There was a little preview. About six months ago we saw a pig kidney get transplanted and temporarily used by a human (at New York University). In that case it was only for a few hours. It was a brain-dead donor. And it was just proof of principle.
I thought that (pig-to-human heart) transplantation was at least several years away. With a heart transplant you need a whole other level of stability. It is a vital organ. If the heart doesn’t work the patient dies.
The thing that’s behind all this are the advances in how we can change genes in animals. In (the Maryland) case they changed 10 genes that we know of in the pig heart. That in itself is an enormous achievement. The rapid improvement in technology around molecular genetics, cloning, CRISPR (genetic editing) all laid the groundwork for this.
Q: Dr. Bartley Griffith, the University of Maryland physician who performed the transplant, said, "(The pig heart) is working and it looks normal. We are thrilled but we don’t know what tomorrow will bring us.” What do you make of that?
Q: The devil is in the details. I remain tremendously excited by this. But as of yesterday that patient was still on mechanical support. He was not fully supported by the heart. That’s one concern. We also don’t know if rejection is going to occur. There’s still a lot that could go wrong. Remember the first heart transplant patient in 1967 (Louis Washkansky) died.
Our goal at UC San San Diego is to have heart transplant patients live for a year. We’re close to that every year. Can we get to that same area with pig-to-human heart transplants? What does this patient look like in a year? That will tell us a lot.
The next big milestone is can they get him off the heart pump that he’s on right now. He’s on bypass. He hadn’t been weaned off that as of yesterday.
Q: What if the patient does live very long? How will it be perceived by the public?
A: The field of gene therapy was set back greatly when a patient died. If this transplant doesn’t work, it will be a setback.
This (operation) was done through a compassionate use (exception), which means they didn’t present it to the FDA, formally, as part of a clinical trial. There is a sense that they rushed to get this done. It wasn’t going through the normal processes. If this doesn’t go well there’s going to be scrutiny. Did they rush this out?