Xenotransplantation

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If this takes off, maybe we'll be able to do major organ transplants during normal business hours, and not in the middle of the night.
 
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They picked a relatively younger person who wasn’t status 1 for transplant to try to optimize the outcome. I agree we’ll see how he does but if he survives even a few years this is huge.
 
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chessknt said:
They picked a relatively younger person who wasn’t status 1 for transplant to try to optimize the outcome. I agree we’ll see how he does but if he survives even a few years this is huge.
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I think in one of the UMMC videos Griffith says the guy was on VA-ECMO and before that on an IABP.
 
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vector2 said:
I think in one of the UMMC videos Griffith says the guy was on VA-ECMO and before that on an IABP.
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Ah missed that the news stories interviewing him made him sound like an ambulatory outpatient. If he has a good medium to long term outcome that is even better news then.

I honestly have mixed feelings about this—the costs will be astronomical if we suddenly can do unlimited transplants but it has always seemed very harsh to be in a waitlist to be in the worst possible shape before you qualify not knowing if you’ll die or not before it happens and making recovery that much harder.
 
chessknt said:
Ah missed that the news stories interviewing him made him sound like an ambulatory outpatient. If he has a good medium to long term outcome that is even better news then.

I honestly have mixed feelings about this—the costs will be astronomical if we suddenly can do unlimited transplants but it has always seemed very harsh to be in a waitlist to be in the worst possible shape before you qualify not knowing if you’ll die or not before it happens and making recovery that much harder.
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The gene editing is very cool but you're right about the cost. The way out of end-stage HFrEF is through advancements in either mass-produced regenerative stem cells (big failure so far in trials), or durable VADs and BiVADs with (eventually) subq batteries that can be recharged inductively through wireless transmission.
 
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vector2 said:
The gene editing is very cool but you're right about the cost. The way out of end-stage HFrEF is through advancements in either mass-produced regenerative stem cells (big failure so far in trials), or durable VADs and BiVADs with (eventually) subq batteries that can be recharged inductively through wireless transmission.
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Pulmonary medicine has the honor of being the shepherd of the worst outcomes of any transplanted organ (discounting small bowel). I’m not worried about a huge influx of pig lung transplants any time soon…
 
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chessknt said:
Pulmonary medicine has the honor of being the shepherd of the worst outcomes of any transplanted organ (discounting small bowel). I’m not worried about a huge influx of pig lung transplants any time soon…
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Speaking of which, the behemoth health system in my area just lost its lung transplant cert in the last couple years. Lowish volumes, really bad outcomes.
 
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idk how much more expensive itd be compared to this guy sitting in a hospital until he dies. report says he agreed to do this because his other option was never leaving the hospital
 
anbuitachi said:
idk how much more expensive itd be compared to this guy sitting in a hospital until he dies. report says he agreed to do this because his other option was never leaving the hospital
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That isn’t true… people are allowed to die when they have a terminal disease and not just sustained on ecmo forever.
 
chessknt said:
That isn’t true… people are allowed to die when they have a terminal disease and not just sustained on ecmo forever.
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But in the interview, the surgeon says the patient stated that he wanted to live.
 
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chessknt said:
That isn’t true… people are allowed to die when they have a terminal disease and not just sustained on ecmo forever.
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nimbus said:
But in the interview, the surgeon says the patient stated that he wanted to live.
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News comes out now, that the recipient stabbed a man 7 times in the past, served a prison sentence. The man he stabbed, "Edward Shumaker had spent the next 19 years in a wheelchair, before he had a stroke in 2005 and died two years later - one week before his 41st birthday." which caused Shumaker's brother to be filled with guilt "He blamed himself for having dropped Shumaker off at the bar that night and for being unable to prevent his paralysis. Eventually, he became addicted to opioids, dying in 1999 of an overdose. He was 28."



www.yahoo.com

He once stabbed a man seven times. Now he's a pig heart transplant pioneer.

Leslie Shumaker Downey was at home babysitting her two grandchildren Monday when a message pinged on her cellphone. Her daughter had sent a link to a news article about a 57-year-old man with terminal heart disease. Three days earlier at the University of Maryland Medical Center, he'd received a...
www.yahoo.com www.yahoo.com
 
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I read the guy was non compliant with meds and doctors f/u in the past. I'm surprised they agreed to transplant a non compliant patient. Also, does anyone have any idea what a year of immunosuppressants costs?
 
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Angus Avagadro said:
I read the guy was non compliant with meds and doctors f/u in the past. I'm surprised they agreed to transplant a non compliant patient. Also, does anyone have any idea what a year of immunosuppressants costs?
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So he wouldn’t have qualified for a human donor heart. Maybe they agreed because it’s a pig heart and it’s a science experiment.
 
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nimbus said:
So he wouldn’t have qualified for a human donor heart. Maybe they agreed because it’s a pig heart and it’s a science experiment.
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This. They’re not going to give a pig heart to someone who is otherwise status 1 for a human heart. They’ll wait for the human donor to become available.
 
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When I first read the story, I thought it was kind of ironic. This is sad.

www.dailymail.co.uk

Muslim doctor behind pig heart transplant faces backlash from family

His family asked him 'why are you using this animal?' and questioned why another species wasn't an option. The doctor sought religious counsel from multiple scholars before conducting the transplant.
www.dailymail.co.uk www.dailymail.co.uk
 
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Any update on how the patient is doing? The above article Nimbus posted says that he’s “recovering and doing well” but doesn’t cite any sources or give more details.

Fascinated to see how this will play out- if it pans out, could signal a sea change in the way we approach end stage heart failure (or kidney failure or liver failure…)
 
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nimbus said:
When I first read the story, I thought it was kind of ironic. This is sad.

www.dailymail.co.uk

Muslim doctor behind pig heart transplant faces backlash from family

His family asked him 'why are you using this animal?' and questioned why another species wasn't an option. The doctor sought religious counsel from multiple scholars before conducting the transplant.
www.dailymail.co.uk www.dailymail.co.uk
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I particularly like this sentence.

“'The final consensus was that there's nothing greater in the eyes of God than saving the life of a human,' he said, recalling the response of numerous scholars”

This can apply to so many other problems that we are dealing with currently….. yes, look at those of you, who believes otherwise.
 
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I looked for info but not many updates. Still concern about rejection. Doesn’t say if he’s off ecmo yet.
 
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Hork Bajir said:
.

Fascinated to see how this will play out- if it pans out, could signal a sea change in the way we approach end stage heart failure (or kidney failure or liver failure…)
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Only if the tech somehow scales up so the cost is reduced by like 90%
 
nyti.ms

Patient in Groundbreaking Heart Transplant Dies (Published 2022)

David Bennett Sr. had received a heart from a genetically modified pig, a procedure that may yet offer hope to millions of Americans needing transplants.
nyti.ms nyti.ms

Sad, but not surprising. Photos from last month looked to me like he was on CRRT, so... hasn't been doing well for some time.
 
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ToliBro said:
nyti.ms

Patient in Groundbreaking Heart Transplant Dies (Published 2022)

David Bennett Sr. had received a heart from a genetically modified pig, a procedure that may yet offer hope to millions of Americans needing transplants.
nyti.ms nyti.ms

Sad, but not surprising. Photos from last month looked to me like he was on CRRT, so... hasn't been doing well for some time.
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Unfortunate but I think it opens the door for this exciting new area for transplant which will hopefully save many lives in the future
 
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Hopefully things will improve as we learn more over time. Average heart transplant recipient lives about 10yrs. About 20% survive 20 yrs. And those numbers have been improving.
 
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I couldn’t find the cause of his death in any of the news articles. Hopefully its not due to rejection otherwise patients will be reluctant to get a xenotransplant.
 
Nephro critical care said:
I couldn’t find the cause of his death in any of the news articles. Hopefully its not due to rejection otherwise patients will be reluctant to get a xenotransplant.
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It's interesting to think about. Ive seen quotes of the heart functioning well a month into his post-operative course. Which would argue against some sort of rejection in that time frame, though a biopsy would likely be needed.

It does open a whole host of other issues though such as high-output cardiac failure, anastomotic considerations and also the differences in porcine vs human physiology.
 
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I can imagine it now. Transplant surgeries during daylight hours….After the organs are harvested, the rest of the pig goes into a pit in the ground to cook…. Transplants finish roughly around dinner time….surgical team can enjoy a pit roasted pig together.
 
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Ronin786 said:
It's interesting to think about. Ive seen quotes of the heart functioning well a month into his post-operative course. Which would argue against some sort of rejection in that time frame, though a biopsy would likely be needed.

It does open a whole host of other issues though such as high-output cardiac failure, anastomotic considerations and also the differences in porcine vs human physiology.
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Just think, all the arrogant BS my DVM physiology professor from college said about physicians only taking care of one species may no longer be so true.

0kazak1 said:
I can imagine it now. Transplant surgeries during daylight hours….After the organs are harvested, the rest of the pig goes into a pit in the ground to cook…. Transplants finish roughly around dinner time….surgical team can enjoy a pit roasted pig together.
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Best, Idea, Ever!
 
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0kazak1 said:
I can imagine it now. Transplant surgeries during daylight hours….After the organs are harvested, the rest of the pig goes into a pit in the ground to cook…. Transplants finish roughly around dinner time….surgical team can enjoy a pit roasted pig together.
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Nothing wasted!
 
0kazak1 said:
I can imagine it now. Transplant surgeries during daylight hours….After the organs are harvested, the rest of the pig goes into a pit in the ground to cook…. Transplants finish roughly around dinner time….surgical team can enjoy a pit roasted pig together.
Click to expand...
The pig is gene edited with human genes to reduce rejection. Is it cannibalism light?
 
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They’ll never say the pig heart failed. Unless pathology shows rejection in which case it submarines the field before it ever takes off.

It’s easy to put your flows at 2lpm and do an echo that shows “good function”. But he was on ECMO for a month right? Probably died of any of the typical things that people on VA die of. But the question remains, why couldn’t he wean off ECMO?
 
Fascinating grand rounds from the surgeon a year later. Talks about the post op course and some of the wild immunologic and infectious problems they faced.

 
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