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美國外科醫師首度將豬心臟移植到人類患者體內

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The Associated Press · Posted: Jan 10, 2022 6:27

在醫學上的最後努力中,外科醫師們首度成功,將經基因改造的豬心臟移植到一名美國男性身上,以挽救其生命的短片,請參閱原文。

 

The experimental procedure was a last-ditch effort to save a man's life. He's still alive 3 days later

該項實驗性做法是挽救一名男性生命的最後努力。3天後,他仍然活著。

 

In a medical first, doctors have transplanted a pig heart into a patient, in a last-ditch effort to save his life. And three days after the highly experimental surgery, a Maryland hospital said Monday that the patient is doing well.

在醫學上,為挽救一名病患生命的最後努力中,醫師們已經首度將一顆豬心臟移植到其體內。該項高度實驗性的手術後三天的星期一(2022110),馬里蘭州一家醫院表示,此病患表現良好。

 

While it's too soon to know if the operation really will work, it marks a step in the decades-long quest to one day use animal organs for life-saving transplants. Doctors at the University of Maryland Medical Center, near Baltimore, say the transplant showed that a heart from a genetically modified animal can function in the human body without immediate rejection.

儘管現在要知曉,是否該項手術實際能起作用,為時尚早。不過,就挽救生命的移植手術而言,這標誌了數十年來,在尋求有朝一日,使用動物器官的一步。馬里蘭大學醫學中心(鄰近巴爾的摩市)的醫師們表示,該項移植顯示,來自一隻經基因改造之動物的心臟,能在人體內發揮作用,而無立即的排斥反應。

 

The patient, David Bennett, 57, knew there was no guarantee the experiment would work, but he was dying, ineligible for a human heart transplant and had no other option, his son told The Associated Press.

David Bennett該名57歲病患的兒子告訴美聯社,他知曉沒有保證,該項實驗能起作用。不過,他垂死中,不合宜接受人類心臟移植,因此別無選擇。

 

"It was either die or do this transplant. I want to live," Bennett said a day before the surgery, according to a statement provided by the University of Maryland School of Medicine. "I know it's a shot in the dark, but it's my last choice."

根據馬里蘭大學醫學院提供的一份聲明,在手術前一天,Bennett宣稱:「這不是死亡,就是進行這種移植。我想活命。我知道,這是幾乎沒有成功希望的姑且一試。不過,這是我的最後選擇。」

 

There's a huge shortage of human organs donated for transplant, driving scientists to try to figure out how to use animal organs instead. Last year in the U.S., there were just over 3,800 heart transplants — a record number — according to the United Network for Organ Sharing (UNOS), which oversees the nation's transplant system.

供移植使用之捐贈的人體器官嚴重短缺,這促使科學家們試圖弄清楚,如何使用動物器官來代替。根據監督美國移植體系之器官共享聯合網絡 (UNOS)的數據,去年在美國就有3800多例心臟移植。這是一個創記錄數字。

 

Numbers are also up in Canada. In 2019, more than 3,000 organ transplant procedures in total were performed, an increase of 42 per cent since 2010, according to the latest data from the Canadian Organ Replacement Register (CORR) — a pan-Canadian information system for organ failure in Canada.

於加拿大,數字也攀升。根據來自加拿大器官置換登記處(CORR:於加拿大器官衰竭的泛加拿大資訊系統)的最新數據,於2019年,總共進行了3000 多例器官移植。打從2010年以來,增加了42%

 

"If this works, there will be an endless supply of these organs for patients who are suffering," said Dr. Muhammad Mohiuddin, scientific director of the animal-to-human transplant program at the University of Maryland.

馬里蘭大學動物到人類移植計劃的科學主管,Muhammad Mohiuddin博士宣稱:「倘若這起作用,對正在受苦的病患而言,將會有源源不絕之此類器官的供應。」

 

But prior attempts at such transplants — or xenotransplantation — have failed, largely because patients' bodies rapidly rejected the animal organs. Notably, in 1984, Baby Fae, a dying infant, lived 21 days with a baboon heart.

不過,先前在這種移植(也就是異種移植)的諸多嘗試,一直失敗。主要是因為,病患的身體迅速排斥動物器官。值得注意的是,於1984年,一名罹患左心發育不全徵候群的垂死嬰兒,Baby Fae以一顆狒狒的心臟,活了21天。

 

The difference this time: The Maryland surgeons used a heart from a pig that had undergone gene-editing to remove a sugar in its cells that's responsible for that hyper-fast organ rejection.

這次的差異:此些馬里蘭州的外科醫師使用了,來自一頭業已經過基因編輯,來去除一種於細胞中,導致超快器官排斥之糖類的豬心臟。

 

"The big issue with the story is that with transplants, the issue is always that you need to find a match, and your body will very quickly reject a heart from another species," Dr. Christopher Labos, a Montreal-based cardiologist, told CBC News in an email exchange.

一名以蒙特婁為據點的心臟病學家,Christopher Labos博士,在一次電子郵件交流中,告訴CBC News:「有關上述移植的最大問題是,關於移植,問題始終是需要找到匹配的。因為,身體會很快排斥,來自另一物種的心臟。」

 

"The interesting thing to me is that they were able to make a genetically modified pig that suppressed the cell markers that would lead to rejection. That's very interesting, going forward."

「對我來說有趣的事是,他們能夠製造出一種經基因改造,來抑制會導致排斥之細胞標記的豬。展望未來,那是很引人關注的。」

 

"I think you can characterize it as a watershed event," Dr. David Klassen, UNOS' chief medical officer, said of the Maryland transplant. Still, Klassen cautioned that it's only a first tentative step into exploring whether this time around xenotransplantation might finally work.

器官共享聯合網絡的首席醫療長,David Klassen博士談到馬里蘭州的移植時宣稱:「我認為能將其描述為一個分水嶺事件。」儘管如此,Klassen警告說,這只是探索這一次以異種移植為基礎,是否最終能起作用的嘗試性一步。

 

The Food and Drug Administration, which oversees xenotransplantation experiments, allowed the surgery under what's called a "compassionate use" emergency authorization — available when a patient with a life-threatening condition has no other options.

監督異種移植實驗的食品暨藥物管理局,在被稱為一種“特許使用”的緊急授權下,允許了這種手術。也就是,當患者具有危及生命的疾病,而沒有其他選擇時,可以使用。

 

Last September, researchers in New York performed an experiment suggesting the genetically modified pigs might offer promise for animal-to-human transplants. Doctors temporarily attached a pig's kidney to a deceased human body and watched it begin to work.

去年(2021) 9月,於紐約的研究人員們進行了一項,暗示經基因改造的豬,可能為動物到人類之移植提供指望的實驗。醫生們暫時將豬的腎臟連接到一具已死的人體上,並觀察其開始起作用。

 

The Maryland transplant takes that to the next level, said Dr. Robert Montgomery, who led that experiment at NYU Langone Health in New York City.

於紐約大學朗格尼健康中心(位於紐約市,是一個學術醫療中心),領導那項實驗的Robert Montgomery博士表示,馬里蘭州的移植將那帶到了一個新的階段。

 

"This is a truly remarkable breakthrough," he said in a statement. "As a heart transplant recipient myself with a genetic heart disorder, I am thrilled by this news and the hope it gives to my family and other patients who will eventually be saved by this breakthrough."

在一份聲明中,他宣稱:「這是一個真正引人矚目的突破。作為一名自身患有遺傳性心臟病的心臟移植受贈者,我對此消息及這給我的家人及其他最終會因為此突破,而得救之患者的可能性,感到興奮。」

 

It will be crucial to share the data gathered from this transplant before opening the option to more patients, said Karen Maschke, a research scholar at the Hastings Center in Garrison, N.Y., who is helping develop ethics and policy recommendations for the first clinical trials under a grant from the National Institutes of Health.

於紐約州加里森村黑斯廷斯中心,在來自美國國家衛生研究院一項補助金下,正協助為首次臨床試驗,制定道德準則及政策建議的研究學者,Karen Maschke表示,在對更多患者開放選擇之前,分享從這次移植中收集的數據,這會是至關重要。

 

"Rushing into animal-to-human transplants without this information would not be advisable," Maschke said. The surgery last Friday took seven hours at the Baltimore-area hospital.

Maschke宣稱:「沒有此資訊,冒然進行動物對人的移植,會是不明智的。」上週五(202217),該項手術在巴爾的摩地區醫院,進行了七個小時。

 

"He realizes the magnitude of what was done and he really realizes the importance of it," David Bennett Jr. said of his father. "He could not live, or he could last a day, or he could last a couple of days. I mean, we're in the unknown at this point."

David Bennett Jr(David Bennett的兒子)談到其父親時宣稱:「他意識到所進行的重要性,且真正意識到其重要性。他可能活不了,或可能維持一天,或可能維持幾天。我的意思是,此時我們是處於未知狀態。」

 

 

網址:https://www.cbc.ca/news/health/doctors-transplant-pig-heart-patient-1.6310098?cmp=rss

翻譯:許東榮

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