A New Jersey woman is alive and improving after undergoing experimental transplant surgery involving a kidney from a genetically modified pig.
Earlier this month, Lisa Pisano — a 54-year-old grandmother from Cookstown, New Jersey, about 20 miles southeast of Trenton — was practically on death’s doorstep. She was in desperate need of a kidney transplant, but antibodies in her tissues made finding a match nearly impossible.
She was also in heart failure, but because she was on dialysis, doctors hesitated to implant a heart pump known as a left ventricular assist device because of the high mortality rates for dialysis patients undergoing that kind of procedure.
Miserable and seemingly out of options, Pisano suddenly received a message of hope from Dr. Robert Montgomery, the director of NYU Langone Transplant Institute. Montgomery and his team offered to perform two separate procedures that, if successful, would at least buy Pisano some more time with her loved ones.
The first surgery, which occurred on April 4, involved implanting the LVAD device. Eight days later, medical teams then transplanted a kidney from a pig into Pisano’s body.
Doctors have dabbled in xenotransplantation — or cross-species organ transplants — for some time, but with little long-term success. Last year, two men received hearts transplanted from pigs at the University of Maryland School of Medicine, but both men died within months. To lessen the chances of organ rejection and improve xenotransplantation possibilities, scientists at United Therapeutics Corp. genetically engineered pigs so that they wouldn’t produce a sugar that the human body does not recognize.
Dr. Montgomery chose a kidney from among those genetically modified pigs at United Therapeutics to implant inside Pisano. The pig’s kidney was also outfitted with the pig’s thymus gland to further reduce the chances of rejection.
Montgomery’s plan seemed to work. After the pig kidney was implanted in Pisano, it began producing urine almost immediately, causing doctors and nurses to erupt in cheers right there in the operating room.
While Pisano will likely have to stay at the hospital for several months, she has already shown dramatic signs of improvement. With the help of a walker and several physical therapists, she even took a few steps on April 22, just 10 days after the transplant.
“I’m feeling better and better and better every day,” she told NPR.
Prior to the surgeries, Pisano said she felt “horrible” and couldn’t perform even basic tasks. “I couldn’t even cook dinner,” she said. “I couldn’t vacuum. I couldn’t play with my grandkids because I couldn’t bend down to get them. I just couldn’t do anything with them.”
Now, she and her family are grateful that she has better quality of life. “With this surgery, I get to see my wife smile again,” her husband, Todd, said.
Though Dr. Montgomery cautions that Pisano’s long-term prognosis is unclear, he’s likewise pleased with the results so far. “When we brought her into the hospital, she was in really bad shape,” he said. But for the moment, he said, “her kidney is working better than yours or mine. So we’re optimistic that she’ll be able to go home and spend time with her children and grandchildren and live a comfortable life.”
That’s exactly what Pisano intends to do. “Any time on this Earth is better than none,” she said. “So if I get two years, that’s two years that I didn’t have before.”
Dr. Tatsuo Kawai of Mass General performed a similar pig-kidney transplant on a patient last month. That patient, Richard “Rick” Slayman, is doing well five weeks later even after some initial concerns about rejection. His most recent biopsy showed no signs of rejection, the AP reported.
Despite these hopeful signs, L. Syd Johnson, a bioethicist at SUNY Upstate Medical University, cautions that xenotransplantation is still experimental and worries about the medical industry exploiting “desperate patients who have no other options.”
“Maybe those patients will benefit,” she added. “Maybe they believe they will benefit and that the risks are worthwhile for them. But I do worry about whether or not we are taking advantage of particularly vulnerable and desperate patients in conducting these experiments.”
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