TALENT EDUCATION

Xijing Hospital successfully transplanted multiple organs and tissues from 1 gene-edited pig to 7 recipient monkeys


On November 10, Xijing Hospital of the Air Force Military Medical University announced that under the guidance of the party committee of the university, more than 20 disciplines of the hospital carried out multi-gene editing pig-monkey multi-organ and multi-tissue transplantation surgery has made a new breakthrough.


President Dang Xiaorong and Political Commissar Zhang Zhijun of Xijing Hospital presented flowers and congratulations to the main members of the surgical team
According to the World Health Organization, there is a severe shortage of human organs available for transplantation, with about 2 million people worldwide currently in need of organ transplants every year. In 2021, there were 144,300 organ transplants worldwide, but only about 10% of patients waited for the right organ.

At present, xenotransplantation of gene-edited pigs as donors at home and abroad has moved towards preclinical trials. Since the launch of the gene-edited pig monkey transplantation project in 2013, Xijing Hospital has been continuously exploring the scope of application and countermeasures to provide scientific basis and technical support for xenotransplantation technology services.
The preparation for this operation has been started since April 2023, and more than 20 disciplines have followed up and guaranteed the whole process, and it has been carried out in five stages: ethical demonstration, donor and recipient matching, surgical plan determination, and pre-experimental implementation. The recipient monkey was provided by the research cooperation unit, the Sichuan Academy of Medical Sciences and the Laboratory Animal Research Institute of Sichuan Provincial People’s Hospital, and the donor six gene edited pigs were provided by the research cooperation unit, Chengdu Zhongke Auge Biotechnology Co., Ltd.
The series of transplantation operations was carried out from October 29th to 30th, led by Academician Dou Kefeng, and more than 40 experts from hepatobiliary, pancreatic and spleen surgery, plastic surgery, urology, cardiovascular surgery, anesthesiology, orthopedics, ophthalmology, and neurosurgery worked together to transplant the liver, kidney, heart, abdominal wall, cornea, bone, median nerve and other organs and tissues of one gene-edited pig to seven recipient monkeys. During the operation, the anesthesiology department quickly implemented individualized anesthesia for different specialties and different procedures, accurately adjusted physiological indicators, and escorted 7 surgeries in real time.

Academician Dou Kefeng of the Chinese Academy of Sciences, Director of the Department of Comprehensive Surgery Yue Shuqiang, and Deputy Director of the Department of Hepatobiliary Pancreatic and Spleen Surgery Yang Yanling carried out ex vivo liver splitting and donor liver trimming


Director Tao Kaishan, Deputy Director Yang Zhaoxu and Deputy Director Wang Lin of the Department of Hepatobiliary, Pancreatic and Spleen Surgery, and Yang Xiaojian, Deputy Director of the Department of Urology, dissected and separated the livers and kidneys of gene-edited pigs and perfused them to obtain donor organs


Director Song Baoqiang of the Department of Plastic Surgery and Deputy Chief Physician Liu Chaohua performed vascular anastomosis between the arteries and veins in the thoracic cage of gene-edited pigs and the arteries and veins on the abdominal wall of the recipient monkeys


Qin Weijun, director of the Department of Urology, Yang Xiaojian, deputy director, and Ma Shuaijun, deputy chief physician, transplanted the kidneys of gene-edited pigs into recipient monkeys

Liu Jincheng, director of the Department of Cardiovascular Surgery, and Yi Wei, deputy director of the Department of Cardiovascular Surgery, performed multi-gene editing pig-monkey orthotopic heart transplantation


According to different specialties and different surgical methods, Director Dong Hailong and Professor Chen Min of the Department of Anesthesiology quickly implemented individualized anesthesia, accurately regulated physiological indicators, and escorted 7 specialized surgeries


Professor Fei Zhou of the Department of Neurosurgery and Ye Zhengxu, deputy director of the Department of Orthopedics, carried out bone grafting and median nerve transplantation respectively


Director Zhou Jian of the Department of Ophthalmology transplanted the cornea of a multi-gene edited pig donor to the recipient monkey


Associate Professor Huang Jinghui and Deputy Chief Physician Zang Chengwu of the Department of Orthopedics carried out multi-gene editing pig-monkey median nerve transplantation
After blood flow to the transplanted organ is restored, bile outflow is seen from the transplanted liver; The transplanted kidney immediately produces urine; The transplanted heart immediately regains its beating, regularity and strength. The liver, kidney, and cardiac function were good after surgery. The transplanted corneal graft and transplant bed were transparent, and the postoperative indexes were significantly better than those of the control group. Bone grafting and median nerve grafting, after 3 months to evaluate the fusion and function of the grafted bone. Among them, the xenovascular abdominal wall transplantation, the 32cm×12cm transplanted abdominal wall, is a full-thickness incision of “skin, fat, muscle, peritoneum, ribs and costochondral and other composite tissues”, which overcame the problem of large gap in the diameter of the donor and recipient blood vessels during the operation, and survived the difficulties of gastrointestinal stress ulcer bleeding and early immune rejection after surgery, and is currently alive well. According to Song Baoqiang, director of the Department of Plastic Surgery, the repair of large-scale full-thickness abdominal wall defects is a huge challenge faced by the medical community, and the current conventional repair methods have certain limitations.
“The above study is another useful exploration and positive attempt to determine whether xenotransplantation is feasible for the first aid of severe tissue damage and organ failure, and will further expand and confirm the feasibility and effectiveness of xenotransplantation in medical treatment.” As one of the potential solutions to solve the problem of the shortage of allogeneic organs and tissues, xenotransplantation has broad clinical application prospects in the future, and Xijing Hospital will continue to deepen its efforts in this field. Academician Dou Kefeng said.

Group photo of representatives of participating departments
(Originally titled “Xijing Hospital Multi-gene Editing Pig-Monkey Multi-organ and Multi-tissue Simultaneous Transplantation Achieves New Breakthrough”)

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