In an operating room at the University of Alabama at Birmingham, the surgical team was nervous but hopeful. It was Sept. 30, and they were attempting a medical first: implanting kidneys from a genetically altered pig into the abdomen of a human.
The lead surgeon, Dr. Jayme Locke, carefully sewed the first pig kidney into the patient, James Parsons, 57, a carpenter and father from Huntsville, Alabama. Days earlier, Parsons had been rendered brain-dead in an accident in a dirt bike race. A registered organ donor, he had long expressed a desire to his family to donate his organs after he died.
If the surgical experiment succeeded, it could help revolutionize organ donation, because shortages have created yearslong waits for those desperately in need of transplants. But if the kidneys turned black within minutes, the dozen or so people in the operating room would know that Parsons’ immune system was rejecting the new organs. The team waited.
“There was a lot at stake at that moment,” said Dr. Paige Porrett, the director of clinical translational research for the Comprehensive Transplant Institute at the university’s surgery department. “We’re talking about the life’s work of a lot of researchers, scientists. The hope of hundreds of thousands, if not millions, of patients who we haven’t met yet were depending on this to work.”
Locke removed the clamps, and the team watched with joy as the kidney turned the pink color it was supposed to be. Twenty-three minutes later, it started making urine, evidence that the transplant had been a success.
“I’m pretty sure there were high-fives at that moment,” said Locke, who is the director of the university’s Comprehensive Transplant Institute.
Peer-reviewed results of the novel operation were reported Thursday in The American Journal of Transplantation. To conduct the experiment, the surgeons got permission from Parsons’ family and then removed his own kidneys. The gene-edited pig kidneys they implanted remained functional up until surgeons removed them about 77 hours later.
The experiment is part of the growing field of xenotransplantation, or the sourcing of animal organs to try to solve the human organ supply crisis.
The field saw a huge breakthrough this month, when a genetically modified pig’s heart was implanted into a living recipient in Maryland.
Meanwhile, days before Locke and her team performed their operation, a functioning kidney from a genetically altered pig was attached for 54 hours to a patient’s thigh at NYU Langone Health.
Dr. David Klassen, the chief medical officer for the United Network for Organ Sharing, which manages the country’s transplant system, said the experiments in xenotransplantation were “important and consequential,” with “tremendous potential” to save lives in the future. More than 100,000 people are waiting for lifesaving transplants, according to Donate Life America.
Klassen praised the amount of detail in the report from Locke’s team, saying it could set future scientists up to make further advancements. He added that he looks forward to more studies investigating how long such transplanted organs can function and whether they might have any safety issues.
“Is this an approach that will solve the organ shortage? It is an approach that has the potential to solve the organ shortage,” he said. “For a therapy like this to be fully understood takes a long time.”
Klassen, Locke and Porrett also praised Parsons’ family for their willingness to make such a significant contribution to scientific research. In addition to helping to advance the science of transplants, the study on Parsons “established brain death as a feasible preclinical model to study,” Locke said. The authors proposed that the model of study on brain-dead patients be referred to as the “Parsons model” in his honor.
Parsons’ ex-wife, Julie O’Hara, with whom he had two grown children, said enrolling him in the experiment was an easy decision. Parsons was a person who would “stop what he’s doing and help anyone in need,” she said.
“I just wish that I could see the look on his face knowing that, my gosh, he has potentially led the way to saving hundreds of thousands of people’s lives,” O’Hara said. “I think he would be so proud that he was able to do that.”
Parsons was an avid motorcycle and dirt bike rider, she added, describing him as fun-loving and the first to crack a joke. His death was hard on his family, particularly on their 19-year-old daughter, Ally, O’Hara said.
“When he first died, her concern was ‘Who’s going to walk me down the aisle?’ And now she’s talking about telling her children about their grandpa and the contribution he made,” O’Hara said. “It really put a different focus on what was a horrible tragedy and made them really proud.”