Towana Looney is the only person in the world living with a functional pig kidney. But her doctor predicts that in less than a decade, pig-to-human organ transplants like hers could become routine.
Looney, 53, is from Alabama and had the transplant at NYU Langone Transplant Institute in New York on November 25. Eleven days later, she was able to walk out the door as hospital staffers lined the hall and applauded. Wearing a mask and NYU Langone Health sweats, Looney held two thumbs up high in the air.
Doctors announced Tuesday that Looney is doing well and that the kidney seems to be functioning as intended.
For now, she lives in an apartment near the hospital so she can get checkups every day. The team of doctors also monitors her health using artificial intelligence and wearable equipment that can keep constant track of her vitals and even potentially detect a problem like an infection before it would make her sick.
Looney won’t be back in Alabama in time for the holidays, but her doctors say that if all goes well, she could go home in three months where she is eager to resume a normal life and spend quality time with her family and grandchildren.
Looney has not had a normal life for some time. She was among more than 90,000 people who are currently on the waiting list for a kidney transplant in the US.
“There have been a lot of letdowns, but I don’t give up,” she said in a video shared by NYU.
Kidney donor becomes kidney patient
Even before this surgery, Looney was no stranger to transplants. In 1999, she donated a kidney to her mother to help save her life. But some time later, she became one of the less than 1% of living kidney donors to develop kidney failure, according to the National Kidney Foundation.
In the last trimester of her pregnancy, Looney developed preeclampsia, a serious condition whose signs include high blood pressure, which damaged her remaining kidney. She also had to have a blood transfusion, and both those factors made it difficult to find a match to a kidney donor.
In 2016, Looney went on dialysis, a procedure to help remove waste and extra fluid from the blood. Dialysis can be helpful in the short term but can do only 10% to 15% of what a healthy kidney does, and people on dialysis face a 50% chance of dying in five years after beginning the treatment, studies show.
“With her pregnancies and blood transfusions, she’s highly sensitized, which means her body makes harmful antibodies against other people’s tissue types,” said one of her doctors, Dr. Robert Montgomery, director of the NYU Langone Transplant Institute.
Looney went on the waiting list for a kidney in 2017. Her doctors said that she was slowly losing accessible blood vessels to continue dialysis and that it would eventually stop being helpful. Without a donor match, she would die.
Looney first heard about the option of a pig kidney transplant from Dr. Jayme Locke, then a professor of surgery and director of the Division of Transplantation at the Heersink School of Medicine at the University of Alabama at Birmingham. Locke was recently appointed to a new transplant leadership position at the US Health Resources and Services Administration.
Locke explained the work she did with xenotransplantation, the term doctors use for transplanting organs from animals to humans. Despite years of study, the field is still in its early stages; Looney is the third person to receive a kidney from a gene-edited pig while alive. But Looney jumped at the chance to try it, saying Locke hadn’t even finished asking about the approach before she agreed.
Locke explained the odds and asked Looney why she would agree to be a part of an experimental procedure. Looney said she wanted “to help so many people.”
‘I tried to make a difference’
The US Food and Drug Administration allows doctors to transplant organs from pigs into humans under what’s commonly known as “compassionate use,” which permits use of an experimental therapy or procedure if “comparable or satisfactory” options aren’t available.
Pigs’ organs are similar to humans’, and the speed of pigs’ reproduction means their organs can be procured quickly. Scientists can edit the genes of the pig to reduce the risk that a human body will reject its organ.
Among the three people to receive a kidney from a gene-edited pig while alive, she’s the first to receive a kidney with 10 gene edits.
In March, 52-year-old Rick Slayman, who had end-stage renal failure, received a pig kidney transplant at Massachusetts General Hospital. The kidney worked at first, and he was able to go home after two weeks, but he died about two months later.
In April, NYU performed a pig kidney transplant with a mechanical heart pump for 54-year-old Lisa Pisano, who lived nearly three more months.
Doctors say Looney is in better health than the previous two recipients, even with her kidney problems. Montgomery says Looney came through the operation “beautifully.” Once attached, the kidney turned pink and started to work right away.
“I know anything can happen now, just like in dialysis, but I want to know that I tried. I tried to make a difference,” Looney says in the NYU video.
She will have to continue taking medication to keep her body from rejecting the pig kidney, but the team is hopeful the kidney will continue to function so she can live a long and healthy life.
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Overall, Montgomery says he’s optimistic about the recent advances in the field. Scientists have been studying xenotransplantation for decades, but in the past couple of years, they’ve learned quickly about what may cause the recipient’s body to reject the organ and how to treat any problems that may be coming.
“Each time we do one of these, we’re more enlightened, and we’re better able to meet the challenges,” Montgomery says in an NYU video.
There are still many outstanding questions about xenotransplantation. Scientists don’t know how long a pig organ might work, for example. But Montgomery makes a bold prediction: He believes that, after few more transplants under compassionate use, he thinks clinical trials could start to prove that this practice works in 2025. He predicts that xenotransplantation will become routine in less than 10 years.
Having that option could be transformative: About 13 people in the US die each day waiting for a kidney transplant.
“It’s not going to completely replace human-to-human transplantation, but I think it will augment the organ supply so we don’t have so many people dying or getting so sick to benefit from a transplant,” Montgomery says in the NYU video.
Looney said it’s been wonderful to live without the need to go to dialysis all day.
“It feels great,” she said. “It feels great to feel the energy, the blood flow of the kidney. It’s just wonderful, amazing.”