Author: Nikki Jiang
Editors: Jaylen Peng and Chiara Chen
Artist: Lalita Ma
Your kidneys are a set of bean-shaped organs that filter waste and water out of your blood. This crucial cleansing process results in the production of urine and the elimination of waste from the body. Within the kidneys, millions of filtering units called nephrons clean the blood through a network of capillaries and specialized cells. When the nephrons come into contact with blood, they separate waste products from valuable substances. Thus, the kidneys are essential to maintaining the body’s equilibrium and proper function.
What happens when your kidney is no longer functioning?
The rapid progression of kidney disease may lead to kidney failure, where the resulting accumulation of waste products and excess water in the body becomes toxic. Extreme cases of kidney disease require a kidney transplant, in which a newly donated kidney is attached to the body. This new kidney can ideally replace the function of the damaged kidneys; however, this is not without risk. Like all organ transplants, rejection of foreign tissue is a significant concern in kidney transplants. Additionally, kidney transplants are highly inaccessible due to a global shortage of kidney donations, which means patients on the kidney transplant list may wait up to 5 years to receive the transplant. According to the United Network for Organ Sharing (UNOS), there are currently over 106,000 patients on the national transplant list, and 87% are waiting for a kidney transplant. In 2022, around 808,000 people will have end-stage kidney disease, where a transplant would be life-saving, yet only 26,000 people will be able to receive a kidney transplant. People are dying due to an insufficient supply of organs, but that problem may soon be resolved.
Recently, a dedicated group of surgeons and scientists at the NYU Langone Transplant Institute may have discovered a solution to the kidney shortage: pigs. Xenoplantation, or transplantation of cells, tissues, or organs from a non-human source into a human recipient, has emerged as a promising solution to organ shortages in recent years. The question has been how to trick the human body into accepting a non-human cell as its own. The answer? Remove the singular gene responsible for the rapid rejection of foreign cells, and prevent immediate rejection of the pig organs. Additionally, embed the pig thymus gland under the transplanted kidney to train the body to recognize the kidney. These essential modifications have been shown to successfully prevent organ rejection during transplantation.
The surgery, led by Dr. Montgomery on July 14, 2023, demonstrated that a pig kidney could replace the function of a human kidney for over a month without being rejected. This was the fifth xenotransplant performed at NYU Langone and has shown the most promising results, with the potential to change the fate of those with late-stage kidney diseases and save millions of lives. A great deal of fine-tuning and testing is needed before the pig liver xenotransplant becomes widely applied, but the work done by Dr. Montgomery and his transplant team is a major step toward progress. The Food and Drug Administration (FDA) has already approved the use of pig liver in human transplantation. Soon, it may be coming to a hospital near you!
Citations:
“Pig Kidney Xenotransplantation Performing Optimally after 32 Days in Human Body.”
NYU Langone News, 2023, nyulangone.org/news/pig-kidney-xenotransplantation-
performing-optimally-after-32-days-human-body. Accessed 29 Sept. 2023.
“Transplant Waiting List.” American Kidney Fund, 15 June 2022,
www.kidneyfund.org/kidney-donation-and-transplant/transplant-waiting-list.
Accessed 29 Sept. 2023.
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