The heart had a total of 10 genetic modifications, including four knockouts-three responsible for rapid antibody-mediated rejection of pig organ and one to prevent excessive growth-and six human genes added to increase likelihood of acceptance. The heart used in Bennett’s operation was manufactured by a company called Revivicor (Blacksburg, VA), owned by United Therapeutics. Yet scientists were decades away from being able to sequence the human genome, much less edit it with CRISPR-Cas9. In 1964, Boyd Rush was the first man to undergo xenotransplant, receiving a chimpanzee heart that beat for 90 minutes, and in 1984, infant Stephanie Fae Beauclair (often referred to as Baby Fae) famously lived for 21 days after receiving a baboon heart. One of the biggest technological breakthroughs that has allowed for the resurgence of xenotransplant is gene editing. “There are a lot of issues that have to be worked through,” he said. The Bennett case represents “a real triumph of science and genetic engineering,” continued Mann, who stressed, though, that animal organs won’t suddenly appear on the market as “pig hearts for everyone.” Mann also hailed the UMMC transplant as “a huge step forward.” Excitement is warranted, he agreed, “but we also ought to realize how much more work we have to do, and we have to do it thoughtfully and correctly in order to prove that this is a good thing for patients rather than just sort of all of a sudden jumping onto the bandwagon.” I'm very hopeful that this patient will live for months, and hopefully years. “I think it's a really important step forward. “I think this is a great achievement,” he commented to TCTMD. Pediatric cardiovascular surgeon David Cleveland, MD (University of Alabama at Birmingham), who has participated in research looking at heart transplants from pigs to infant baboons, urged that “you have to be a little bit humble here” because much remains unknown. We have to do it thoughtfully and correctly in order to prove that this is a good thing for patients, rather than just sort of all of a sudden jumping onto the bandwagon. “And then the reality of it kind of dampens people's spirits a little bit, because maybe other places they'll get acute rejection or patients won't do so well.” “After something like this, there's going to be this huge swell of enthusiasm and you'll have everybody and their uncle getting into the xenotransplant business or be excited about it,” said Mann. Louis, MN), came to realize how much progress had been made in recent years, he told TCTMD, and was reminded of a quote by heart transplant pioneer Norman Shumway, MD: “Xenotransplantation is the future, and always will be.” Upon hearing the news of the surgery, heart failure specialist Douglas Mann, MD (Washington University School of Medicine in St. He remains in stable condition and continues to recover, according to a UMMC source. The procedure, conducted in 57-year-old David Bennett at the University of Maryland Medical Center (UMMC), was authorized by the US Food and Drug Administration under its compassionate use provision given that Bennett was not eligible for a human heart transplant or an artificial ventricular assist device. But as time goes on, some are urging humility and warning against overhyping this relatively unproven technique. The acute success of the first xenotransplantation using a genetically engineered porcine heart into a man with end-stage heart disease 2 weeks ago had many cardiologists and cardiac surgeons excited about what seems to be an abrupt paradigm shift.
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