death. To test alternatives, half a dozen people in the United States and China received genetically modified pig organ transplants. The surgeries were allowed on compassionate grounds for terminally ill patients. The surgeries weren’t exactly groundbreaking, as most recipients didn’t survive past a few months.
In the initial phase of the trial, four individuals with acute-on-chronic liver failure (sudden worsening of chronic liver failure) and hepatic encephalopathy (a brain disorder caused by impaired liver functioning) will be connected to genetically modified pig liver for 72 hours over a 2-week period. The trial is set to begin later this year. eGenesis, a bioengineering firm based in Cambridge, Massachusetts, and OrganOx, a biotechnology company based in Oxford, UK, will conduct the trial. The blood that will be sent through the pig liver will filter out harmful waste products that have accumulated. Thereafter, patients will be monitored for a year to test for safety and changes in liver function. Hawthorne adds that the livers will act as a “bridging graft” to keep people with liver failure alive, and might even help slowly regain liver function.
Safety reviews are a must for a trial of this nature. eGenesis will conduct a safety review of the first two patients receiving the liver transplant before setting up the trial with the next two patients. A second safety review will determine if the treatment can be expanded to 20 patients. The main hindrance the research team might face is the long-term viability of the transplanted organ. The risk of infections and organ rejection can also pose a considerable obstacle to the success of xenotransplantation.
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