Washington Needs to Champion Breakthroughs on Organ Transplants

COMMENTARY

Thanks to better treatments for more diseases like cancer and heart disease, Americans are living longer and life after 60 is becoming more active and productive. The trend is expanding, because by 2030 about one in five Americans will be 65 and older. Longer life can mean later retirement and an extended period of contributing more to society than is needed from it, a moral and economic miracle in the making, thanks to science.

But it also means that pressure is building on treatments that have lagged for decades and continue to plague millions of American families. For example, dialysis is the only treatment for kidney disease, which nearly 40 million Americans suffer from. It dates back to the 1940s and remains an agonizing and expensive stopgap with diminishing benefits over time. Liver failure, by comparison, has no effective treatment for the 4.5 million Americans with that condition.

The only cure for either condition is transplantation, and demand for kidney and liver transplants far outweighs others. But less than half of needy patients in the U.S. can find a human donor each year. We will never catch up with current methods, because even if every American signed an organ donor card, we still wouldn’t come close to meeting the demand.

Organ and tissue transplants from animal donors have been studied for more than a century, and heart valve transplants from pigs have been successfully performed for more than 30 years. But American scientists in this field, called xenotransplantation, are racing to make the next big leap just as longer lives are turning a brighter spotlight on this area of medical science in desperate need for a breakthrough.

Dr. Joseph Tector, a renowned Florida-based transplant surgeon who leads the transplantation research program at the Miami Transplant Institute, has spent decades on creating gene-editing technology that can breed pigs who can donate viable kidneys and livers that can be successfully transplanted into human patients. After many promising advances, his Makana Therapeutics team and partners at several universities are preparing for clinical trials that could be a game changer for generations to come.

The similarities between pig and human organs are what spurred research in the field of xenotransplantation. Tector’s decades-worth of research has been aimed at breeding genetically altered pigs without key antigen blockers that play a role in organ rejection. This would dramatically lower the immune response to those organs in human recipients and increase the success rate for kidney and liver patients. His lab has already bred genetically advanced versions of these pigs for highly promising studies in primates as a last step before clinical human trials.

Today, the majority of Americans waiting for kidney and liver transplants are over the age of 50, with a sharply rising statistic among those 65 and older. These numbers point not only to higher demand in the future but growing need for so-called re-transplants, where donated organs reach the end of their effectiveness and a new transplant is needed to preserve the continued health of a patient.

This is especially true for kidney transplant recipients. Currently, donated kidneys last on average from 14 to 28 years before failing and requiring a new transplant. With Americans living longer, demand for kidneys will therefore multiply. This makes the need to solve the supply problem all the more urgent.

The worst thing that could happen to this rapidly advancing field of research is for the usual gears of Washington bureaucracy to grind it unnecessarily to a halt. The COVID vaccine effort was a hallmark in American achievement through Operation Warp Speed, but it took decisive commitment from both our political leaders and the best minds at the U.S. Food and Drug Administration to make it happen.

A similar meeting of the minds is needed to solve the organ shortage, now that Tector’s team has a possible solution in the works. Those of us in the trenches on health care advocacy must be vigilant again with an FDA that has a spotty record on innovation. We’ve come so far that we’ve revolutionized life after 60. Now is not the time to leave behind millions of Americans on transplant waitlists today and in the future who deserve to share in it.

Saul Anuzis is the president of the 60 Plus Association, a nonprofit organization that advocates for seniors who believe in market-based solutions.