October 11, 2024, Xenotransplantation
Greetings, Kidney Friends! In recent years, the medical community has achieved remarkable advancements in xenotransplantation.
2021
A medical team at the University of Maryland successfully performed the first transplant of a gene-edited pig kidney into a human, marking a significant milestone in pig-to-human xenotransplantation. They subsequently conducted the first living heart xenotransplantation, offering a potential treatment for patients with organ failure. Many people may wonder if xenotransplantation can be applied clinically in the near future. The answer, unfortunately, is no.
Image: Poor Things—Xenotransplantation in Animals
Dating back to the 1950s, scientists have been conducting experiments with xenotransplantation in animals, but these efforts have consistently raised ethical controversies. With advancements in science and technology, particularly the development of gene-editing technology, the ethical issues surrounding xenotransplantation have become increasingly complex. Scientists, physicians, ethicists, and policymakers are actively debating these issues.
Currently, strict ethical and policy guidelines, both domestically and internationally, govern the clinical trials of xenotransplantation. For instance, in 2008, the World Health Organization (WHO) issued the Changsha Declaration, establishing standards for clinical research in xenotransplantation. These standards have been updated multiple times since then. Concurrently, the China Organ Transplantation Development Foundation has released the “Chinese Expert Consensus on Human Xenotransplantation Clinical Trials,” which provides clear regulations for xenotransplantation clinical trials. These guidelines and consensuses indicate that xenotransplantation remains in the preclinical and early-stage clinical trial phases, with a significant journey ahead before it can be implemented in routine clinical practice. Indeed, the clinical application of xenotransplantation has not been officially approved either domestically or internationally. The successful cases cited earlier occurred under exceptional circumstances and can only be applied under the “compassionate use” provision, which applies to critically ill patients with no other treatment options.
What Conditions Must Be Met?
So, what conditions must be fulfilled for xenotransplantation to be fully integrated into clinical practice? The International Xenotransplantation Association has established clear objectives: first, 60% of recipients must survive more than 3 months post-xenotransplantation, with at least 10 consecutive successful cases required. Second, xenotransplantation must demonstrate the capacity to permanently replace the original organ, meaning at least 50% of recipients must survive more than six months post-transplant. Thus, extensive clinical trials and long-term observation are necessary before xenotransplantation can be adopted in clinical practice. This process could take several years or longer. Therefore, at least in the short term, using pig kidneys is not feasible. However, with advancements in science and technology and deeper research, we believe xenotransplantation will offer greater hope and potential for humanity in the future.
That concludes today’s discussion. If you find this article helpful, please follow, like, save, share it with friends, or explore more about kidney transplantation. Until next time.
