US surgeons test pig kidney transplant in a human

By Michelle Roberts
Health editor, BBC News online

US surgeons say they have successfully given a pig's kidney to a person in a

transplant breakthrough they hope could ultimately solve donor organ shortages.

The recipient was brain-dead, meaning they were already on artificial life support with no
prospect of recovering.
The kidney came from a pig that had been genetically modified to stop the organ being
recognised by the body as "foreign" and being rejected.
The work is not yet peer-reviewed or published but there are plans for this.
Experts say it is the most advanced experiment in the field so far.
Similar tests have been done in non-human primates, but not people, until now.

Using pigs for transplants is not a new idea though. Pig heart valves are already widely
used in humans.
And their organs are a good match for people when it comes to size.
During the two-hour operation at the New York University Langone Health medical
centre, the surgeons connected the donor pig kidney to the blood vessels of the brain-
dead recipient to see if it would function normally once plumbed in, or be rejected.

Over the next two-and-a-half days they closely monitored the kidney, running numerous
checks and tests.

Lead investigator Dr Robert Montgomery told the BBC's World Tonight

programme: "We observed a kidney that basically functioned like a human kidney
transplant that appeared to be compatible in as much as it did all the things that a normal
human kidney would do.

"It functioned normally, and did not appear to be undergoing rejection."

The surgeons transplanted a bit of the pig's thymus gland too, along with the kidney. They
think this organ might help stop the human body rejecting the kidney in the long term by
mopping up any stray immune cells that might otherwise fight the pig tissue.

A heart transplant recipient himself, Dr Montgomery says there is an urgent need for
finding more organs for people on waiting lists, although he acknowledges his work is
controversial.
"The traditional paradigm that someone has to die for someone else to live is never going
to keep up.
"I certainly understand the concern and what I would say is that currently about 40% of
patients who are waiting for a transplant die before they receive one.
"We use pigs as a source of food, we use pigs for medicinal uses - for valves, for
medication. I think it's not that different."
He said it was still early research and more studies were needed, but added: "It gives us, I
think, new confidence that it's going to be all right to move this into the clinic."

The family of the recipient, who had wanted to be an organ donor, gave permission for the
surgery to go ahead.
US regulator the FDA has approved the use of the genetically modified pig organs for this
type of research use.

Dr Montgomery believes that within a decade, other pig organs - hearts, lung and livers -
could be given to humans needing transplants.
Dr Maryam Khosravi, a kidney and intensive care doctor who works for the NHS in the UK,
said: "Animal to human transplantation has been something that we have studied for
decades now, and it's really interesting to see this group take that step forward."

On the ethics, she said: "Just because we can doesn't mean we should. I think the
community at large needs to answer these questions."

A spokesperson for NHS Blood and Transplant, said matching more human donors
remained the priority for now: "There is still some way to go before transplants of this kind
become an everyday reality.
"While researchers and clinicians continue to do our best to improve the chances for
transplant patients, we still need everyone to make their organ donation decision and let
their family know what they want to happen if organ donation becomes a possibility."

GLOSARIO
 Trasplante:Procedimiento quirúrgico mediante el que se trasfiere tejido o un órgano de un
área a otra del cuerpo o de una persona (el donante) a otra persona (el receptor).
 Muerte cerebral: es la pérdida permanente de la actividad cerebral. Como
resultado, el paciente no puede respirar o mantener cualquier otra función vital.
 Timo: es un órgano pequeño ubicado en la parte superior del pecho, bajo el
esternón. Elabora glóbulos blancos, que se llaman linfocitos; estos protegen el
cuerpo contra las infecciones.
 FDA: La Administración de Medicamentos y Alimentos es la agencia del Gobierno
de los Estados Unidos responsable de la regulación de alimentos, medicamentos,
cosméticos, aparatos médicos, productos biológicos y derivados sanguíneos.
 Modificación Genética: manipulación directa de los genes de un organismo usando
la biotecnología para modificar sus genes, ya sea eliminando, duplicando o
insertando material genético por medio de las diferentes tecnologías de edición
genética.

GLOSSARY
 Transplantation: A surgical procedure in which tissue or an organ is transferred
from one area of the body to another or from one person (the donor) to another
person (the recipient).
 Brain death: is the permanent loss of brain activity. As a result, the patient is
unable to breathe or maintain any other vital functions.
 Thymus: it is a small organ located in the upper part of the chest, under the
breastbone. It makes white blood cells, which are called lymphocytes; these protect
the body against infection.
 FDA: The Food and Drug Administration is the agency of the United States
Government responsible for the regulation of foods, drugs, cosmetics, medical
devices, biological products, and blood derivatives.
 Genetic Modification: direct manipulation of the genes of an organism using
biotechnology to modify its genes, either by eliminating, duplicating or inserting
genetic material through different gene editing technologies.

https://www.bbc.com/news/health-58993696
 Covid: Virus may have killed 80k-180k health workers,
WHO says
Covid has severely affected healthcare staff and may have killed between 80,000
and 180,000, the World Health Organization (WHO) says.
Healthcare workers must be prioritised for vaccines, WHO head Tedros Adhanom
Ghebreyesus said, and he criticised unfairness in the distribution of jabs.
The deaths occurred between January 2020 and May of this year.
Earlier, another senior WHO official warned a lack of jabs could see the pandemic
continue well into next year.
There are an estimated 135 million healthcare workers globally.
"Data from 119 countries suggest that on average, two in five healthcare workers globally
are fully vaccinated," Dr Tedros said.
"But of course, that average masks huge differences across regions and economic
groupings."
Fewer than one in 10 healthcare workers were fully vaccinated in Africa, he said,
compared with eight in 10 in high-income countries.

A failure to provide poorer countries with enough vaccines was highlighted earlier by Dr
Bruce Aylward, a senior leader at the WHO, who said it meant the Covid crisis could
"easily drag on deep into 2022".
Less than 5% of Africa's population have been vaccinated, compared with 40% on most
other continents.
The vast majority of Covid vaccines overall have been used in high-income or upper
middle-income countries. Africa accounts for just 2.6% of doses administered globally.
 More than 50 countries missing Covid vaccine target
 Covax: How many Covid vaccines have the US and the other G7 countries
pledged?
 Covid vaccines: How fast is progress around the world?

The original idea behind Covax, the UN-backed global programme to distribute vaccines
fairly, was that all countries would be able to acquire vaccines from its pool, including
wealthy ones, writes BBC Global Affairs correspondent Naomi Grimley.
But most G7 countries decided to hold back once they started making their own one-to-
one deals with pharmaceutical companies

Dr Aylward appealed to wealthy countries to give up their places in the queue for vaccines
so that pharmaceutical companies can prioritise the lowest-income countries instead.
He said wealthy countries needed to "stocktake" where they were with their donation
commitments made at summits such as the G7 meeting in St Ives this summer.
"I can tell you we're not on track," he said. "We really need to speed it up or you know
what? This pandemic is going to go on for a year longer than it needs to."
The People's Vaccine - an alliance of charities - has released new figures suggesting just
one in seven of the doses promised by pharmaceutical companies and wealthy countries
are actually reaching their destinations in poorer countries.
The alliance, which includes Oxfam and UNAids, also criticised Canada and the UK for
procuring vaccines for their own populations via Covax.
Official figures show that earlier this year the UK received 539,370 Pfizer doses from
Covax while Canada took just under a million AstraZeneca doses.
Oxfam's Global Health Adviser, Rohit Malpani, acknowledged that Canada and the UK
were technically entitled to get vaccines via this route having paid into the Covax
mechanism, but he said it was still "morally indefensible" given that they had both obtained
millions of doses through their own bilateral agreements.
The UK government pointed out it was one of the countries which had "kick-started" Covax
last year with a donation of £548m.
The UK has also delivered more than 10 million vaccines to countries in need, and has
pledged a total of 100 million.
The Canadian government was keen to stress that it had now stopped using Covax
vaccines.
The country's International Development Minister, Karina Gould, said: "As soon as it
became clear that the supply we had secured through our bilateral deals would be
sufficient for the Canadian population, we pivoted the doses which we had procured from
Covax back to Covax, so they could be redistributed to developing countries."
Covax originally aimed to deliver two billion doses of vaccines by the end of this year, but
so far it has shipped 371m doses.

GLOSARIO
 La Organización Mundial de la Salud (OMS): es el organismo de la Organización de
las Naciones Unidas especializado en gestionar políticas de prevención, promoción e
intervención a nivel mundial en la salud.
 Crisis: Situación grave y decisiva que pone en peligro el desarrollo de un asunto o un
proceso.
 Covid: es una enfermedad infecciosa causada por el virus SARS-CoV-2.
 COVAX:El Fondo de Acceso Global para Vacunas Covid-19 es una alianza impulsada por
actores públicos y privados con el supuesto objetivo de garantizar el acceso equitativo a
las vacunas que se logren desarrollar contra la COVID-19. Actualmente forman parte de
esta alianza 190 países.
 G7:Grupo de los Siete a un grupo de países del mundo cuyo peso político, económico
y militar es considerado relevante a escala global. Representa a los siete principales
poderes económicos avanzados. Está conformado por Alemania, Canadá, Estados
Unidos, Francia, Italia, Japón y Reino Unido.

GLOSSARY
 The World Health Organization (OMS): is the organism of the United Nations
Organization specialized in managing prevention, promotion and intervention policies
worldwide in health.
 Crisis: A serious and decisive situation that endangers the development of an issue or
a process.
 Covid: It is an infectious disease caused by the SARS-CoV-2 virus.
 COVAX: The Global Access Fund for Covid-19 Vaccines is an alliance promoted by
public and private actors with the supposed objective of guaranteeing equitable access
to the vaccines that are developed against COVID-19. Currently 190 countries are part
of this alliance.
 G7:Group of Seven to a group of countries in the world whose political, economic and
military weight is considered relevant on a global scale. It represents the seven main
advanced economic powers and is made up of Germany, Canada, the United States,
France, Italy, Japan and the United Kingdom.

https://www.bbc.com/news/health-58973697