For historic patient, a new beginning
After transplant of pig’s kidney, he leaves MGH
The first man to receive a kidney transplant from a genetically engineered pig was released from Massachusetts General Hospital on Wednesday, officials said, less than three weeks after he underwent the milestone operation.
The patient, Richard “Rick” Slayman, a manager with the state Department of Transportation, said he was leaving the hospital with “one of the cleanest bills of health I’ve had in a long time” and called it “one of the happiest moments of my life.”
“I’m excited to resume spending time with my family, friends, and loved ones free from the burden of dialysis that has affected my quality of life for many years,” Slayman said in a statement.
He also thanked his team of doctors “and the countless nurses who looked after me every day of my stay.”
“The care I received was exceptional,” Slayman said.
He also had a message for other patients in need of a kidney transplant.
“Today marks a new beginning not just for me, but for them, as well,” he said.
Previous experiments have transplanted pig kidneys in the bodies of brain-dead people and nonhuman primates. In the last two years, two men have received genetically modified pig hearts and lived for up to seven weeks.
“It’s a big deal, and I’m so happy that it’s happened,” said Dr. Muhammad M. Mohiuddin, who transplanted pig hearts into two patients at the University of Maryland School of Medicine. Both died in the hospital.
Slayman’s discharge “will give a big, big, big boost to not only the field but all these patients who are waiting for a transplant. Just leaving the hospital is a huge, big deal. This will energize the field tremendously,” said Mohiuddin, who is president of the International Xenotransplantation Association. “We are hoping that with all these success stories, that the FDA will give us permission to do a clinical trial, where a lot of data can be accumulated from multiple patients.”
Dr. Jayme Locke, director of the division of transplantation at the University of Alabama Birmingham Heersink School of
‘I think this may be the first time a xenograft recipient has ever left the hospital alive.’
DR. JAYME LOCKE, director of the division of transplantation at University of Alabama Birmingham
Medicine, was equally enthusiastic. “I think this may be the first time a xenograft recipient has ever left the hospital alive,” Locke said, using the name for a transplant from a non-human species. “That speaks to how well the xenograft is working and how well the patient is doing. … It really suggests that the xenograft is here to stay.”
Locke said her team is seeking FDA approval to perform a similar pig-kidney transplant.
Dr. Winfred Williams, associate chief of the renal division at Mass. General and a transplant nephrologist who has known Slayman for a decade, said Slayman developed kidney failure as a result of diabetes and hypertension. After seven years on dialysis, Slayman received a donated human kidney in 2018. A year ago, the kidney failed and Slayman went back on dialysis, which was especially grueling because of repeated difficulties accessing his blood vessels.
On March 16, doctors removed two kidneys from the donor pig, including one as a backup, put them on ice, and delivered them to the hospital.
They cut open Slayman’s lower abdomen on the left side, and attached the blood vessels of the new kidney to his, clamping them closed to avoid bleeding. At that point, the pig kidney lay pale and beige inside Slayman’s abdomen, drained of its own blood. Then the surgeons removed the clamps, and Slayman’s blood flowed into the transplanted organ, turning it a vivid pink, suddenly alive.
Slayman had “an episode of rejection” the Sunday after the transplant, said Dr. Nahel Elias, one of the surgeons who performed the transplant. Blood tests indicated the kidney was not cleaning the blood as well as it should, and a sonogram and a biopsy showed that the organ was swollen and under attack by the patient’s immune system.
But the episode, which Elias said was not unusual for a kidney transplant, was brought under control with additional medication, and Slayman has been doing well since then.
He’ll come back to the hospital for tests on Friday, Elias said, and will continue to come in three times a week. In caring for him, as with all transplant recipients, doctors walk a tightrope, trying to find just the right dose of immunosuppressant medication — enough to prevent the rejection but not so much that the patient is vulnerable to infection.
“It’s a whole cocktail of medications that are tailored to each patient’s needs,” Elias said.
Slayman is unique as the world’s first recipient of a genetically modified pig kidney and so will be monitored closely — but his care is essentially the same as for any transplant recipient.
Elias said that Slayman has been active and walking around in recent days. At discharge, he emerged dressed in his own clothes, no longer looking like a patient, “which was a great moment,” Elias said.
If Slayman continues to do well for months, the hospital may start the process of identifying another prospective patient and seeking FDA approval for another pig-kidney transplant, Elias said. A number of patients have already expressed interest.
If the pig kidney ultimately fails, Slayman can go back on dialysis, and doctors will have learned a great deal from the experience.
“If it does well, we will learn from it. If it doesn’t do well, we will learn from it,” Elias said, and this is why doctors are so appreciative of patients willing to partake in such experiments.
Elias dreams of the day when there are no transplant waiting lists. “Hopefully it becomes like, ‘You need your transplant, let’s schedule it,’” he said.