How pig kidney transplants could help those struggling with organ failure
Experts say procedure can reduce wait times but some say it's not a long term solution
The list of Canadians waiting for a kidney donation has thousands of people, and it can take years for some to get surgery. But a New Hampshire man who is now living with a pig kidney is giving some researchers hope there's a temporary solution.
"Immediately following the transplant, it just changed his life," Mike Curtis, the president and CEO of eGenesis, told The Current host Matt Gallaway.
eGenesis, based in Cambridge, Mass., developed the pig kidneys used in recent transplants.
Kidneys are the most in-demand organ for solid organ transplants in Canada. According to the Canadian Institute of Health Information, 71 per cent of people waiting for a solid organ transplant needed kidneys in 2023.
But with the help of animal organs, Curtis believes we're entering a transformative era in organ transplantation that will lead to better medical outcomes for people with kidney disease.
"Now there's the potential to get them off of dialysis and greatly improve their quality of life and potentially improve their overall survival," said Curtis.
Life on dialysis
Nearly 30,000 Canadians are on dialysis to treat kidney disease, which can be time-consuming and physically taxing, with some patients undergoing multiple hour-long sessions every week.
The annual costs associated with dialysis treatment range from $56,000 to $107,000 per patient, and the average out-of-pocket cost could be up to $2,500, according to a report published by the Kidney Foundation of Canada in 2021.
Karen Fisher says she's hopeful about the positive impact a pig kidney transplant could make for her husband, Christian Lemieux. His expected wait time for a kidney transplant is three to five years.
"An advancement in science is always very exciting. It feels like we're a step closer to a solution," Fisher said.
She says her family is doing their best to support Lemieux while he receives treatment to deal with kidney failure. When he was receiving care at the hospital, sometimes he'd feel too unwell to drive home after treatment.
"Being in a hospital setting three times a week for six hours at a time, it wasn't good for his mental health," Fisher said.
The family opted to continue treatment at home but that comes with its own set of complications, like the dozens of boxes of medical equipment the family gets delivered.
Lemieux is on dialysis for 10 hours overnight, and some days needs even more treatment during the day. He sets up in the living room when the night is winding down so he's able to spend time with his wife and kids.
"It's really hard for the kids to witness every night," Fisher said.
Dr. Ali Rabi says innovations such as pig-to-human kidney transplants could make a huge difference for people like Lemieux.
Rabi, a cardiac surgeon at Massachusetts General Hospital who wasn't involved in the transplant, says medical interventions will be even more crucial as the population ages and the need for organ transplants increases.
"We are going to have to come at this problem from multiple angles, and xenotransplantation is definitely one angle that has been explored," said Rabi.
Transplant concerns
Syd Johnson, an ethics consultant at the Center for Bioethics and Humanities at the Upstate Medical University in Syracuse, N.Y., questions the overall value of pig kidney transplants if they're not a permanent solution.
"We're only talking about using pig organs as a bridge to a human transplant, so we'll get you through the next few months or through the next few years. That doesn't solve the organ shortage problem at all. It just kicks the can down the road," Johnson said.
The first four pig-to-human organ transplants — two hearts and two kidneys — were short-lived, with one man living less than two months. However, doctors found no indication that his death was caused by the transplant.
Johnson acknowledged that many people die waiting for organs or get stuck on dialysis for years, but says pig organ transplants don't address the core issues.
"That shortage of organs is going to persist unless we can actually do something about the causes of organ failure or find better ways to treat organ failure so that people don't need organ transplants at all," she said.
The spread of disease from animals to humans is another concern for Johnson. She says patients who receive transplants are less equipped to fight off infections than others.
"Under that scenario, a virus has the opportunity to stay in that person's body and mutate. And we don't know what might happen in the long run," said Johnson.
Curtis says using a technique called metagenomics, they're able to screen donor pigs and recipients by using genetic sequencing to look for any changes in the genetic material, which could indicate disease or infection.
He says this is a critical step that could avoid the nightmare scenario of another pandemic.
"I think one of the fears is you're going to have a virus that you're not looking for that could blindside us. COVID-19 is a good example of a virus that we weren't looking for and all of a sudden showed up," said Curtis.
Scientists at eGenesis use gene-editing technology on the pig kidneys, which enables them to edit parts of the pig's genome by removing, adding or altering sections of the DNA sequence to add specific human genes to improve organ compatibility with humans. They also remove harmful pig genes and eliminate antigens that cause the immune response that leads to organ rejection.
Curtis says most of his team's efforts are dedicated to controlling zoonosis, which is diseases or infections caused by pathogens naturally transmitted between animals and humans. Curtis says there are always risks and unknowns when it comes to experimental therapies and that patients must balance risk against potential benefits.
Fisher is hopeful about the advancements but is concerned about how Lemieux's body would respond to a pig kidney transplant because undergoing the surgery would trigger the immune response to increase antibody protections.
"There would still be certain things that he needs to watch, but it would give him his life back," said Fisher.
Audio produced by Paul MacInnis and Amanda Grant
