Expectations for progress in transplantation medicine by gene engineering

The enzyme alpha1,3-galactosyltransferase synthesizes alpha1,3-galactose (α-1,3Gal) epitopes, which are the major xenoantigens causing hyperacute rejection in pig-to-human xenotransplantation. Bacterial infection with α-1.3GT has been shown to acquire anti-α-1.3GT antibody in humans. Complete removal of α-1,3Gal from pig organs is the critical step toward the success of xenotransplantation. In Jan. 17, 2003, Phelps et al. reported in Science that healthy α-1,3GT double-knockout female piglets, which were produced by three consecutive rounds of cloning, had the potential to make a safer product for human use.

In Nov. 1, 2021, Dolgin reported in Science that the transplant study, performed at New York University, showed the human immune system doesn’t immediately reject an organ from a pig engineered to lack alpha-gal, a sugar molecule that sends the human immune system into a frenzy. The porcine kidney filtered waste from the blood and produced urine for at least 54 hours.

Approximately 19 years after the report of the first basic research, clinical research on humans was conducted, and great progress was reported. I look forward to future advances in transplantation medicine.

Doctor specializing in cancer medicine / emerging infectious diseases　    New Engl J Med. published at Jan 06, 2022 by Kyoto@takumaH