Years after donating a kidney, Alabama woman receives one from a pig

Twenty-five years after donating a kidney to her mother, an Alabama woman became the third human to receive a genetically engineered pig’s kidney, raising hopes for thousands of Americans on the waiting list for organ transplants, officials at NYU Langone Health announced Tuesday. She is the first live patient to receive a pig’s kidney with 10 gene edits designed to reduce the risk of organ rejection.

“Emotionally I’m overjoyed. I don’t know what I want to do next,” said the transplant recipient, Towana Looney, 53. “I am full of energy, got an appetite I haven’t had in 8 years. I can put my hand on this kidney and feel it buzzing.”

Looney, who had developed kidney failure after a complication during pregnancy and lived for almost eight years on kidney dialysis, received the transplant in a seven-hour procedure on Nov. 25 at Langone Health in New York City. Robert Montgomery, a transplant surgeon for 30 years, co-led the procedure and said Looney is doing well 11 days after her discharge from the hospital to an apartment in New York. He said she passed the two-week “honeymoon” following transplant “and we’re in the critical period now that extends to about six weeks,” after transplant when the threat of organ rejection peaks.

Doctors are examining her daily and will be able “to adjust and jump on things very early,” if they see a warning sign, Montgomery said.

With nearly 104,000 people on the list for organ transplants, most of them seeking kidneys, the field of xenotransplantation – transplanting an organ from one species to another – has been accelerating.

“We don’t have all the answers. The field is still in its infancy, but our learning curve has been steep and fast,” said Montgomery, himself the recipient of heart transplant six years ago.

In March, doctors at Massachusetts General Hospital performed the first transplant of a gene-edited pig’s kidney, implanting the organ in Richard Slayman, a 62-year-old worker for the Massachusetts Department of Transportation. He lived for 52 days.

Lisa Pisano, a 54-year-old grandmother, was the next to receive a gene-edited pig’s kidney, the first time such a kidney had been transplanted in a person also receiving a heart pump; the two procedures were performed on different days in April. She survived 86 days, though the gradually failing kidney had to be removed after 47 days.

“Our challenge is to learn how to support these kidneys for longer periods of time so that they become a reasonable alternative for the scarce, highly rationed supply of human organs,” Montgomery said.

The gene-edited pig, used in Looney’s transplant, was developed by Revivicor Inc., a subsidiary of United Therapeutics Corporation.

The 10 changes to the pig’s genetic code included the removal of three immunogenic antigens, molecules that can trigger an immune response. A growth hormone receptor, which can regulate growth and metabolism, was also removed.

In addition, scientists gave the pig six human transgenes, pieces of DNA that have been experimentally constructed, and were intended to make the pig organ more compatible to the human body.

Doctors received permission to perform the procedure under the Food and Drug Administration’s compassionate use program, which allows the use of investigational medical products outside of clinical trials when a patient has a life-threatening condition.

Looney had spent eight years waiting for what Montgomery called “a 1-in-a-million” match. She was hindered by unusually high levels of antibodies in her blood that made an especially devastating form of rejection likely.

“Her journey is one of tenacity,” said Jayme Locke, the transplant surgeon at the University of Alabama at Birmingham who cared for Looney and started the application to the FDA to receive approval for her transplant.

Locke said that after donating the kidney to her mother, Looney experienced preeclampsia, a potentially life-threatening condition involving high blood pressure that affects about 2 to 7 percent of pregnant women. The condition contributed to her development of chronic kidney disease, a condition she lived with for about 16 years.

Montgomery said that in addition to the two previous transplants of gene-edited pig kidneys to live patients, surgeons have also learned from transplants performed on decedents, patients who were brain-dead but had beating hearts and were on ventilators. One such transplant was maintained for two months, allowing doctors to learn more about the physiology and function of a pig’s kidney and how to treat rejection of the organ.

In 2023, researchers at the University of Alabama at Birmingham Heersink School of Medicine published a case study of a brain-dead patient who had received two pig kidneys that underwent 10 gene alterations.

Leigh Peterson, executive vice president of product development and xenotransplantation at United Therapeutics, said the company plans to submit an application to the FDA to begin clinical trials in 2025 with the same gene-edited pig kidney design used in Looney’s transplant.

In 2023, the waiting list for kidneys reached almost 90,000, while a little more than 27,000 kidney transplants were performed.