A New Hampshire man fought for a chance at a pig kidney transplant, spending months getting into good enough shape to qualify for a small pilot study of a highly experimental treatment.
His efforts paid off. Tim Andrews, 66, is now the second person known to be living with a pig kidney. Massachusetts General Hospital announced Friday that Andrews is free from dialysis and recovering so well from the Jan. 25 transplant that he was discharged just a week later.
“When I woke up in the recovery room, I was a new man,” Andrews told The Associated Press.
His surgery marks a turning point in the quest to determine whether animal-to-human transplants can help address the shortage of donated human organs. The first four pig organ transplants—two hearts and two kidneys—were short-lived.
However, the fifth xenotransplant recipient, an Alabama woman who was not as critically ill as previous patients, has boosted confidence in the field. She has been thriving for over 2½ months after receiving a pig kidney transplant at NYU Langone Health in November.
Doctors are now shifting from isolated experiments to formal studies. As they monitor Andrews’s recovery, doctors at Mass General Brigham have received U.S. Food and Drug Administration approval to perform two additional transplants as part of their pilot study using gene-edited pig kidneys supplied by biotech company eGenesis.
United Therapeutics, another developer of gene-edited pig organs, recently won FDA approval for the world’s first clinical trial of xenotransplantation. Initially, six patients will receive pig kidneys, and if they do well over six months, up to 50 more will undergo transplants.
“This is uncharted territory,” said Dr. Tatsuo Kawai, the Mass General surgeon who led both Andrews’s surgery and the world’s first pig kidney transplant last year. However, with insights from animal research and previous human attempts, he remains optimistic. “Hopefully, we can get to survival, kidney survival, for over two years.”
Scientists are genetically modifying pigs to make their organs more human-like in hopes of addressing the transplant shortage. More than 100,000 people in the U.S. are on the transplant list, most needing a kidney, and thousands die waiting.
Andrews’s kidneys abruptly failed two years ago, and the Concord, N.H., grandfather struggled with fatigue and dialysis complications. Though he was on the transplant list, doctors warned it could take seven years or more to find a matching kidney for his blood type. Many patients deteriorate on dialysis, which has a five-year survival rate of just 50%. Andrews, who had previously suffered a heart attack, knew time was running out.
“I have seen my mortality, and I was ready to fight,” Andrews said. He pleaded with Mass General to consider him for a pig kidney transplant. “I told them, ‘Anything, I’ll do anything. You give me a list of things you want me to do, and I’ll do it.'”
Mass General transplant nephrologist Dr. Leonardo Riella said Andrews was weak and battling diabetes, including a slow-healing foot ulcer that hindered his mobility. To qualify for the procedure, he had to get into better physical condition.
Andrews committed to physical therapy and returned six months later, nearly 30 pounds lighter and far more active. “He was just, you know, a different person,” Riella recalled, prompting doctors to assess his eligibility for the pilot study.
One major concern was cardiac fitness. Mass General’s first pig kidney recipient had underlying heart disease that led to his death. However, extensive evaluations revealed that Andrews’s heart was in the best condition possible.
Still, Andrews was nervous. He reached out to the only other person who had undergone a pig kidney transplant—Towana Looney, the NYU patient.
“We just prayed together and talked about how it would be,” Andrews said of their phone conversations before and after his transplant. Looney encouraged him to “just stay strong,” advice that he has taken to heart.
Doctors reported that Andrews’s pig kidney quickly turned pink and began producing urine in the operating room. Since then, it has functioned normally with no signs of rejection. After being discharged, Andrews stayed in a Boston hotel for daily checkups and is expected to return home to New Hampshire soon.
NYU transplant surgeon Dr. Robert Montgomery believes patients like Andrews—who aren’t yet too sick from dialysis but unlikely to survive long enough for a human kidney—are ideal candidates for early xenotransplants.
“Those are the patients where it really makes sense for them to try something else,” Montgomery said. His hospital is one of two institutions participating in United Therapeutics’s clinical trial later this year, which will involve similar patients.
It’s too early to predict Andrews’s long-term outcome. However, if the pig kidney fails, Riella said Andrews would still qualify for a human transplant. He has been placed on an inactive status on the transplant list but will retain his waiting time, which determines priority.
Andrews now hopes to return to his old dialysis clinic and share his story. “I want to tell these people there’s hope because no hope is not a good thing,” he said.
Source: Swifteradio.com
