A New Hampshire man fought for the chance at a pig kidney transplant, spending months getting into good enough shape to be part of a small pilot study of a highly experimental treatment.
His effort paid off: Tim Andrews, 66, is only to be living with a pig kidney. Andrews is free from dialysis, Massachusetts General Hospital announced Friday, and recovering so well from the Jan. 25 transplant that he left the hospital a week later.
鈥淲hen I woke up in the recovery room, I was a new man,鈥� Andrews told The Associated Press.
Andrews鈥� surgery comes at a in the quest to tell if animal-to-human transplants could help ease the shortage of donated human organs. The first four pig organ transplants 鈥� and 鈥� were short-lived. But the fifth xenotransplant recipient, as prior patients, boosted the field 鈥� thriving for now 2 1/2 months after a pig kidney transplant at NYU Langone Health in November.
Doctors are moving from those one-off experiments to more formal studies. As they monitor Andrews鈥� recovery, doctors at Mass General Brigham have Food and Drug Administration permission to perform two additional transplants in their pilot study, using gene-edited pig kidneys supplied by biotech eGenesis.
And United Therapeutics, another developer of gene-edited pig organs, just won FDA approval for the world鈥檚 first clinical trial of xenotransplantation. Initially, six patients will receive pig kidneys 鈥� and if they fare well over six months, up to 50 additional patients will receive transplants.
鈥淭his is uncharted territory,鈥� said Mass General鈥檚 Dr. Tatsuo Kawai, who led both Andrews鈥� surgery and the world鈥檚 first pig kidney transplant last year. But with lessons from animal research and the prior human attempts, he said, 鈥淚鈥檓 very optimistic. And hopefully we can get to survival, kidney survival, for over two years.鈥�
Scientists are so their organs are more humanlike to address the transplant shortage. More than 100,000 people are on the U.S. transplant list, most who need a kidney, and thousands die waiting.
Andrews鈥� kidneys abruptly failed about two years ago, and the Concord, New Hampshire, grandfather struggled with fatigue and complications from dialysis. He鈥檚 on the transplant list but doctors warned it was a long shot. It can take seven years or more for people with Andrews鈥� blood type to find a matching kidney. Meanwhile, people slowly get sicker on dialysis 鈥� five-year survival is about 50% 鈥� and Andrews already had had a heart attack.
鈥淚 have seen my mortality and I was ready to fight,鈥� Andrews said. So he asked Mass General if he could get a pig kidney instead. 鈥淚 told them. 鈥楢nything, I鈥檒l do anything. You give me a list of things you want me to do and I鈥檒l do it.鈥欌��
Mass General transplant nephrologist Dr. Leonardo Riella said Andrews was weak and struggling with diabetes, including a slow-healing diabetic foot ulcer that hindered walking. He鈥檇 have to get more fit to be a candidate.
Andrews started physical therapy and returned six months later about 30 pounds lighter and 鈥渞unning down the hallway almost,鈥� Riella recalled. 鈥淗e was just, you know, a different person,鈥� so they started checking if he鈥檇 qualify for the pilot study.
One big question was cardiac fitness: Mass General鈥檚 had underlying heart disease that killed him. But Riella said intense exams showed Andrews鈥� 鈥渉eart was in the best shape possible.鈥�
Still, Andrews was a little nervous and sought advice from the only other person who knew what a pig kidney transplant was like 鈥� the NYU patient, Towana Looney.
鈥淲e just prayed together and talked about how it would be,鈥� Andrews said of their phone calls before and after his transplant. He said Looney advised 鈥渢o just stay strong and that鈥檚 what I鈥檓 doing.鈥�
Doctors said Andrews' pig kidney turned pink and quickly began producing urine in the operating room, and since then has cleared waste normally with no signs of rejection. Andrews spent the week after his discharge in a nearby Boston hotel for daily checkups but is expected to return home to New Hampshire soon.
NYU transplant surgeon Dr. Robert Montgomery said patients like those in Mass General鈥檚 pilot study could be 鈥渢he sweet spot鈥� for early xenotransplants 鈥� not yet too sick from years of dialysis but unlikely to survive long enough for a human transplant.
鈥淭hose are the patients where it really makes sense for them to try something else,鈥� said Montgomery. His hospital is one of two that will be part of United Therapeutics鈥� clinical trial later this year, which will include similar patients.
It鈥檚 too early to know how Andrews will fare but if the pig kidney were to fail, Riella said he鈥檇 still qualify for a human transplant and, now deemed inactive on the transplant list, wouldn鈥檛 lose his 鈥渨aiting time鈥� that helps determine priority.
Andrews now wants to return to his old dialysis clinic and 鈥渢ell these people there鈥檚 hope, because no hope is not a good thing,鈥� he said.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute鈥檚 Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
Lauran Neergaard, The Associated Press
