After decades of failed attempts at transplanting kidneys from one person to another, Joseph Murray, MD, a surgeon
at the former Peter Bent Brigham Hospital in Boston, achieved success in 1954 when he transplanted a kidney
between identical twin brothers.
Reporting on their findings in Surgical Forum in 1955, Dr Murray and his coauthors noted that the recipient had
good renal function persisting after 9 months.1 “The survival of the renal homograft for this period of time
with continuing good function indicates the complete lack of a rejection response by the host and demonstrates that renal transplantation is a technically feasible procedure,” they concluded. Several years later, Dr Murray performed a successful kidney transplant between non-identical twin brothers.2 Since then, development and continued improvement of immunosuppressive medications, better donor-recipient matching criteria, and other advancements have made kidney transplantation routine.
In 2021, 24,670 kidney transplant procedures took place in the United States, up from 22,817 in 2020, according to the Organ Procurement and Transplantation Network. Among the most formidable challenges today, however, is the lack of kidneys for transplantation. As a result, 100,000 people in the United States are waiting for a kidney
transplant, according to the National Kidney Foundation.
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Among the options being considered to ease the problem is xenotransplantation — the transplantation of organs or tissues from nonhuman animals into human beings. Numerous hurdles need to be resolved for this to work successfully, but investigators in 2022 reported an important milestone in the endeavor. Two separate teams—one at the NYU Langone Transplant Institute in New York City and another at the University of Alabama at Birmingham (UAB)—described how they transplanted kidneys from genetically modified pigs into brain-dead human beings with encouraging results.
“Our results add significantly to the prior knowledge generated in non-human primate models and suggest that many barriers to xenotransplantation in humans have indeed been surmounted,” the UAB team wrote in a paper in the American Journal of Transplantation.3 They also noted that “the decedent model has significant potential to
propel not only the field of xenotransplantation forward but to answer a multitude of other scientific questions unique to the human condition.”
Kidney transplantation is considered the optimal treatment for end-stage kidney disease, but the performance of the procedure is limited by a shortage of usable kidneys. The latest reports offer hope that this impediment could disappear or at least diminish in coming years.
References
- Murray JE et al. Renal homotransplantation in identical twins. Surg Forum. 1955;6:432–436.
- Murray JE, et al. Kidney transplantation in modified recipients. Ann Surg. 1962; 156:337–355.
- Porrett PM, et al. First clinical-grade porcine kidney xenotransplant using a human decedent model.
Am J Transplant. 2022;22:1037-1053.
