The details of the first pig heart transplantation were fully disclosed: human herpes virus was found in the patient, the weight of the heart doubled after death, and myocardial cell fibrosis

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A few months after the death of the first pig heart transplant patient , The inquiry into the cause of his death continues .

Is it related to rejection reaction , It has become the focus of attention .

lately ,《 New England Journal of Medicine 》 Publish papers , More details before and after the operation were disclosed .

The paper shows that , The patient's heart weight after death was almost Doubled , from 328 G increased to 600 g .

Fibrotic tissue appears in the heart , With red blood cell extravasation .

△ chart B The patient's heart is enlarged

meanwhile , The doctor also found... In the patient's lungs Human herpesvirus （HHV-6）.

This virus can be compared with those detected in transplanted hearts Porcine cytomegalovirus , Cross react ; It is also related to xenotransplantation rejection .

however , The researchers also said , Abnormal phenomenon of the patient's heart , And the rejection reaction caused by typical organ transplantation Don't agree with each other .

But there is no proof yet , Whether the patient died of viral infection .

The heart weighs from 328 G rises to 600 g

This paper details the details of patients before and after transplantation , Including the condition of heart transplantation 、 The patient's own health and postoperative medication .

Autopsy results showed that , There is really a big problem with the heart transplant .

The most obvious phenomenon , The weight of the heart almost doubled . Doctor explains , This is mainly because the blood vessels show signs of leakage .

meanwhile , There are also some signs of myocardial fibrosis .

Generally speaking , Myocardial fibrosis is a response to myocardial necrosis , And the reaction is irreversible , This phenomenon occurs in many late heart attacks .

But the researchers stress , These problems are related to the typical rejection of allogeneic organ transplantation , Don't agree with each other .

And another issue that people are very concerned about —— On the transplanted heart Whether it carries virus , The answer is also given in detail in this paper .

According to introducing , This genetically edited pig heart , Only porcine endogenous retrovirus was carried before transplantation PERV-A and PERV-B, Did not detect PERV-C、 Porcine cytomegalovirus and porcine lymphotropic herpesvirus .

As for why after the operation 20 days , A low level of porcine cytomegalovirus was detected in the patient's blood , The paper still gives no explanation .

at that time , As the level of porcine cytomegalovirus in the blood increases , The doctor used the therapy originally used for cytomegalovirus infection in patients with AIDS , On the other side, the patient was injected with human immunoglobulin to enhance their resistance .

And then , The patient's physical condition is relieved , After surgery 48 Even get out of bed during the day .

But then , His situation took a sharp turn , Abnormal hypertrophy of the heart wall of the transplanted heart was found 、 Ventricular volume decreases , The level of antibody to pig tissue is also rising .

The doctors think , This may be due to the emergence of antibody mediated Atypical immune rejection The phenomenon .

Finally, it is transplanted 60 days , The patient suffered from severe heart damage , Unfortunately died .

One More Thing

With the completion of the first pig heart transplantation , People from all walks of life pay more and more attention to xenotransplantation .

Although it can alleviate the current shortage of organ transplant donors , But it also brings a lot of risks and concerns .

“ Immune rejection ”、“ Cross species biosafety ”、“ Social ethics ” It has become an academic circle 、 Several major problems that the society is generally worried about .

In the other direction ——3D Printing organ , Maybe it deserves our attention .

lately , For the first time in the world 3D Print ear transplant operation completed .

a 20 Year old Mexican girl , adopt 3D Printed collagen hydrogel scaffolds and cartilage tissue cultivated by their own cells , A transplantable left ear was successfully obtained .

And because surgery uses its own cells , Therefore, the probability of rejection reaction will be reduced .

This operation was performed by American regenerative medicine company 3DBio Therapeutics Provide support .

According to its executives , In the future, they will try to print other body parts , Such as spine 、 Nose, etc .

Address of thesis ：
https://www.nejm.org/doi/pdf/10.1056/NEJMoa2201422