[HN Gopher] Surgeons transplant pig kidney into a patient
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Surgeons transplant pig kidney into a patient
Author : jonwachob91
Score : 77 points
Date : 2024-03-21 13:42 UTC (9 hours ago)
(HTM) web link (www.nytimes.com)
(TXT) w3m dump (www.nytimes.com)
| stainablesteel wrote:
| quite impressive, there must have been an insane amount of work
| that went into this
|
| the forecasting market should capitalize on if someone dies who
| is it or who dies first? this guy or the neuralink patient
| superzamp wrote:
| Alternatively, let's wish the best to both of them.
| ilc wrote:
| That merely means go long on them :)
| huytersd wrote:
| It doesn't mention the most important thing. Does he have to take
| immunosuppressants? If so is it for the rest of his life.
| eadmund wrote:
| I don't feel like that's the most important thing. If we can
| farm kidneys for folks with kidney failure, rather than rely on
| a combination of the kindness of live donors and harvesting
| organs from corpses, it will be a _huge_ step forward, even if
| recipients still need immunosuppressants (as they do with human
| organs).
|
| I do wonder if the immunosuppressants for cross-species organs
| have to be stronger/nastier than for intra-species organs
| though.
| huytersd wrote:
| I didn't realize you had to take lifelong immunosuppressants
| with human organs as well. That makes this indistinguishable,
| provided it keeps working.
| ejolto wrote:
| I'm curious, when did you think patients had to take
| immunosuppressants?
| Fomite wrote:
| There's also a number of autoimmune diseases out there...
| mschuetz wrote:
| Immunosuppressants are very commonly used for various
| diseases that are caused by overreactions or undesired
| reactions of your immune system. Glucocorticoids, for
| example, are very widespread for all sorts of stuff
| (rashes, asthma, allergies, inflammations, ...).
| Monoclonal antibodies are also getting popular as a way
| to treat allergic reactions by means such as "killing"
| your IgE antibodies (They're basically antibodies that,
| in this instance, are used against your own body's
| antibodies).
| huytersd wrote:
| Autoimmune diseases like lupus
| vannucci wrote:
| It does at the end of the article: "The procedure was performed
| under a Food and Drug Administration protocol known as a
| compassionate use provision, which is granted to patients with
| life-threatening illness who might benefit from an unapproved
| treatment. New drugs to suppress the immune system and prevent
| rejection of the organ were also used under the protocol."
| martinky24 wrote:
| It does mention that? Read the whole article.
| mhalle wrote:
| Anyone who gets a transplant needs to take immunosuppressants
| for the rest of their life (except some older patients with
| liver transplants many years post transplant).
|
| In general for many patients, immunosuppressants have
| relatively little impact on daily life.
|
| Source: liver transplant recipient.
| deanc wrote:
| Many immunosuppressed patients will disagree. Viruses hit
| harder and can often require antibiotics (not a good idea
| long term). And Covid/Flu/Noro is a constant risk to
| immunosuppressed people.
|
| Source: son of a transplant patient.
| office_drone wrote:
| https://archive.is/gzSFf
| msie wrote:
| Very promising!!!
| martinky24 wrote:
| It's hard for me to imagine the bravery it takes to sign up for
| this -- even if you're dying already, something like this is
| unlikely to result in a peaceful final days on earth (between
| being a science experiment, the media, optional major traumatic
| surgery, etc...). The folks undergoing this are incredibly
| admirable.
| thefounder wrote:
| The alternative is certain death so not a lot to choose from
| Rinzler89 wrote:
| All death is certain. And taxes.
| kerkeslager wrote:
| Disagree. The "choose life at any quality of life" ideology
| causes immense suffering.
|
| Ideally in the long run, this is a step in the direction of
| keeping people alive _with_ a higher quality of life, but
| that 's unlikely to be this first person's experience.
| acchow wrote:
| Doctors (and society) should not be encouraging this
| mentality.
|
| But individuals surely have the freedom to think like this
| and make decisions accordingly.
| hsbauauvhabzb wrote:
| Don't many religions encourage the complete opposite
| mentality? Shouldn't they be censored also?
| dr8eirkif7 wrote:
| Why? My doctor's job is to give me health advice and
| treatment not moral advice. And it's none of society's
| business so really they shouldn't be chiming in anyway.
| LeifCarrotson wrote:
| Sure, but is a low quality life worse than oblivion? Even
| if you're not 25 and healthy and wealthy and happy, I think
| life is still worth living.
|
| Plus, if the suffering experienced by this patient helps
| cause someone else (or many someones else for centuries to
| come) to have a higher quality of life, one person's
| suffering can buy a lot of QALYs.
|
| Alternatively if as my mother tells me, I'm doomed to an
| eternity of unimaginable physical and psychological torture
| by supernaturally powerful fallen angelic beings with
| complete control of my entire sensorium, even a few more
| minutes of being hooked up to a hospital bed with doctors
| trying to make things better are preferable to that!
| mxkopy wrote:
| This viewpoint comes about from a lack of
| empathy/knowledge of the type of pain that would want
| someone to seek death.
|
| As a general rule of thumb, trying to decide someone's
| own stream of consciousness is assholeish behavior.
| 3D30497420 wrote:
| I'd wager such choices are highly personal, and different
| people will weigh things differently. I've seen quotes from
| people undergoing dangerous and highly experimental
| treatments stating that they felt happy to help medicine
| learn, even at significant cost to themselves. The patient
| in this case said much the same.
|
| Nonetheless, I do generally agree with you. I've seen
| several articles about how doctors die very differently
| than most people (they often have DNRs and far fewer end-
| of-life interventions).
| lr1970 wrote:
| > The alternative is certain death so not a lot to choose
| from.
|
| Human kidney transplants (both cadaveric and from a living
| donor) have been a common operation for many years.
| gpm wrote:
| The article addresses this. The patient previously had a
| human kidney transplant in 2018, which failed sometime in
| (reading slightly between the lines) 2023, as well as
| having other health issues. Another human Kidney wouldn't
| have been made available to him for five to six years, and
| his doctors didn't believe that he would live that long.
|
| I still think it counts as brave though, certainly not an
| easy choice.
| quasarj wrote:
| If you actually read the article, it goes into details
| about why he's ineligible for a normal transplant and also
| why his dialysis is failing.
| ilrwbwrkhv wrote:
| The patients, the nurses, the surgeons, doctors, researchers.
|
| Literally magic. The Indian god Ganesha for example has a head
| of an elephant and we humans are doing something similar.
|
| What an amazing species we are when we are doing something
| positive.
| Ekaros wrote:
| What happens to other parts from these genetically modified pigs?
| Can some be used for other transplants? Can rest be eaten?
| huytersd wrote:
| I don't think you'd want to eat severely genetically modified
| pigs though. Who know what kinds of viruses can make the jump
| to humans in a chimera like that. Ideally those pigs would be
| kept in some kind of sterile biohazard location and their
| bodies would ideally be incinerated afterwards.
| hsbauauvhabzb wrote:
| Do we also do that to the organ recipient?
| huytersd wrote:
| Well the organ recipient's body is now an incubation
| chamber for pig human virus crossovers. But it's a human,
| so we deal with the risks. Hopefully he doesn't deal with a
| lot of pigs on a daily basis.
| quasarj wrote:
| I have CKD and need a transplant. I'm keeping an eye on this
| progress. I hope I get to eat the rest of the pig when I wake
| up from the surgery, myself. Mmmmm bacon!
| wiz21c wrote:
| I remember this; didn't last long :-(
|
| https://www.npr.org/2022/03/09/1085420836/pig-heart-transpla...
| reocha wrote:
| Different cases and different organs
| John23832 wrote:
| If successful, this is great. However, I would like to see how
| long this lasts. I can recall seeing similar stories with either
| a rejection at the end, or some negative outcome for the patient.
| quesera wrote:
| Even if not successful, it's fascinating and a necessary step
| along the way to something that is successful.
|
| Good luck to the guy though!
| adamredwoods wrote:
| The hearts lasted weeks, about 2 months. The test primate for
| the kidney lasted 2 years, which would be impressive.
| candiddevmike wrote:
| How many times can you receive a transplant for the same
| organ? Does scar tissue for at the transplant site?
| mikeInAlaska wrote:
| Speaking for liver transplants, they are a many hour
| traumatic affair. My daughter lost and received more than
| her entire blood volume during hers. Initial recovery is
| extremely immunosuppressed and some of the drugs we had to
| handle with masks and gloves, and had 4x a day medication
| schedules. So you couldn't burn through pig livers I
| believe getting them swapped frequently. My daughter
| received her liver at age 8 months by the way and is now 19
| yrs old.
| josephst18 wrote:
| For renal transplants - not sure if there's an upper limit,
| although each subsequent transplant becomes a more
| difficult match (as antibodies build up) and eventually may
| have to remove previous transplants. Generally renal
| transplants go in the right or left groin with native
| kidneys left in place. If one transplant fails, a
| transplant to the opposite side may be attempted, or a
| different location (such as intra-abdominal). Otherwise,
| will need to explant the first transplant
| lokar wrote:
| The old kidneys tend to shrink quite a bit
| quesera wrote:
| It's impossible for me to see this as anything but an amazing
| development.
|
| But the sentient-pig SF horror genre pretty much writes itself.
| whythre wrote:
| ... does it? It's a kidney, not a brain. Brain transplants from
| a pig seem like a pretty obviously bad idea.
| quesera wrote:
| Sorry, overcomplicating English syntax:
|
| The ... SF horror genre, as written by sentient pigs ...
| pretty much writes itself.
| egorfine wrote:
| But you never know until you try.
| adamredwoods wrote:
| Quite amazing! Doubtful we'll see any Animal Farm animals. The
| modified genes are for mostly endothelial modifications.
|
| >> The Yucatan miniature pig breed was chosen because its organ
| sizes are comparable to human organs28. In addition, pigs with
| OO blood type were selected to eliminate ABO blood-type
| incompatibilities29.
|
| >> The pigs were engineered to carry 69 genomic edits, using
| the clustered regularly interspaced short palindromic repeats
| (CRISPR) and CRISPR-associated protein 9 (Cas9)-mediated
| nonhomologous end joining and homology-directed repair30,31,
| and recombinase-mediated cassette exchange.
|
| https://www.nature.com/articles/s41586-023-06594-4
| kurthr wrote:
| Oh, where the sentient pigs have set this all up, but for
| reverse kidney transplants from humans to pigs, and we pay for
| it?
| TrinaryWorksToo wrote:
| It's easy to transplant a pigney into a human. The hard part is
| keeping them alive afterward, especially in the long term. It
| seems like the event is not far enough in the past to know.
| y04nn wrote:
| I would like to have more details on the list of genetic
| modifications needed to make the kidney implantable in an human
| without being rejected/attacked by the immune system.
| kovacs_x wrote:
| I'm sure (99.9%) its patented, so you can find and read those
| patents. i expect there should also be a list of publications
| in it what it was based on. its probably heavy biology /
| chemistry though (i know, as I've been researching other gene
| modification patent stuff before)
| kovacs_x wrote:
| imo only way forward (in broad terms) is taking ones cells,
| fixing dna/genes, growing cells as neccesary and transplanting
| them back and having valid cells of your own making.
|
| everything else is just suffering and living with "incompatible"
| parts.
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