NYU Langone Health surgeons successfully completed the first-ever combined mechanical heart pump and genetically modified pig kidney transplant surgery in April on a 54-year-old woman with heart and kidney failure.
New Jersey-native Lisa Pisano underwent the first-ever combined surgery using the transplant of a genetically-altered, non-human organ.
Prior to surgery, Pisano faced heart failure and late-stage kidney disease. She required routine dialysis. And Pisano suffered from several other chronic medical conditions that caused high levels of antibodies in her body to attack human tissue. Thus, she was not eligible for heart and kidney transplants.
“All I want is the opportunity to have a better life,” Pisano said in a statement. “After I was ruled out for a human transplant, I learned I didn’t have a lot of time left. My doctors thought there may be a chance I could be approved to receive a gene-edited pig kidney, so I discussed it with my family and my husband. He has been by my side throughout this ordeal and wants me to be better.”
So Pisano received a series of landmark, life-saving procedures from two surgical teams at NYU Langone over a course of nine days.
Surgeons first implanted a heart pump, also known as a left ventricular assist device, or LVAD, on April 12. Without the pump, doctors estimated Pisano would have had only days or weeks to live.
Then it was time for a xenotransplant, which is a transplant of an organ between different species. Pisano received a genetically altered pig kidney, which was key to avoiding the pitfalls of her chronic health conditions. While her body develops high levels of antibodies against human tissue, the same is not the case for tissue from another species like pig.
Dr. Nader Moazami is chief of the heart and lung transplant division at NYU Langone and one of the surgeons who performed Pisano’s heart pump surgery.
“Without the possibility of a kidney transplant, she would not have been eligible as a candidate for an LVAD due to the high mortality in patients on dialysis with heart pumps,” Moazami said in a statement. “This unique approach is the first time in the world that LVAD surgery has been done on a dialysis patient with a subsequent plan to transplant a kidney. The measure for success is a chance at a better quality of life and to give Lisa more time to spend with her family.”
The landmark procedure required clearance from the NYU Langone institutional review board and approval by the FDA through its Expanded Access Program, which is meant for patients with a life-threatening condition.
The surgeries’ success could have powerful future outcomes, since many patients today are stuck on the waitlist for organ transplants. Nearly 104,000 people are currently on the transplant waiting list, according to NYU Langone, and 89,360 of those patients are in need of a kidney.
While nearly 808,000 people in the United States have end-stage kidney disease like Pisano, only about 27,000 patients were able to receive a kidney transplant last year, according to NYU Langone.
Dr. Robert Montgomery led the transplant surgery. He is chair of the Surgery Department, director of the NYU Langone Transplant Institute and the H. Leon Pachter professor of surgery.
“By using pigs with a single genetic modification, we can better understand the role one key stable change in the genome can have in making xenotransplantation a viable alternative,” Montgomery said in a statement. “Since these pigs can be bred and do not require cloning like more-complex gene edits, this is a sustainable, scalable solution to the organ shortage. If we want to start saving more lives quickly, using fewer modifications and medications will be the answer.”
