A 53-year-old woman from Alabama, Towana Looney, has become the recipient of a genetically modified pig kidney, marking a milestone in the field of xenotransplantation. The seven-hour operation took place at NYU Langone Health last month.
Looney had been living with dialysis since December 2016 after high blood pressure from a pregnancy condition damaged her remaining kidney. Finding a suitable organ match proved impossible due to her unusually high levels of harmful antibodies, which made organ rejection highly likely.
"I feel like I've been given a second chance at life," Looney said in a press release three weeks after the operation. "I can't wait to be able to travel again and spend more quality time with my family and my grandchildren," she added, expressing her gratitude and optimism for the future.
The surgery was led by Dr. Robert Montgomery, director of the NYU Langone Transplant Institute, and co-directed by Dr. Jayme Locke, a transplant surgeon who had been in dialogue with Looney for over two years about the possibility of such a procedure. The kidney was provided by Revivicor, a subsidiary of United Therapeutics Corporation, and was genetically modified with ten alterations to prevent immediate rejection by the human body.
"Transplant is one of the few therapies that can cure a complex disease overnight, yet there are too few organs to provide a cure for all in need," Locke said, according to the MIT Technology Review. "The thought that we may now have a solution to the organ shortage crisis for others who have languished on our waiting lists invokes the most welcome of feelings: pure joy!"
Looney's case represents a promising advance in the emerging field of xenotransplantation, which offers hope for addressing the chronic shortage of organ donations. In the United States, there are more than 100,000 patients on the waiting list for organ transplants, with over 90,000 of them waiting for a kidney, and seventeen people die every day while waiting. The need for alternative solutions is critical, as only about 27,000 received kidney transplants in 2023, while nearly 808,000 people have end-stage kidney disease.
The genetically modified pig kidney transplanted into Looney was designed to prevent immediate rejection by the human body. Recent advances in gene editing and control of the immune system's response have limited the risks of organ rejection, facilitating progress in xenotransplantation. The procedure was authorized under the FDA's expanded access program due to the worsening of Looney's medical conditions from prolonged dialysis and the improbability of finding a compatible donor after years of searching.
"Without the generosity and altruism of those who participated in our research up to this point, this next step in xenotransplantation would not have been possible," Dr. Montgomery said, according to Punch. "Towana's case is a precursor to potential clinical trials, under the FDA's guidance, to determine if these organs are safe as a new, sustainable source of organs for those who need them."
Earlier this month, Looney was discharged from the hospital to an apartment in New York City to continue her recovery. She is expected to stay in New York for another three months to check in with doctors at the hospital for evaluations. Since the transplant, she has been off dialysis, and her blood pressure, which had been stubbornly high for decades despite medications, is now controlled.
The kidney she received started making urine even before she woke from surgery, and blood tests show the transplanted kidney is clearing creatinine, a waste product, from her body. "I've never felt better," Looney said, describing how easy it had become to do household chores or prepare meals, tasks that were difficult when she was on dialysis. "I used to do one task, sit down and take a rest, then go do another task. Now I multitask!"
Her surgery marks the third instance of a gene-edited pig kidney being transplanted into a living human. The transplant community is closely watching Looney's case, as success could accelerate clinical trials for pig transplants, addressing the organ-supply shortage.
Looney's journey began when she heard about pig kidney research at the University of Alabama at Birmingham and told Dr. Locke, at the time a UAB transplant surgeon, she'd like to try one. After nearly two years of seeking special FDA permission for the xenotransplant procedure, Dr. Locke and Dr. Montgomery performed the surgery. "This is new territory. This is new ground. I don't know what might happen, and a lot of things could go wrong here," Dr. Locke told The New York Times. Despite the uncertainties, Looney remained resolute, responding, "OK, when are we going to do it?"
As she continues her recovery, Looney is already planning trips, including to Disney World, that she can now make without worrying about finding dialysis services while traveling. Her appetite, dimmed for years, has returned, and she noted that she can eat full meals now, not just dabble with soup. She humorously mentioned her fondness for hospital food, an oddity she attributes to many years spent in hospitals.
Dr. Montgomery stated that the next few weeks are critical for Looney. "The thought that we may now have a solution to the organ shortage crisis for others who have languished on our waiting lists invokes the most welcome of feelings: pure joy!" Dr. Locke said.
This article was written in collaboration with generative AI company Alchemiq