Can Pigs Solve the Shortage of Heart Donors?
In recent years, the demand for organ donors, more specifically heart donors, has outnumbered the number of available hearts qualified for transplantation. When a patient’s organ has failed, that same organ in a healthy state from another individual can be put into, or transplanted in, the patient’s body. Transplantation saves the lives of many individuals, but a lack of available organ donations means that many patients are forced to wait indefinitely for a healthy organ. The transplantation of an organ between two individuals of the same species is called allotransplantation, whereas organ transplantation between individuals of different species is called xenotransplantation. As such, there is a shortage of hearts for allotransplantation between humans. But what about hearts from porcine animals or pigs for xenotransplantation into humans?
Scientists have been working on the finer details of porcine xenotransplantation by transplanting porcine hearts into baboons instead of humans. One of the many obstacles they needed to overcome was the number of genetic modifications. Even with human allotransplantation, one of the biggest concerns is the host body, or the recipient’s body, rejecting the donated organ, which can lead to complicated health issues. However, with xenotransplantation, scientists can make genetic modifications to the donated organ before transplantation to reduce the likelihood of organ rejection. For example, one reason for organ rejection is organ overgrowth. As such, one of the many goals of genetic modification was to interfere with the growth hormone to prevent the organ from overgrowing after transplantation. With too many genetic modifications, it is hard to prevent unpredicted interactions between different modifications, but not enough modifications increases the risk of organ rejection. After many trials, scientists found that three genetic modifications to the pig heart were the most effective at satisfying their numerous goals.
Scientists have been working on the finer details of porcine xenotransplantation by transplanting porcine hearts into baboons instead of humans. One of the many obstacles they needed to overcome was the number of genetic modifications. Even with human allotransplantation, one of the biggest concerns is the host body, or the recipient’s body, rejecting the donated organ, which can lead to complicated health issues. However, with xenotransplantation, scientists can make genetic modifications to the donated organ before transplantation to reduce the likelihood of organ rejection. For example, one reason for organ rejection is organ overgrowth. As such, one of the many goals of genetic modification was to interfere with the growth hormone to prevent the organ from overgrowing after transplantation. With too many genetic modifications, it is hard to prevent unpredicted interactions between different modifications, but not enough modifications increases the risk of organ rejection. After many trials, scientists found that three genetic modifications to the pig heart were the most effective at satisfying their numerous goals.
Scientists are considering the possibility of using porcine hearts to solve the shortage of human heart donors that limits the availability of heart transplantation.
Image Source: National Cancer Institute
A second challenge for porcine xenotransplantation is preventing the transmission of diseases from the pig to the human recipient. Failure to properly overcome this challenge could, at its worst, result in a pandemic like the current COVID-19 pandemic. One advantage of xenotransplantation is that any microorganisms that can potentially cause diseases are screened for in advance. Additionally, the pigs are bred under clean conditions in order to eliminate the microorganisms. Therefore, scientists suspect that xenotransplantation may be safer than allotransplantation due to the strict surveillance and sanitary conditions that the pigs would be raised in.
Figuring out how to match patients to porcine hearts is the last challenge described in the article. Having a high compatibility between the donor and the recipient is important for long term efficacy in both allotransplantation and xenotransplantation. One proposed method is to crossmatch the organ recipient’s serum against the donor’s cell to identify if it is a good match. Scientists would screen for any signs of antibodies in the recipient that could potentially cause organ rejection. More complicated cell matching tests would be conducted by scientists before transplantation to maximize the compatibility between the porcine donor and the human recipient.
After significant research and numerous experiments, xenotransplantation between porcine animals and humans may soon enter mainstream medicine as a solution to the shortage of heart donors. However, before this can occur, strict regulations and practices must be put into place by administrative organizations such as the World Health Organization (WHO) and the U.S. Food and Drug Administration (FDA). Proper legislation is also a necessity that may take longer to enact after xenotransplantation has been approved. Although it may take time, robust legislation and tight regulations for xenotransplantation are necessary to maintain ethical practices and ensure the safety of donors and recipients.
Figuring out how to match patients to porcine hearts is the last challenge described in the article. Having a high compatibility between the donor and the recipient is important for long term efficacy in both allotransplantation and xenotransplantation. One proposed method is to crossmatch the organ recipient’s serum against the donor’s cell to identify if it is a good match. Scientists would screen for any signs of antibodies in the recipient that could potentially cause organ rejection. More complicated cell matching tests would be conducted by scientists before transplantation to maximize the compatibility between the porcine donor and the human recipient.
After significant research and numerous experiments, xenotransplantation between porcine animals and humans may soon enter mainstream medicine as a solution to the shortage of heart donors. However, before this can occur, strict regulations and practices must be put into place by administrative organizations such as the World Health Organization (WHO) and the U.S. Food and Drug Administration (FDA). Proper legislation is also a necessity that may take longer to enact after xenotransplantation has been approved. Although it may take time, robust legislation and tight regulations for xenotransplantation are necessary to maintain ethical practices and ensure the safety of donors and recipients.
Featured Image Source: Forest Simon
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