[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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