Groundbreaking eye transplantation project unites top experts from Pittsburgh and beyond
It's a "moonshot" project, but Dr. José-Alain Sahel is up for the challenge.
It may seem like the stuff of science fiction, but a team of doctors and scientists — many based in Pittsburgh — are aiming to make vision-restoring eye transplants a reality.
It’s the type of project referred to as a “moonshot,” but Dr. José-Alain Sahel is ready for the challenge.
Sahel, who relocated to Pittsburgh from France about eight years ago because of rising antisemitism, is chair and distinguished professor in the Department of Ophthalmology at the University of Pittsburgh School of Medicine. He has been tapped to co-lead the groundbreaking project with Dr. Jeffrey Goldberg, chair of ophthalmology at the Byers Eye Institute at Stanford University. They are bringing together a team of scientists, doctors and other experts from around the country to find a way to give sight to the blind.
The project, called Transplantation of Human Eye Allografts, will receive an award of up to $56 million from the Advanced Research Projects Agency for Health, an agency within the U.S. Department of Health and Human Services, and include team members from three Pittsburgh universities: Pitt, Carnegie Mellon and Duquesne.
The roots of the endeavor, Sahel said, go back to the late 19th century, when the founder of the French Society of Ophthalmology attempted the first eye transplantation in France.
“It failed miserably,” Sahel said.
After that, efforts for eye transplantation were largely put aside for many decades. They were not revived until about 15 years ago, following successful face and hand transplantations.
“People started to consider that maybe transplanting an eye would be also a possibility,” Sahel said.
But he told Science magazine in 2015 that he had his doubts.
“All of this is no longer deemed impossible, it is just a huge, huge crazy effort,” Sahel said then.
Around that time, Vijay Gorantla, a plastic surgeon in Pittsburgh who helped pioneer Pitt’s hand and arm transplants, began an eye transplantation project along with one of his trainees, Kia Washington. Partnering with Pitt’s ophthalmology department and Sahel’s predecessor, Dr. Joel Schuman, the team began their experiments with rats and pigs. The most daunting challenge they faced, Science reported, was “coaxing nerves to regenerate and connect the donor eye to the recipient’s brain.” The team knew then that they were years away from human eye transplants.
It was also around that time that the Louis J. Fox Center for Vision Restoration, a multi-disciplinary research and clinical program dedicated to ocular regenerative medicine, was established at the University of Pittsburgh. The center was funded by Connecticut residents Louis and Dorothy Fox. Louis Fox was almost totally blind due to a blockage in the vein leading away from the eye and was motivated to support Pittsburgh in its efforts toward vision restoration.
When Sahel moved to Pittsburgh from France, he met with Fox.
“We had discussions and I told him that the main challenge [to reverse blindness] was with the optic nerve regeneration,” Sahel said. “How do we reconnect the brain and the eye? And that we should, instead of trying to do everything, we should focus on this very question, because this is the core question. This was the next frontier, and it’s still the next frontier.”
Sahel and his team then began recruiting people outside of Pittsburgh who also were working on optic nerve regeneration for collaboration. Each year, experts from around the world gather for a symposium to share information about their projects and discuss ways to work together to restore vision.
Two events occurring last fall “had a strong impact” in moving the eye transplantation project ahead, Sahel said.
The first was that a team at New York University, which performed a face transplantation on a patient, performed an eye transplantation at the same time. But while the cosmetic aspect of the eye transplant was successful, there was no vison in the eye.
“The surgery was done very well, which is good news,” Sahel said he told the press at the time, “but the surgery is probably the smallest part of a problem. We have many more problems, especially the optic nerve and other things.”
The other event that impacted the momentum of the project was the Biden administration’s creation of ARPA-H, a research funding agency supporting transformative biomedical and health breakthroughs.
“They created this agency for ‘moonshot’ projects — this is how they define that,” Sahel said. “These projects are things that you would never do. But if you are told this is the challenge, then you assemble the team.”
Dr. Calvin Roberts, a renowned ophthalmic surgeon, who is the program manager for the Transplantation of Human Eye Allografts project, contacted several experts in the field, including Sahel, asking if they thought they could “contribute to the idea of an eye transplantation,” Sahel said.
Sahel explained the many challenges to Roberts. He also discussed the proposal with his colleagues Dr. Larry Benowitz, a professor of ophthalmology at Pitt (formerly of Harvard), and Goldberg at Stanford.
“We had all been approached by Calvin Roberts about this idea of eye transplantation, and we thought, well, if this is going to happen, we have to do it right,” Sahel said. “We should not hide any question, because this is a big endeavor. It’s going to raise a lot of hopes and it’s also going to get significant support. So we started to work on the plan.”
They initially thought they would form two consortia, “one around optic nerve regeneration, that would be mostly led by Jeff Goldberg, but involving several people in Pittsburgh, and the other one on how to protect the eye between the donor and the recipient.”
But the ARPA-H agency suggested the two proposed consortia be merged into a single project.
“So this is what’s happening,” Sahel said. “Jeff [Goldberg] is leading the project, and I’m co-leading the project, and we brought into that around 27 teams from across the country. And so it’s a massive project.”
Of the 27 teams, about 10 are in Pittsburgh.
“Pittsburgh has very strong expertise in transplantation, as you know, from the Thomas Starzl era, and are still very, very good,” Sahel said.
The project is bringing together many types of experts, “which is something I like to do,” he added. “It’s very exciting.”
The project has a six-year timeline.
While the scientists do not yet know whether their efforts will be successful, Sahel said, “we will do everything we can to make it work.”
Sahel was awarded the Wolf Prize in Medicine last summer for his work in vision restoration using optogenetics. The Wolf Prize, conferred in Israel by the Wolf Foundation, is considered one of the world’s most prestigious recognitions for scientific and artistic achievements, according to Forbes. PJC
Toby Tabachnick can be reached at ttabachnick@pittsburghjewishchronicle.org.
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