Pig heart transplant failed as its heart muscle cells died
arstechnica.com
arstechnica.com
I'm not a medical professional. But I have been present and watched multiple people of systemic failures.
You first try the new, experimental drug on people who may die soon anyways, before you hand it out like smarties at the local drugstore.
The international xenotransplantation community found out about David Bennett's heart transplant through the news, and some people feel as though competition between groups may have contributed to a lack of sharing of clinically relevant information that could have benefited Mr. Bennett.
While you can soften the failure by highlighting the patient's broad systemic issues, this is still a notable failure that will likely put a damper on future similar pig transplants.
I should hope not. Not everything works first time. Hopefully it gives data such that the next one works for 16 weeks, and the one after that for 3 months, until this is a standard source of transplant organs.
Not sure that’s a good trade for the pig though.
Don’t misunderstand me, I love meat, and while I think that killing pigs (at least someone else killing pigs) is acceptable for that purpose, I would have a harder time justifying killing a whole pig to keep someone alive a little longer. For the same reasons we don’t just raise humans as cattle to use as organ transplant sources. We tell ourselves that it is acceptable with pigs, and while this certainly makes it easier on the humans (and they grow faster), I’m not sure it’s fundamentally different.
I'm a little baffled by your ethical calculus here. Raising pigs for muscle to eat seems substantially less ethical than raising pigs for organs to transplant; you can eat plant-based alternatives, but good luck pumping blood with a soybean.
Is the idea that they should have it all worked out before they even try it?
The first human heart transplant was successful for a little less than three weeks, until the patient died of systemic organ failure. That procedure is historically regarded as wildly successful.
A team of medical scientists did something even more amazing. This procedure was a success. The next one will be better.
7 weeks doesn’t sound like long, but a great many things needed to work for the patient to survive even 1 week.
So no, the first transplant didn't "fail even sooner" because it wasn't the heart that failed.
Before human heart transplantation was available, you could pick someone with severe heart disease but otherwise in good condition as a test candidate. It was entirely ethical; they'd die without the transplant anyways.
Now that we have viable human heart transplantation, you have to pick sicker patients as candidates - people who wouldn't survive even if they got a human heart transplant. Giving someone who'd survive with a human heart an experimental pig heart isn't ethical.
It makes sense that the failure model would be different.
I mean if we do have enough human hearts to transplant into anyone who needs it I suppose that's a good thing, but all I hear about transplants is how long the wait times usually are for human organs.
Which means if someone has stage 4 cancer etc they aren’t on the list.
“After Washkansky’s surgery, he was given drugs to suppress his immune system and keep his body from rejecting the heart. These drugs also left him susceptible to sickness, however, and 18 days later he died from double pneumonia.”
We can try a couple a year, steadily improving until we ultimately get lucky and someone's life is significantly extended.
That’s the point.
Validating that it's possible allows for carefully expanding to the patients not undergoing massive multi-system organ failure at the time.
[edit]
A 57-year-old man with chronic mild thrombocytopenia, hypertension, nonischemic cardiomyopathy, and previous mitral valve repair was hospitalized for severe heart failure with a left ventricular ejection fraction (LVEF) of 10%. His care was escalated to include multiple intravenous inotropic agents, and the placement of an intraaortic balloon pump was added on hospital day 11. Despite these measures, he had multiple ventricular arrythmias with arrests leading to resuscitation and began to receive peripheral venoarterial extracorporeal membrane oxygenation (ECMO) on hospital day 23.
Sad.
As a society we need to think about the ethics implications of using this technique to save some lives while dramatically increasing the risk of zoonotic viruses which will impact many others.
Except the pig still got porcine CMV from somewhere.
> the researchers indicate there's some question about whether the tests that picked it up might have been recognizing a closely related human virus
> The presence of an apparent pig cytomegalovirus was worrying, but the researchers indicate there's some question about whether the tests that picked it up might have been recognizing a closely related human virus—one that's often associated with organ transplant problems.
Perhaps because it involved a pig heart, not a human heart? If this is new territory, I see no reason to expect failure to follow "typical" patterns.
Perhaps in some cases the organ contains unidentified infective agents, thus the typical pattern with white blood cells etc.
Perhaps in this case the body decided it was straight up foreign matter and the process of failure was fundamentally different.
1. This is uncharted territory.
2. My understanding is we don't actually understand "normal" rejection all that well to begin with.
If we don't know how and why rejection occurs to begin with, we have no reasonable means to distinguish it from some other type of failure.
But I shall stop annoying professionals with my amateur opinions here.
Have a good day.
The guy died.
Anyway, trying to walk away from this particular thread.
"We don't see signs that this person was shot in the head"
DoreenMichele: Getting shot in the head leads to death. The guy died.
It sounds like this was actually quite successful in that the immune system didn’t immediately start attacking it, as would be the case with a normal pig heart.
It's foreign matter, not really part of a living body.
Very likely, they probably also attract infections that like eating plastics and such. These are inherently hard for the human body to combat if they get traction, from what I gather. They aren't a normal infection in humans and tend to be deadly when they do take root.
Hearts are critical infrastructure in the body, with 100% uptime requirements and not-insignificant energy consumption.
https://syncardia.com/clinicians/our-products/freedom-portab...
However, how does it make any financial sense? This one of those things that makes sense to cut when you start talking universal healthcare, right?
I wish there was more emphasis on helping people keep their original equipment from the manufacturer, so to speak.
Transplanting a kidney or liver into a 20 year old has more of my support than transplanting a heart into an 85 year old.
Systems that use QALYs still often end up considering organ transplants a viable treatment.
And then you take immunosuppressive drugs the rest of your life.
https://www.chron.com/neighborhood/katy/news/article/The-cos...
Also, bear in mind the FTA is about an artificially engineered pig heart, not a human heart.
In relation to this article, part of the genetic engineering of the pig is to try to not just have a human not reject it, but possibly to end up having the pig heart be less likely to reject than a human heart.
If the chance of rejection can be reduced, that means fewer drugs over time, and lower cost to a universal healthcare system.
Also, reliable transplantation would reduce long term traditional healthcare costs. For example, in the US dialysis is basically the one procedure with universal healthcare. If kidney transplantation was readily available with a low risk of rejection it could actually save the US a lot of money at this point.