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Doctors Combined a Heart Pump and Pig Kidney Transplant in Breakthrough Surgery

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The kidney used in the latest NYU transplant was procured from a pig with a single genetic edit—the removal of a gene that produces a sugar known as alpha gal. This sugar appears on the surface of pig cells and seems to be responsible for rapid rejection in humans. The pig was engineered by Revivicor, a subsidiary of United Therapeutics Corporation.

Mandeep Mehra, a cardiologist and professor of medicine at Harvard Medical School, is excited by the NYU news. “It’s very innovative to combine the two,” he says, but the heart pump carries a risk of infection. Left ventricular assist devices require external batteries to power them. A wire comes out of the patient’s abdomen and connects to a controller and battery pack. “It’s that exit site that can be prone to infection,” he says.

Mehra says it also remains to be seen whether the single gene edit will be enough to prevent rejection and keep the kidney functioning for the long term. “The entire premise of gene editing was to overcome the immunological barrier,” he says.

Close up of surgeons in organ transplant surgery

PHOTOGRAPH: JOE CARROTTA FOR NYU LANGONE HEALTH

In the previous pig organ transplants in living patients, the animals had more modifications. The pig used for the heart transplants had 10 edits and the one used in Slayman’s procedure last month had 69. Yet with both Bennett’s and Faucett’s hearts, doctors noted signs of rejection. And even a week after Slayman’s surgery, his kidney showed early evidence of rejection—something his medical team hadn’t expected.

“The evolutionary distance between humans and pigs is 100 million years,” Mehra says. “Any gene editing needs to overcome that.”

The NYU’s team is taking a “less is more” approach with gene editing, Montgomery said, and instead relying on the pig’s thymus to help mediate the immune mismatch.

Pisano says she’s glad she took a chance on the procedure. She hopes she can leave the hospital so she can go shopping and play with her grandchildren. “The worst case scenario is that it doesn’t work,” she says, but even then she thinks it would be worthwhile. “It might work for the next person.”

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Featured

Apple’s Vision Pro successfully helps nurse assist in spinal surgery – and there’s more mixed-reality medical work on the way

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In a fascinating adoption of technology, a surgical team in the UK recently used Apple’s Vision Pro to help with a medical procedure.

It wasn’t a surgeon who donned the headset, but Suvi Verho, the lead scrub nurse (also known as a theater nurse) at the Cromwell Hospital in London. Scrub nurses help surgeons by providing them with all the equipment and support they need to complete an operation – in this case, it was a spinal surgery. 

Verho told The Daily Mail that the Vision Pro used an app made by software developer eXeX to float “superimposed virtual screens in front of [her displaying] vital information”. The report adds that the mixed reality headset was used to help her prepare, keep track of the surgery, and choose which tools to hand to the surgeon. There’s even a photograph of the operation itself in the publication. 

Vision Pro inside surgery room

(Image credit: Cromwell Hospital/The Daily Mail)

Verho sounds like a big fan of the Vision Pro stating, perhaps somewhat hyperbolically, “It eliminates human error… [and] guesswork”. Even so, anything that ensures operations go as smoothly as possible is A-OK in our books.

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