Heart failure

Pig heart transplant patient died of heart failure, study finds

BALTIMORE — Doctors at the University of Maryland School of Medicine have concluded that a man who received a pig heart transplant, the first of its kind, in January, died two months later of heart failure . Although the reason for the failure remains under investigation.

The man, David Bennett, was able to get out of bed, begin rehabilitation and spend time with his family in the weeks following the transplant at the University of Maryland Medical Center. His doctors say that makes the effort a success.

All the information gathered afterwards will be applied when it is ready for the next so-called xenograft patient. This includes clues about how to prevent problems that may have contributed to heart failure, including a reaction to medication aimed at preventing rejection.

“We are still trying to figure out what went wrong; we don’t have a single answer,” said Dr. Muhammad M. Mohiuddin, co-lead of the porcine heart study and Professor of Surgery and Scientific/Program Director of the Cardiac Xenotransplantation Program at the School of Medicine. .

“But we don’t see it as a setback,” he said. “We consider that he lived the surgery of the first victory. When he seemed to recover and be fine for two months, we really thought he was a huge success. If we could have identified the reason why his heart suddenly gave out, he might have left the hospital.

An autopsy revealed that Bennett’s body showed no traditional signs of heart rejection. Instead, doctors saw thickening and then stiffening of the heart muscle, possibly a reaction to a drug used to prevent rejection and infection. This made him unable to relax and fill with blood like he’s supposed to.

According to the doctors’ study, published in June in the New England Journal of Medicine, they also found DNA from a latent infection in the specially bred pig that escaped precautions and screening. It is still unclear whether this contributed to the heart failure.

Bennett, 57, had been bedridden and hooked up to a heart-lung bypass machine that saved his life for eight weeks with end-stage heart failure before the transplant with the genetically modified pig heart. He was ineligible for a traditional heart transplant, and federal regulators granted him a so-called “compassionate use” exemption to have the experimental pig heart transplant. These animal organ transplants are not approved by the United States Food and Drug Administration.

Mohiuddin said any findings will lead to changes in practices and techniques in future trials. Patients and their families have contacted him and other doctors since the announcement of the transplant, but there is no timeline for another transplant.

“There is a patient population that could benefit from it, and many have come forward, volunteered for the procedure,” he said. “Before satisfying someone else, we must be convinced that what we have learned can be applied to the next.”

The transplant is the result of a $15.7 million research grant from Virginia-based biotech company Revivicor to study its genetically modified pig UHearts in baboons.

About 110,000 Americans are currently waiting for organ transplants, and more than 6,000 die each year while on the list, according to federal figures.