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or the past 100 years the medical industry has achieved some amazing milestones, but today we are looking at a goal that can only be compared with the first landing on the moon (just as mentioned by Joachim Denner). For the first time, a human has received through transplant a pig’s heart. The procedure of transplanting animal organs to humans is called xenotransplantation and the term had been created about 70 years ago when the first xenotransplantation was attempted.

There are hundreds of thousands of patients with various heart diseases that are waiting on a long list to receive a human heart. It is sad to say that most of them pass away before receiving a new heart. Last year for example only 3,817 people within America received human donor hearts, yet the list is filled with thousands of patients waiting.

The man with a pig’s heart

A 57-year-old man named David Bennet was in the same boat with heart disease that could not be cured, so the only solution was a transplant. Bennet was hospitalized at the University of Maryland Medical Center where doctors have told him that his chances to receive a donor heart in time are very slim. Despite the desperate necessity, the transplant list follows a “human selection” criterion where the young are chosen first.

However, scientists at the University of Maryland Medical Center have been working with a company named “Revivicor” in order to grow a genetically engineered heart. The company is looking to solve problems such as donor organ shortage with futurist solutions. The organs of a pig are compatible with the human organism, however, the immune system within the human organism would see an animal’s organ as a foreign object, and therefore it would not accept the organ.

In order for the human organism to accept the pig’s heart, the pig itself had 10 genes modified in order to boost the chance of acceptance in the human body. Four of those were inactivated as they were the ones causing an aggressive immune response within the human body. The other six are actually human genes that have been inserted into the genome of the pig in order to force the heart to be accepted by the human organism.

Surgeons prepare genetically engineered pig heart for transplant (Source: Univerity of Maryland School of Medicine)

When Bennet was told about this last resort he accepted it with quite some humor, despite the low chances that have been presented.

“I said, ‘We can’t give you a human heart; you don’t qualify. But maybe we can use one from an animal, a pig,” Dr. Griffith recalled. “It’s never been done before, but we think we can do it.’” “I wasn’t sure he was understanding me,” Dr. Griffith added. “Then he said, ‘Well, will I oink?’”

Dr. Bartley Griffith, left, with David Bennett Sr. after the surgery (Source: Univerity of Maryland School of Medicine)

The surgery took place on the 7th of January 2022. Before the surgery, Bennet was put on medication that was surprising to his immune system in order to raise the chances of acceptance even higher. The heart was transplanted just like a normal human heart and connected to Bennet’s body.

From an exclusive interview with Dr. Bartley Griffith taken by The New York Times, the surgeons said that despite Bennet being on a heart-lung bypass machine supporting his recovery, the new heart does most of the work and seems to be holding up well. Bennet’s body has successfully accepted the pig’s heart. Taking into consideration that the life span of a pig is between 15 to 20 years, the longest Bennet would be able to live is till the age of 77. However, because this is a genetically altered heart it could be incentivized by the human organism to live longer.

Dr. Bartley Griffith has made the history books by becoming the first surgeon to transplant a pig’s heart into a human body. This procedure however has been in the making since 2015 when Revivicor announced that they have been breeding pigs that have some genetic similarities to humans. Only 7 years ago their aims have been criticized by the public, saying that this was not sustainable as people didn’t have faith in xenotransplantation because of 70 years of failed attempts.

History of Xenotransplantation

Although most experts consider that xenotransplantation had been first performed by Dr. James D. Hardy, it was actually Serge Voronoff who performed organ transplants from animals to humans. In the 1920s Voronoff advocated the transplantation of slices of chimpanzee testis into aged men whose “zest for life” was deteriorating. He believed that the hormones within the chimpanzee testicles would give more potency to aged men. Many of the attempts if not all have resulted in death.

The lamassu. This mythological beast has been adopted for the logo of the International Xenotransplantation Association and its official journal, Xenotransplantation (Source: Baylor University Medical Center Proceedings)

Interestingly enough, xenotransplantation is represented by Lamassu, a celestial being from ancient Mesopotamian religion bearing a human head, bull’s body, sometimes with the horns and ears of a bull, and wings. This has been chosen to be the symbol of xenotransplantation as it represents a human that features different parts from different animals.

Throughout the 20th century, many practitioners and even some sick people have tried transplanting various organs from animals into humans but none of them had major success. At the time the technology simply wasn’t there and neither was the knowledge required. Many surgeons were yet to understand the compatibility issue and why the immune system wasn’t allowing those organs to be accepted into a human body.

Dr. James D. Hardy (Source: The Journal of Heart and Lung Transplantation)

One of the more notable attempts similar to this case was in 1963 when Dr. James D. Hardy, at the time professor of surgery and chairman of the department at the University of Mississippi Medical Center transplanted the heart of a chimpanzee into a human body. What was amazing the heart of the chimpanzee was only half the size of a human heart and yet the human lived for 90 minutes before dying.

A storm of ethical, moral, social, religious, financial, governmental, and even legal problems followed which put off any other attempts at xenotransplantation within America for quite a few years. James Hardy was a prolific surgeon well known for performing the world’s first human lung transplant, and yet despite his reputation, the world did not want to believe in xenotransplantation.

Dr. Keith Reemtsma (Source: Baylor University Medical Center Proceedings)

Another important mention is Dr. Keith Reemstsma who in 1964 transplanted chimpanzee kidneys into 13 patients, one of whom returned to work for almost 9 months before suddenly dying from what was believed to be an electrolyte disturbance. He is still is to this day the record holder for most xenotransplantation surgeries performed despite all of his patients dying from the procedure.

For those people who have accepted the procedure, it was a last resort, just like in Bennet’s case. Anything is better than death, but that cannot be understood by anyone until they are faced with a message of inevitable death. Dr. Reemstsma was received a bit better by the public as he tried to explain the importance of xenotransplantation and the problem that the medical field will face in the future (which we face today), which is a shortage of organ donors.

Dr. Thomas E. Starzl (Source: Baylor University Medical Center Proceedings)

What people do not understand is that no matter what animal or creature the organ comes from, it is still a living organism that is able to sustain life. The surgery that had the longest-living patient was performed by Dr. Thomas E. Starzl in 1992 when he transplanted the liver of a baboon into a human. The patient managed to live well for 70 days after passing away from complications. Even in his case, he was arguably the best in his field by modernizing the transplant of kidneys and making it a standard procedure across the world.

Once again, he was also hit by a storm of ethical issues as it was seen by society as inhumane to give humans organs from animals as if they are receiving some sort of worthless leftovers. The only ones that probably do appreciate these strives within the medical field are the ones on the waiting lists, waiting for an organ whilst hoping death won’t knock on their door.

There are many other very interesting attempts that I might write about in the future which are very different from the ones mentioned above.

Xenotransplantation is the future of the medical field as most of the organs from animals that are being butchered for our consumption are thrown away. Why should we not use them to save lives? What will change the public’s perspective on this is the life quality of David Bennet and how long he will live with his new pig heart.

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