Yehuda Lave is an author, journalist, psychologist, rabbi, spiritual
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Published Oct. 19, 2021Updated Oct. 20, 2021, 6:19 a.m. ET
Surgeons
in New York have successfully attached a kidney grown in a genetically
altered pig to a human patient and found that the organ worked normally,
a scientific breakthrough that one day may yield a vast new supply of
organs for severely ill patients.
Although
many questions remain to be answered about the long-term consequences
of the transplant, which involved a brain-dead patient followed only for
54 hours, experts in the field said the procedure represented a
milestone.
“We need to know more about
the longevity of the organ,” said Dr. Dorry Segev, professor of
transplant surgery at Johns Hopkins School of Medicine who was not
involved in the research. Nevertheless, he said: “This is a huge
breakthrough. It’s a big, big deal.”
Researchers
have long sought to grow organs in pigs suitable for transplantation
into humans. A steady stream of organs — which could eventually include
hearts, lungs and livers — would offer a lifeline to the more than
100,000 Americans currently on transplant waiting lists, including the
90,240 who need a kidney. Twelve people on the waiting lists die each
day.
An even larger number of Americans with kidney failure — more than a half million — depend on grueling dialysis treatments to survive. In large part because of the scarcity of human organs, the vast majority of dialysis patients do not qualify for transplants, which are reserved for those most likely to thrive after the procedure.
The
surgery, carried out at N.Y.U. Langone Health, was first reported by
USA Today on Tuesday. The research has not yet been peer-reviewed nor
published in a medical journal.
The
transplanted kidney was obtained from a pig genetically engineered to
grow an organ unlikely to be rejected by the human body. In a close
approximation of an actual transplant procedure, the kidney was attached
to a person who had suffered brain death and was maintained on a
ventilator.
The kidney, attached to
blood vessels in the upper leg outside the abdomen, started functioning
normally, making urine and the waste product creatinine “almost
immediately,” according to Dr. Robert Montgomery, the director of the
N.Y.U. Langone Transplant Institute, who performed the procedure in
September.
Although
the organ was not implanted in the body, problems with so-called
xenotransplants — from animals like primates and pigs — usually occur at
the interface of the human blood supply and the organ, where human
blood flows through pig vessels, experts said.
The fact that the organ functioned outside the body is a strong indication that it will work in the body, Dr. Montgomery said.
“It
was better than I think we even expected,” he said. “It just looked
like any transplant I’ve ever done from a living donor. A lot of kidneys
from deceased people don’t work right away, and take days or weeks to
start. This worked immediately.”
Last
year, 39,717 residents of the United States received an organ
transplant, the majority of them — 23,401 — receiving kidneys, according
to the United Network for Organ Sharing, a nonprofit that coordinates
the nation’s organ procurement efforts.
Genetically
engineered pigs “could potentially be a sustainable, renewable source
of organs — the solar and wind of organ availability,” Dr. Montgomery
said.
Reactions to the news among
transplantation experts ranged from cautiously optimistic to wildly
effusive, though all acknowledged the procedure represented a sea
change. The prospect of raising pigs in order to harvest their organs
for humans is bound to raise questions about animal welfare and
exploitation, though an estimated 100 million pigs already are killed in
the United States each year for food.
While
some surgeons speculated that it could be just months before
genetically engineered pigs’ kidneys are transplanted into living human
beings, others said there was still much work to be done.
“This
is really cutting-edge translational surgery and transplantation that
is on the brink of being able to do it in living human beings,” said Dr.
Amy Friedman, a former transplant surgeon and chief medical officer of
LiveOnNY, the organ procurement organization in the greater New York
area.
The group was involved in the
selection and identification of the brain-dead patient receiving the
experimental procedure. The patient was a registered organ donor, and
because the organs were not suitable for transplantation, the patient’s
family agreed to permit research to test the experimental transplant
procedure.
Dr. Friedman said she
envisioned using hearts, livers and other organs grown in pigs, as well.
“It’s truly mind-boggling to think of how many transplants we might be
able to offer,” she said, adding, “You’d have to breed the pigs, of
course.”
Other experts were more
reserved, saying they wanted to see whether the results were
reproducible and to review data collected by N.Y.U. Langone.
“There’s
no question this is a tour de force, in that it’s hard to do and you
have to jump through a lot of hoops,” said Dr. Jay A. Fishman, associate
director of the transplantation center at Massachusetts General
Hospital.
“Whether this particular
study advances the field will depend on what data they collected and
whether they share it, or whether it is a step just to show they can do
it,” Dr. Fishman said. He urged humility “about what we know.”
Many
hurdles remain before genetically engineered pigs’ organs can be used
in living human beings, said Dr. David Klassen, chief medical officer of
the United Network for Organ Sharing.
While he called the surgery “a watershed moment,” he warned that long-term rejection of organs occurs even when the donor kidney is well-matched, and “even when you’re not trying to cross species barriers.”
The
kidney has functions in addition to clearing blood of toxins. And there
are concerns about pig viruses infecting recipients, Dr. Klassen said:
“It’s a complicated field, and to imagine that we know all of the things
that are going to happen and all the problems that will arise is
naïve.”
Xenotransplantation, the
process of grafting or transplanting organs or tissues between different
species, has a long history. Efforts to use the blood and skin of
animals in humans go back hundreds of years.
In
the 1960s, chimpanzee kidneys were transplanted into a small number of
human patients. Most died shortly afterward; the longest a patient lived
was nine months. In 1983, a baboon heart was transplanted into an
infant girl known as Baby Faye. She died 20 days later.
Pigs
offered advantages over primates for organ procurement — they are
easier to raise, reach maturation faster, and achieve adult human size
in six months. Pig heart valves are routinely transplanted into humans,
and some patients with diabetes have received pig pancreas cells. Pig
skin has also been used as temporary grafts for burn patients.
The
combination of two new technologies — gene editing and cloning — has
yielded genetically altered pig organs. Pig hearts and kidneys have been
transplanted successfully into monkeys and baboons, but safety concerns
precluded their use in humans.
“The
field up to now has been stuck in the preclinical primate stage, because
going from primate to living human is perceived as a big jump,” Dr.
Montgomery said.
The kidney used in the new procedure was obtained by knocking out a pig gene that encodes a sugar molecule that elicits an aggressive human rejection response. The pig was genetically engineered by Revivicor and approved by the Food and Drug Administration for use as a source for human therapeutics.
Dr. Montgomery and
his team also transplanted the pig’s thymus, a gland that is involved
in the immune system, in an effort to ward off immune reactions to the
kidney.
After attaching the kidney to
blood vessels in the upper leg, the surgeons covered it with a
protective shield so they could observe it and take tissue samples over
the 54-hour study period. Urine and creatinine levels were normal, Dr.
Montgomery and his colleagues found, and no signs of rejection were
detected during more than two days of observation.
“There
didn’t seem to be any kind of incompatibility between the pig kidney
and the human that would make it not work,” Dr. Montgomery said. “There
wasn’t immediate rejection of the kidney.”
The
long-term prospects are still unknown, he acknowledged. But “this
allowed us to answer a really important question: Is there something
that’s going to happen when we move this from a primate to a human that
is going to be disastrous?”
Genetically Edited Pigs and Organ Transplants
Israeli scuba diver discovers 900-year-old Crusader sword off Hof HaCarmel
Sword’s discovery suggests that the natural anchorage where it was found was also used by ships in the Crusader period.
The Crusader swordצילום: אנסטסיה שפירו - רשות העתיקות
Atlit
resident Shlomi Katzin was scuba diving last Saturday off the Carmel
coast, when he was amazed to discover ancient artifacts on the sea bed,
apparently uncovered by waves and undercurrents that had shifted the
sand. He saw ancient stone anchors, anchors made of metal, pottery
fragments, and an impressive sword with a one meter long blade and a
hilt measuring 30 cm in length.
Fearing that the find would be stolen or buried beneath subsequent
shifting of the sands, Katzin took the sword ashore. Demonstrating
outstanding citizenship, he contacted the inspector for the Israel
Antiquities Authority Northern District’s Robbery Prevention Unit and
reported the find to the Israel Antiquities Authority.
The sword was handed over to the National Treasures Department and
Katzin received a certificate of appreciation for good citizenship.
According
to Nir Distelfeld, Inspector for the Israel Antiquities Authority’s
Robbery Prevention Unit, “The sword, which has been preserved in perfect
condition, is a beautiful and rare find and evidently belonged to a
Crusader knight. It was found encrusted with marine organisms, but is
apparently made of iron. It is exciting to encounter such a personal
object, taking you 900 years back in time to a different era, with
knights, armor and swords.”
“The
Carmel coast contains many natural coves that provided shelter for
ancient ships in a storm, and larger coves around which entire
settlements and ancient port cities developed, such as Dor and Atlit,”
explains Kobi Sharvit, Director of the Israel Antiquities Authority’s
Marine Archaeology Unit.
“These conditions have attracted merchant ships down the ages,
leaving behind rich archaeological finds. The recently recovered sword
is just one such find.”
The site where the anchors and the sword
were found has been monitored by the Israel Antiquities Authority since
June, when it was first discovered by Boaz Langford and Rafael Bahalul.
The site’s finds are very elusive, since they appear and disappear with
the movement of the sands.
“The discovery of ancient finds by swimmers and leisure divers is a
growing phenomenon in recent years, with the increasing popularity of
such sports,” said Sharvit.
“Underwater
surveying is dynamic. Even the smallest storm moves the sand and
reveals areas on the sea bed, meanwhile burying others. It is therefore
vitally important to report any such finds and we always try to document
them in situ, in order to retrieve as much archaeological data
as possible. The archaeological finds at the site show that it served
as a small, temporary natural anchorage for ships seeking shelter.
Identification of the various finds shows that the anchorage was used in
as early as the Late Bronze Age, 4,000 years ago. The recent discovery
of the sword suggests that the natural cove was also used in the
Crusader period, some 900 years ago.”
Israel Antiquities Authority’s general director, Eli Escosido,
praised Shlomi for coming forward with the discovery. “Every ancient
artifact that is found helps us piece together the historical puzzle of
the Land of Israel. Once the sword has been cleaned and researched in
the Israel Antiquities Authority’s laboratories, we will ensure it is
displayed to the public.
UK radical Islamist suggests MP was murdered for being pro-Israel
Radical Islamist preacher Anjem Choudary suggests David Amess may have been targeted due to his stance on Israel.
Radical Islamist preacher Anjem Choudary has suggested that UK lawmaker David Amess, who was stabbed multiple times on Friday, may have been targeted due to his stance on Israel, the Jewish Chronicle reported on Sunday
According to the report, speaking to the Mail on Sunday, the 54-year-old cleric said he was unsure about Amess’ views but added he was rumored to be pro-Israel.
Amess previously served as the honorary secretary of Conservative Friends of Israel, noted the Jewish Chronicle.
“Many
people do [believe] that [Israel] is a terrorist state, and who would
possibly be a friend of Israel after you see the carnage that they
carried out against Muslims in the West Bank and Gaza Strip and continue
to do with the appropriation of properties,” Choudary was quoted as
having said.
He reportedly said he did not condone violence, adding, “Obviously
that does not give someone justification for someone to kill someone. I
believe there is a covenant of security in this country, where the lives
and wealth of people with whom we Muslims live are protected in return
for our lives and wealth.”
Choudary is the former head in Britain of Islam4UK or al-Muhajiroun, a
group that called for Islamic law in Britain and which was banned under
counter-terrorism legislation in 2010.
He
has often praised Muslim terrorists, referring to the September 11
terrorists as “magnificent martyrs.” Choudary has in the past praised
the 2008 terrorist attack in Mumbai, India and has also called for stoning homosexuals, assassinating the Pope, and prosecuting Queen Elizabeth for genocide.
In 2013, he was filmed while threatening at a protest outside the French Embassy in London that Islam will dominate France and England.
Choudary was sentenced in 2016 to five and a half years in prison after he and another person were charged with inviting support for ISIS, which is banned under UK anti-terror laws. He was released from prison in 2018.
Amess, who represented Southend West in Essex, was stabbed at
approximately noon on Friday by a man who walked into the meeting in the
Belfairs Methodist Church.
An air ambulance landed after the stabbing but Amess was declared
dead at the scene despite emergency services attempting to save his
life.