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You have full access to this article via your institution. Download PDF Surgeons at Massachusetts General Hospital have transplanted a pig kidney into a living person for the first time. On
16 March, a 62-year old man with end-stage kidney disease received a kidney from a genome-edited pig developed by eGenesis. The humanized pig organ was taken from a genetically engineered
Yucatan miniature pig carrying a total of 69 gene edits designed to increase compatibility between the pig graft and its human recipient. The changes in the genome were of three types:
knockouts of three genes involved in glycan antigen synthesis to avoid acute rejection; inserts of seven human transgenes involved in pathways that regulate immunity, coagulation and
complement; and inactivation of porcine endogenous retroviruses to avoid their transmission and integration into the recipient. Xenotransplants — ones from animal to human — have long been
considered as a potential solution to the chronic shortage of organs for transplantation, but progress has been slow, with only a few successful examples of xenotransplants surviving for a
few months in nonhuman primates. In recent years, the first person to receive a genetically edited pig heart from the company Revivicor, a subsidiary of United Therapeutics, lived for two
months; a second transplant recipient lived for six weeks. Revivicor introduced 10 genetic modifications in the pigs to ensure the organs do not grow too big, to avoid blood clots, and to
limit rejection. The go-ahead for eGenesis’s pig kidney transplant came from the US Food and Drug Administration ‘Expanded Access’ program. At the time _Nature Biotechnology_ went press, the
organ recipient was recovering well, the kidney was filtering and there was no sign of rejection. Long-term follow up will define whether gene-editing tools have ushered in the possibility
of using pigs as human organ donors. eGenesis is also co-developing human-compatible porcine livers as an ex vivo perfusion system to support patients with liver failure. The porcine livers
carry the same three types of genetic modification as the porcine kidneys. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE First gene-edited pig kidney
transplant. _Nat Biotechnol_ 42, 543 (2024). https://doi.org/10.1038/s41587-024-02223-1 Download citation * Published: 17 April 2024 * Issue Date: April 2024 * DOI:
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