NYU Langone makes transplant history

Lisa Pisano suffered from heart failure and end-stage kidney diseases — conditions that required routine dialysis. Because of that, the 54-year-old New Jersey resident wasn’t a candidate for either a heart or kidney transplant, because doctors feared it just wouldn’t help her long-term.

But those same doctors refused to give up. And last month, NYU Langone Health completed its first transplant surgery to combine a mechanical heart pump and a gene-edited pig kidney.

NYU Langone Health — which operates a hospital in Mineola — completed the first transplant surgery to combine a mechanical heart pump and a gene-edited pig kidney,

More than 100,000 people are currently awaiting a transplant across the country, with most specifically looking for a kidney. More than 800,000 people suffer from end-stage kidney disease in the United States alone, yet just 1-in-30 were fortunate enough to undergo a transplant last year, according to the United Network for Organ Sharing.

With little to no options, Pisano considered xenotransplant — which depends on animal organs to replace human ones in people.

“When the opportunity first came to me, I was like, ‘I got to try it,’” Pisano told reporters through a video conference from her intensive care unit room. “So, when this opportunity came, I was going to take advantage of it.”

The effort involved approval from NYU Langone’s review board and Food and Drug Administration clearance through its expanded access program. Also known as “compassionate use, “ the expanded access program is designed for patients with serious or life-threatening conditions.

“There are opportunities for us to learn a lot,” Robert Montgomery, NYU Langone’s surgery department chair told reporters last week. “But obviously, the intent here is to try to preserve and save that person’s life.”

It otherwise would have taken years for Pisano to find the right match for a human kidney transplant. Montgomery, with the help of the United Therapeutics Corp., matched an investigational gene-edited pig kidney with a thymus, which was available. 

Two surgical teams conducted the series of procedures over nine days. On April 4, Pisano received a mechanical heart pump — a device known as a left ventricular assist device. On April 12, she received a gene-edited pig kidney, and the pig’s thymus gland. 

Montgomery performed the transplant itself, while Nader Moazami — a cardiothoracic surgery chief at NYU Grossman School of Medicine —  along with Deane Smith, director of mechanical circulatory support, performed the mechanical heart pump surgery at the Kimmel Pavilion in Manhattan. 

NYU Langone officials described the overall procedure as the first reported organ transplant in a person with a mechanical heart pump, and second known transplant of a gene-edited pig kidney into a human.

Pisano expressed feeling “fantastic” after the procedures.

“I’ve felt the best I’ve felt in a long time,” she said. “I can’t thank anyone enough for that. My family, the doctors, nurses, staff — everyone here.”

Although uncertain about how she will react over time, Pisano acknowledged the treatment may prove beneficial for someone else — if not for her.

“Worst-case scenario, if it doesn’t work, it might work for the next person,” Pisano said.

“At least somebody is going to benefit from it. If not me, then who? Somebody.”