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Pedro Baptista, researcher at IIS Aragón and general secretary of the European Society of Artificial Organs, evaluates the first transplant of a pig's kidney to a brain-dead patient carried out in New York. "It is undoubtedly a first step to give hope; it will help someone who is very sick," he says.
Animals "have the potential to be a sustainable and renewable source of organs". This is how emphatic the Dr. Robert Montgomery, in statements to the American newspaper 'The New York Times', after perform -together with his medical team- first transplant of the world of kidney from a genetically modified pig to a human. Although the news has now emerged, the operation took place on September 25 in a New York hospital and it was possible that the organ will work for 54 hours in a brain-dead woman.
For Montgomery, of NYU Langone Hospital, the biggest problem that arises in transplants is that there are not enough organs available. "This is a transformative moment in the history of medicine, which could lead to the donation of organs from a deceased person not being needed to save the life of another person," she said during a virtual appearance before the press.
However, the founding partner of the spin-off company Beonchip considers that it is "very far" from using them as an alternative to normal transplants. "He has been a hours essay; We don't know the long-term answers. And we must not ignore the ethical component of the animal aspect," says Ochoa, which in his opinion opens the possibility that it could be considered as a "last option" in "very desperate" cases.
Likewise, the I3A researcher refers to the step taken by Robert Montgomery as "a bridge" between human transplants that are currently being carried out and tissue engineering. "Where all the animal's cells are human and the problem of cross-disease is avoided," she emphasizes.
On the other hand, researchers from the I3A-University of Zaragoza (among which is Ochoa), the Aragón Health Research Institute (IIS Aragón) and Beonchip participate in a European project to advance towards personalized medicine. Specifically, they work on recreating the skin in the most realistic way possible to study its conditions and increase the safety of topical products.
Two great barriers
One of the people who works in the Community in tissue engineering is Pedro Baptista, researcher at IIS Aragón and elected at the end of 2020 new secretary general of the European Society of Artificial Organs. This outstanding scientist highlights two problems when addressing the transplant of animal organs into humans: that related to rechazo ("within minutes or hours there is massive coagulation of that organ, it has a thrombosis and is lost," he explains) and the possibility of some zoonoses or animal diseases passing to humans. "We have seen the disastrous results we have had with the coronavirus problem, which we still suffer with pandemic (of SARS-CoV-2)", he recalls.
Baptista considers what was achieved at NYU Langone hospital interesting. "By changing the pig's genome, hyperacute rejection is avoidable. This already allows an organ from an animal to be transplanted into a human being for a few days or weeks. The problem is that these organs will not be able to stay in the human being for life, so to speak, even if you use immunosuppression. Once the immune system recognizes the other molecules that are from the pig, it will produce rejection," emphasizes the co-director of the Regenerative Hepatology Consortium - within the European Association for the Study of the Liver -.
"This Will it help someone who is very sick?. To save his life we will give him a kidney or a liver from these special pigs, so to speak, and we will hold this patient for a few weeks to see if an organ appears. It's what we call bridge transplants. It is without a doubt a first step to give hope What really is the transplant of animal organs into humans? one day it will be reality. But, we must understand that we are still very far from this truly reaching the clinic," he adds.
A final step that would solve the problem completely would be tissue engineering, in which they work at the Aragón Health Research Institute. "Our goal is to make a human organ for transplant. In the future you will be able to use the patient's cells to generate the bioengineered organ and that means that there will never be rejection of the organ that you have made in the laboratory because it has the patient's own cells. That is the big difference between using an organ from an animal than another that has been made especially for the patient with their cells," explains Pedro Baptista.
"In the future you will be able to use the patient's cells to generate the bioengineered organ and that means that there will never be rejection"
Meanwhile, Pedro Moreo, CEO of the Aragonese company Ebers, describes the transplant carried out by Dr. Montgomery's team as a "very important" achievement, although he also alludes to the "Lots of doubts" what are left to resolve before its application in human patients can be considered in a general way. "The main one is If in the long term that organ is viable and don't end up being rejected. And also if in the long term it does not end up deteriorating and, therefore, its function is diminished as a consequence of being implanted in a different species," he explains.
Machines that replace the ice refrigerator
One of the lines of activity of the Ebers company is medical technology aimed at preserving organs for kidney and liver transplants, where it has been working for five years and is now about to launch the first versions on the market (machines to replace the conventional ice refrigerator). "They are systems that allow an organ to be taken from a donor and preserved in optimal conditions so that it can be transplanted and even improve its quality.. That is a way to increase the number of transplants. Today, despite being a very successful technique with good results, one of its main limitations is the shortage of organs; even in a country like Spain, which has some of the highest transplant rates in the world," details Moreo.
Likewise, the CEO of Ebers remembers that a third way alternative to increase their number - along with xenotransplants and improving the quality of human organs - is make them from scratch through 3D printing, video printing and tissue engineering. "This is being investigated for solid organs - liver and kidney -, but is years away", concluye.
En Aragon se they made 41 transplants between January 1, 2021 and May 31 (latest data available), specifically: 28 kidney transplants, 9 liver and 4 heart transplants. It was made possible through the generosity of 17 families who lost a loved one.
