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NEW YORK (AP) — Doctors transplanted a pig kidney into a dying New Jersey woman. This is part of two dramatic surgeries to stabilize her weakened heart.
Lisa Pisano has heart and kidney failure, and her symptoms are too severe to qualify for a traditional transplant, leaving her with no options. So doctors at NYU Langone Health have devised a new one-two punch. A mechanical pump was implanted to keep the heart beating, and a few days later a genetically modified pig kidney was transplanted.
Pisano is recovering well, the New York University team announced Wednesday. She is the second patient to receive a pig kidney following the ground-breaking transplant surgery. Last month at Massachusetts General Hospital – and the latest in a series of attempts to make animal-to-human transplantation a reality.
This week, the 54-year-old grabbed a walker and took her first few steps.
“I was at my limit,” Pisano told The Associated Press. “I just took a chance. And worst case scenario, even if it didn't work for me, it might have worked for someone else and I could have helped the next person.” yeah.”
Dr. Robert Montgomery, director of the New York University Langone Transplant Institute, described the cheers in the operating room when the organ immediately began producing urine.
Lisa Pisano looks at photos of her dog after surgery at NYU Langone Health on Monday, April 22, 2024 in New York. Doctors transplanted a pig kidney into the dying Pisano, part of two dramatic surgeries that also included damage to his heart. Let's heal her weakening heart. (AP Photo/Shelby Lamb)
“It's been transformative,” Montgomery said of the experiment's early results.
But “we're not out of the woods yet,” cautioned Dr. Nader Moazzami, the New York University cardiac surgeon who implanted the heart pump.
“Thanks to this surgery, I was able to see my wife smile again,” Pisano's husband, Todd, said Wednesday.
Other transplant specialists are closely monitoring the patient's condition.
“We have to congratulate them,” said Dr. Tatsuo Kawai of Massachusetts, noting that his pig kidney patients were in better overall health heading into surgery than the patients at New York University. “It is very difficult to perform a kidney transplant if your heart is in poor function.”
pig organs quest
More than 100,000 people are on the transplant waiting list in the United States, most of them people who need kidneys, and thousands die while waiting. To make up for the shortage of donor organs, several biotech companies are genetically modifying pigs to make their organs more human-like and less likely to be destroyed by the human immune system.
New York University and other researchers temporarily transplanted pig kidneys and hearts Transplanted into brain-dead bodies with promising results. The University of Maryland then transplanted pig hearts into her two men who had no other options. They both died within a few months of each other..
Mass General's pig kidney transplant last month has given him new hope. Kawai said Richard “Rick” Suleiman experienced an early fear of rejection, but recovered enough to be sent home earlier this month and is still doing well five weeks after his transplant. That's what it means. A recent biopsy revealed no further problems.
The complex case of New York University
Pisano was the first woman to receive a pig organ, but unlike previous xenotransplant experiments, both her heart and kidneys failed. She went into cardiac arrest and required resuscitation before her experimental surgery. She was so weak that she could not even play with her grandchildren. “It was miserable,” said the Cookstown, N.J., woman.
Because her heart was failing, she was unable to undergo a traditional kidney transplant. But while undergoing her dialysis, she also did not qualify for her heart pump, called a left ventricular assist device, or LVAD.
“You're in a maze and you can't find your way out,” Dr. Montgomery explained — until surgeons decided to combine a heart pump with a pig kidney.
2 surgeries in 8 days
With emergency approval from the Food and Drug Administration, Montgomery selected pig organs that United Therapeutics genetically engineered so that their cells do not produce a particular sugar that is foreign to the human body and causes immediate organ rejection. I did it like that.
Additionally, a donor pig's thymus gland, which trains the immune system, was attached to the donated kidney in hopes of helping Pisano's body tolerate the new organ.
Surgeons implanted the LVAD that powers Pisano's heart on April 4, and transplanted the pig kidney on April 12. While there's no way to predict Pisano's long-term outcome, Montgomery said there have been no signs of organ rejection so far. And in adjusting the LVAD to fit his new kidney, doctors are already learning lessons that could inform the future care of heart and kidney patients, Moazami said.
Special “compassionate use” experiments can teach doctors a lot, but rigorous studies are needed to prove whether xenotransplants really work. What happens to Pisano and the kidney transplant patients at Massachusetts General Hospital will no doubt influence the FDA's decision whether to allow such experiments. United Therapeutics hopes to begin testing next year.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Education Media Group. AP is solely responsible for all content.
