A distinguished surgeon renowned for his pioneering work in the field of xenotransplantation, Bartley P. Griffith, MD, FACS, FRCS, will deliver the annual John H. Gibbon Jr. Lecture this morning.
In his presentation, What’s New May Be Old: Xenotransplantation (9:45 am in Room 104ABC), Dr. Griffith will share details about the historic, first-of-its-kind in-human xenotransplant of a genetically modified pig heart that his team from the University of Maryland Medical Center (UMCC) in Baltimore, Maryland, successfully performed in January 2022.
The patient, 57-year-old David Bennett, who was in end-stage heart failure and nearing the end of his life, did not qualify for a traditional heart transplant. The procedure, which marked an important milestone for medical science, was authorized by the US Food and Drug Administration under its expanded access (compassionate use) provision. Bennett survived 2 months after the transplantation.
“We were determined to shed light on what led to the heart transplant dysfunction in Mr. Bennett, who performed a heroic act by volunteering to be the first in the world,” said Dr. Griffith, who is director of the Cardiac and Lung Transplant Programs and the Thomas E. and Alice Marie Hales Distinguished Professor of Transplant Surgery at the University of Maryland School of Medicine. “We want our next patient to not only survive longer with a xenotransplant but to return to normal life and thrive for months or even years.”
Just last month, Dr. Griffith and his team performed another xenotransplantation, as 58-year-old Lawrence Faucette, who was facing near-certain death from heart failure, became the second person in the world to receive a transplant of a genetically modified pig heart. As of publication, he is continuing to recover.
In the Gibbon Lecture, Dr. Griffith promises to share fascinating, behind-the-scenes details of the groundbreaking surgeries, as well as discuss lessons learned and the essence of what propels surgical pioneers.
“While I recognize the impact and potential of these operations, it’s important to note that many of these firsts are prompted out of clinical need, preparedness, and a surgeon’s drive to make a difference,” said Dr. Griffith, who has performed more than 1,200 heart transplants on patients throughout his 40-year career.
Dr. Griffith plans to weave a narrative that bridges the past with the present, starting with an apt case in point from the lecture’s namesake, John H. Gibbon Jr., MD.
In 1931, Dr. Gibbon was part of a team that used an “off-pump” surgical embolectomy to treat a patient with a massive pulmonary embolism. At that time, this treatment had a staggeringly high mortality rate and had never been performed successfully in the US.
It is no surprise that this experience profoundly affected Dr. Gibbon, as his job was to stay with the patient while she deteriorated. During that long night, he had an idea for a machine that could take deoxygenated blood, oxygenate it, and pump it back into the arterial system. Dr. Gibbon spent more than 20 years developing the heart-lung machine, and on May 6, 1953, he performed the first successful operation using an extracorporeal circuit on an 18-year-old woman with a large atrial septal defect.
“His success followed years of clinical experience and trial and error in the laboratory,” said Dr. Griffith.
Dr. Griffith will draw a parallel between his own team's trailblazing procedure and how firsts often result from clinical need. On December 3, 1967, a young woman who was carrying a caramel cake she had just purchased was struck and killed while crossing the street. Christiaan N. Barnard, MD, transplanted her heart into a middle-aged man suffering from intractable heart failure caused by coronary artery disease. He died 18 days later from extensive bilateral pneumonia. However, the limited success was hailed throughout the world as a major medical triumph and provided the impetus for him to keep trying.
Similarly, more than 50 years later, the UMCC team replaced a failing heart, but this time with a genetically engineered pig heart. "We exchanged our patients’ blood-starved hearts with genetically engineered pig hearts,” said Dr. Griffith. “And like Dr. Barnard, we faced many challenges and relied on past mentorship, clinical experiences, and laboratory outcomes. We built a just confidence that we might save a life, add to our knowledge, and move the field toward transplant organ on demand.”
The John H. Gibbon Jr. Lecture, sponsored by the Advisory Council on Cardiothoracic Surgery, will be available for on-demand viewing shortly after the live presentation.
