A few months after the death of the first pig heart transplant patient, the search for the cause of his death continues. Whether it is related to rejection has become the focus of attention.
A paper published recently in the New England Journal of Medicine revealed more details about the before and after surgery.
The paper states that,Heart weight nearly doubles after patient’s deathfrom 328 grams to 600 grams.Fibrotic tissue in the heartaccompanied by extravasation of red blood cells.
▲ The patient’s heart is enlarged in Figure B
At the same time, doctors also found that the patient’s lungsHuman herpesvirus (HHV-6). This virus can cross-react with porcine cytomegalovirus detected in transplanted hearts; it is also associated with xenograft rejection.
However, the researchers also said that the abnormal phenomenon in the patient’s heart,Not consistent with typical organ transplant rejection. However, it has not yet been proved whether the patient died of the virus infection.
Heart weight increased from 328 grams to 600 grams
The paper details the details of the patient before and after transplantation, including the condition of the transplanted heart, the patient’s own health, and postoperative medication.
The autopsy found that the transplanted heart did have a major problem.The most obvious phenomenon is thatThe weight of the heart has almost doubled. The doctor explained that this was mainly because the blood vessels showed signs of leakage.
At the same time, there was alsoSigns of partial myocardial fibrosis. Generally speaking, myocardial fibrosis is a reaction after myocardial necrosis, and this reaction is not reversible, and this phenomenon occurs in many late stages of heart disease.
However, the researchers stress that these problems are not consistent with typical allogeneic organ transplant rejection.
And another question that people are very concerned about – whether the transplanted heart carries the virus, is also answered in detail in this paper.
According to reports, the gene-edited pig heart only carried porcine endogenous retroviruses PERV-A and PERV-B before transplantation.PERV-C, porcine cytomegalovirus and porcine lymphotropic herpesvirus were not detected.
As for why low levels of porcine cytomegalovirus were detected in the patient’s blood 20 days after surgery, the paper still does not give an explanation.
At that time, as the level of porcine cytomegalovirus in the blood increased, doctors used the treatment originally used for cytomegalovirus infection in AIDS patients, and on the other hand, the patients were injected with human immunoglobulin to increase their resistance. Afterwards, the patient’s physical condition improved.Able to even get out of bed at 48 days postoperatively.
But then, his condition took a turn for the worse. Tests found that the heart wall of the transplanted heart was abnormally enlarged, the size of the ventricle was shrinking, and the level of antibodies against pig tissue in the body was also rising.
Doctors believe thatThis may be due to the occurrence of atypical immune rejection mediated by antibodies.
Finally, 60 days after the transplant, the patient unfortunately passed away due to severe heart damage.
One More Thing
With the completion of the first pig heart transplant, the attention of all walks of life on xenotransplantation is also increasing. Although it can alleviate the current shortage of organ transplant donors, it also brings many risks and concerns.
“Immune rejection”, “cross-species biosecurity”, and “social ethics” have become major concerns of the academic community and society.
And the other direction –3D printed organsmay also be worth our attention.
Recently, the world’s first 3D printed ear transplant was completed. A 20-year-old Mexican girl has successfully obtained a transplantable left ear using 3D-printed collagen hydrogel scaffolds and cartilage tissue grown from her own cells.
and because of surgeryuse your own cells, so the probability of rejection will be reduced. The procedure was supported by 3DBio Therapeutics, an American regenerative medicine company. According to its executives, in the future they will also try to print other body parts, such as spine, nose and so on.
Paper address:
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