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 Nov. 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.
“I am overjoyed. I’m blessed to have received this gift, a second chance at life,” Looney said at a news conference on Tuesday. “I am full of energy. Got an appetite I’ve never had in eight years. And of course, you know, I can go to the bathroom. I haven’t been going in eight years. Can’t get used to that.”
Asked what she wants to do next, she said, “I want to go to Disney World.”
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 U.S.
“If I listened to the negatives and not follow the positives, I wouldn’t be here,” Looney said. “I go by faith. Know where your faith lies, and the rest will follow.”
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 one per cent 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 per cent to 15 per cent of what a healthy kidney does, and people on dialysis face a 50 per cent chance of dying in five years after beginning the treatment, studies show.
“She has become sensitized to nearly every tissue type in the population, making it nearly impossible for her to find a kidney match,” said one of her doctors, Dr. Robert Montgomery, director of the NYU Langone Transplant Institute. “She languished for eight years on the dialysis and was waiting for a one in a million match. She began to develop problems associated with chronic dialysis dependence. Without a pathway to receiving a human kidney, she decided a gene-edited pig kidney was worth a try, and a lot of people rallied around her decision, including her husband and family.”
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 U.S. 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 people.
Locke said Tuesday that Looney’s energy, even immediately after the transplant, said so much about what xenotransplantation can do for people.
“To be in her room immediately post-transplant and to see her husband look at her and to describe her as having a life in her that he hasn’t seen, this rosiness in her cheeks, to watch her have FaceTime calls with her family and then see an immediate change, that is the miracle of transplantation,” Locke said. “It literally restores people to their health before they ever faced dialysis. And she felt it instantly. Her family felt it, and her community has felt it, and I think you saw that today.”
‘I tried to make a difference’
The U.S. 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. The gene edits should make the pig organ more human-friendly so that the body does not reject it. United Therapeutics, the company that developed the modified pig kidney, said Tuesday that it plans to submit to the FDA “very, very soon” so that clinical studies could start with the 10-edit kidney as early as next year.
“I think that the next goal post is just extending the life of these kidneys and part of that is putting them in healthier people who have a better chance of living longer,” Montgomery said.
Looney, doctors said, is healthier than the other patients who had pig kidney transplants earlier this year, and that should work to her advantage.
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.
In Looney’s case, Locke said, the kidney started working right away, functioning like a kidney from a human donor would. Three weeks out, she is still in good shape.
“This kidney is remarkable,” Locke said.
Looney’s medical team is hopeful the kidney will continue to function so she can live a long and healthy life. At the news conference, Looney had an IV providing additional medicine to make sure her body does not reject the pig kidney.
“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 said in a video made by NYU.
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.
“We have learned a tremendous amount from each transplant,” Montgomery said. “We don’t have all the answers. This field is still in its infancy, but our learning curve has been steep and fast.”
There are still a lot of questions about xenotransplantation. Among them: Scientists don’t know how long a pig organ might work. But Montgomery makes a bold prediction that xenotransplantation will become routine in less than 10 years.
Montgomery said the challenge going forward will be to learn how to support kidneys for longer periods so that they can become “a reasonable alternative for this scarce, highly rationed supply of human organs.”
“Patients like Towana are our pioneers who, through their courage, will show us the way,” Montgomery said.
Having that option could be transformative: About 13 people in the US die each day waiting for a kidney transplant.
Looney said it’s been wonderful to live without the need to go to dialysis all day.
“It’s like I can feel the blood pumping through my veins. You can put your hand on my fistula and feel it buzzing. I could put my hand on this kidney and feel it buzzing. It’s so strong,” Looney said. “Emotionally, I’m overjoyed.”
CNN’s Nadia Kounang contributed to this report.