The Happy Pod: Record pig kidney transplant brings hope

**Holly Gibbs** (0:00)
This is the HappyPod from the BBC World Service. I'm Holly Gibbs, and in this edition, the new hope for people waiting for organ transplants.

**Leonardo Riella** (0:16)
The biggest issue that we have currently in transplantation is the organ shortage. It's a crisis. The majority of our patients do not have access to organs in a timely manner.

**Holly Gibbs** (0:27)
We hear about the man who lived with a pig's kidney for a record nine months.

**Alison Balance** (0:32)
Also on this podcast, It's so unusual, a giant flightless night parrot found only in New Zealand.
It looks endearing, of course. It's got such unusual biology.

**Holly Gibbs** (0:44)
The rare bird brought back from the brink of extinction.

**Michael Lewis** (0:47)
You can get really, really close to the tapestry, quite unlike you could in Bayeux in a way. So I think people are just gonna be overwhelmed by the detail and the fact that it brings that period of, you know, the 11th century to life.

**Holly Gibbs** (1:00)
The new display showing the world famous Bayeux Tapestry as it's never been seen before. Plus the DJ making music with strangers on the streets of New York, and.

**Matthew Wilcock** (1:13)
I've done London. I've almost got Tokyo done.
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**Holly Gibbs** (1:21)
The composer turning the world's underground trains into melodies.
We start with a medical breakthrough that could offer new hope to people around the world waiting for organ transplants. Every year, tens of thousands die because there simply aren't enough human donor organs available. But now, a man in the US has survived for a record nine months with a kidney from a genetically modified pig. Speaking before the transplant, 66-year-old Tim Andrews explained how much it meant to him.

**Tim Andrews** (1:57)
Hope, because I'm in a room with a bunch of people that are having the same problem, depressed, tired, three quarters of them are in wheelchairs because they've been so exhausted. I'm like, this is hope. Hope is the biggest thing.
You know, the chance to be free from the machine and live your life.

**Holly Gibbs** (2:21)
Mr. Andrews went on to receive a human donor kidney and is doing well.
Dr. Leonardo Riella from Harvard Medical School led the team. He told my colleague Gary O'Donoghue why this breakthrough was so significant.

**Leonardo Riella** (2:35)
We passed through a major milestone for two reasons. I think number one, we had a pig kidney working and performing all the expected kidney functions for more than nine months, allowing our patient to be off dialysis. And second, we were able to transition this patient from a pig kidney to a human kidney, which was something that scientists and physicians have some concerns that by doing a pig kidney, first we may prevent patients from having the option of human transplantation in the future, so those are two very important milestones that we were able to pass.

**Gary O'Donoghue** (3:13)
And this is no ordinary pig kidney, you had to sort of do some genetic modifications to the pigs themselves to begin with, correct?

**Leonardo Riella** (3:21)
Correct, these are very unique pigs, they are cloned and they have genetic edits to improve the compatibility between the pig kidney and humans.

**Gary O'Donoghue** (3:34)
Now this is a kind of bridge technique, I understand it, while you wait for a human kidney to be available, a donor kidney, what problems did you encounter after you had implanted this kidney? Because it did eventually fail, didn't it?

**Leonardo Riella** (3:48)
Yes, the immune system of humans do recognize certain things in the pig that's slightly different than a traditional human transplant. So I think they're learning, you know, in terms of trying to understand what are some of the differences between a human and a pig kidney and how the immune system recognizes that. And second, how can we tweak, how can we change slightly our anti-rejection meds in order to be able to control that in the long term? So I think we're sort of getting in the right direction. And we have another patient who just passed the nine month mark with the pig kidney. So these are very exciting findings so far.

**Gary O'Donoghue** (4:26)
And for those who don't know, give us an idea of what this means in terms of the patient's quality of life while they're waiting for a donor kidney.

**Leonardo Riella** (4:36)
So the biggest issue that we have currently in transplantation is the organ shortage. It's a crisis. Because we know that with patients with kidney failure, the best treatment option for the majority of patients is to get a transplant. And unfortunately, the majority of our patients do not have access to organs in a timely manner, so they have to remain on dialysis. And dialysis is an incredible technology and innovation that keeps patients alive. But unfortunately, it is a treatment that cannot reproduce the function of a true kidney. So you go to a dialysis center, you filter your blood three times a week for three or four hours. And the consequences of that is that many of these patients that stay on dialysis, they start developing cardiovascular disease and worse outcomes.