Insights gained from genetically modified pig heart transplantation

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Insights gained from genetically modified pig heart transplantation
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Insights gained from genetically modified pig heart transplantation TheLancet geneticallymodifiedpigheart geneticallymodified GM pigheart xenozoonosis zoonosis

By Neha MathurJul 3 2023Reviewed by Lily Ramsey, LLM In a recent case report published in The Lancet, researchers described a genetically engineered pig cardiac xenotransplantation in a 57-year-old male patient with end-stage heart failure. This highlighted factors that might help improve xenotransplant outcomes in the future.

About the study In the present study, researchers extensively monitored the patient in an intensive care unit to gather all physiological and biochemical parameters critical for caring for all heart transplant recipients. The endomyocardial biopsy on postoperative day 50 uncovered that fluid and red blood cells accumulated with few inflammatory cells in the interstitial space. Then, by day 56, fibrotic tissue replaced the interstitial edema over time, leading to rare thrombotic microangiopathy and complement deposition.

Related StoriesHe had significant amounts of B and T lymphocytes in the mediastinal lymph node after two days of immunosuppression therapy, indicating incomplete induction; yet, the results of B-cell phenotyping were inaccurate because of interference by plasma cells and few circulating B cells. Since the minimum efficacious KPL-404 dose in humans in transplant settings is unknown, the researchers attempted to deliver its highest concentration to this patient while accounting for extrinsic factors.

However, the observation that the patient's serum had high concentrations of anti-pig IgG and its increased binding on immunohistochemistry suggested an exogenous IgG source. So, they performed a few complement assays to accurately interpret the complement pathway's role in xenotransplantation and its rejection. However, due to a lack of tissue availability and proper controls, these assays could not fetch convincing results about the autologous role of C3.

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