Doctors combine a pig kidney transplant and a heart device in a bid to extend woman's life

NEW YORK (AP) — Doctors have transplanted a pig kidney into a New Jersey woman who was near death, part of a dramatic pair of surgeries that also stabilized her failing heart.

Lisa Pisano’s combination of heart and kidney failure left her too sick to qualify for a traditional transplant, and out of options. Then doctors at NYU Langone Health devised a novel one-two punch: Implant a mechanical pump to keep her heart beating and days later transplant a kidney from a genetically modified pig.

Pisano is recovering well, the NYU team announced Wednesday. She’s only the second patient ever to receive a pig kidney -- following a landmark transplant last month at Massachusetts General Hospital – and the latest in a string of attempts to make animal-to-human transplantation a reality.

This week, the 54-year-old grasped a walker and took her first few steps.

“I was at the end of my rope,” Pisano told The Associated Press. “I just took a chance. And you know, worst case scenario, if it didn’t work for me, it might have worked for someone else and it could have helped the next person.”

Dr. Robert Montgomery, director of NYU Langone Transplant Institute, recounted cheers in the operating room as the organ immediately started making urine.

“It’s been transformative," Montgomery said of the experiment's early results.

But "we’re not off the hook yet,” cautioned Dr. Nader Moazami, the NYU cardiac surgeon who implanted the heart pump.

“With this surgery I get to see my wife smile again,” Pisano's husband Todd said Wednesday.

Other transplant experts are closely watching how the patient fares.

“I have to congratulate them," said Dr. Tatsuo Kawai of Mass General, who noted that his own pig kidney patient was healthier overall going into his operation than NYU's patient. “When the heart function is bad, it’s really difficult to do a kidney transplant.”

More than 100,000 people are on the U.S. transplant waiting list, most who need a kidney, and thousands die waiting. In hopes of filling the shortage of donated organs, several biotech companies are genetically modifying pigs so their organs are more humanlike, less likely to be destroyed by people's immune system.

NYU and other research teams have temporarily transplanted pig kidneys and hearts into brain-dead bodies, with promising results. Then the University of Maryland transplanted pig hearts into two men who were out of other options, and both died within months.

Mass General’s pig kidney transplant last month raised new hopes. Kawai said Richard “Rick” Slayman experienced an early rejection scare but bounced back enough to go home earlier this month and still is faring well five weeks post-transplant. A recent biopsy showed no further problems.

Pisano is the first woman to receive a pig organ — and unlike with prior xenotransplant experiments, both her heart and kidneys had failed. She went into cardiac arrest and had to be resuscitated before the experimental surgeries. She'd gotten too weak to even play with her grandchildren. “I was miserable,” the Cookstown, New Jersey, woman said.

A failed heart made her ineligible for a traditional kidney transplant. But while on dialysis, she didn't qualify for a heart pump, called a left ventricular assist device or LVAD, either.

“It’s like being in a maze and you can’t find a way out,” Montgomery explained — until the surgeons decided to pair a heart pump with a pig kidney.

With emergency permission from the Food and Drug Administration, Montgomery chose an organ from a pig genetically engineered by United Therapeutics Corp. so its cells don't produce a particular sugar that’s foreign to the human body and triggers immediate organ rejection.

Plus a tweak: The donor pig’s thymus gland, which trains the immune system, was attached to the donated kidney in hopes that it would help Pisano's body tolerate the new organ.

Surgeons implanted the LVAD to power Pisano's heart on April 4, and transplanted the pig kidney on April 12. There's no way to predict her long-term outcome but she’s shown no sign of organ rejection so far, Montgomery said. And in adjusting the LVAD to work with her new kidney, Moazami said doctors already have learned lessons that could help future care of heart-and-kidney patients.

Special “compassionate use” experiments teach doctors a lot but it will take rigorous studies to prove if xenotransplants really work. What happens with Pisano and Mass General's kidney recipient will undoubtedly influence FDA's decision to allow such trials. United Therapeutics said it hopes to begin one next year.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

This family photo shows Lisa Pisano, right, and her daughter, Brittany Harvill. In April 2024, doctors transplanted a pig kidney into Pisano, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (Courtesy NYU Langone Health via AP)

Lisa Pisano steps back into her bed while recovering from her surgeries at NYU Langone Health in New York on Monday, April 22, 2024. Doctors transplanted a pig kidney into Pisano, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (AP Photo/Shelby Lum)

Lisa Pisano looks at photos of her dog after her surgeries at NYU Langone Health in New York on Monday, April 22, 2024. Doctors transplanted a pig kidney into Pisano, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (AP Photo/Shelby Lum)

In this photo provided by NYU Langone Health, surgeons work during the implantation of a gene-edited pig kidney for Lisa Pisano at the hospital in New York on April 12, 2024. Doctors transplanted a pig kidney into Pisano, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (Joe Carrotta/NYU Langone Health via AP)

In this photo provided by NYU Langone Health, surgeons lower a gene-edited pig kidney into Lisa Pisano's abdomen at the hospital in New York on April 12, 2024. Doctors transplanted the organ into Pisano, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (Joe Carrotta/NYU Langone Health via AP)

In this photo provided by NYU Langone Health, a gene-edited pig kidney with thymus is removed from its transport container to be prepared for transplantation at the hospital in New York on April 12, 2024. Doctors transplanted a pig kidney into a patient, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (Joe Carrotta/NYU Langone Health via AP)

In this photo provided by NYU Langone Health, a surgeon lifts the gene-edited pig kidney out of Lisa Pisano's abdomen to check its function at the hospital in New York on April 12, 2024. Doctors transplanted the organ into Pisano, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (Joe Carrotta/NYU Langone Health via AP)

In this photo provided by NYU Langone Health, surgeons operate on Lisa Pisano at the hospital in New York on April 12, 2024. Doctors transplanted a pig kidney into Pisano, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (Joe Carrotta/NYU Langone Health via AP)

Lisa Pisano looks at photos of her dog after her surgeries at NYU Langone Health in New York on Monday, April 22, 2024. Doctors transplanted a pig kidney into Pisano, who was near death, part of a dramatic pair of surgeries that also included a fix for her failing heart. (AP Photo/Shelby Lum)

BERLIN (AP) — No Xabi, no problem.

Even without coach Xabi Alonso on the touchline, Bayer Leverkusen remained unbeaten Sunday with a 5-1 Bundesliga win over Eintracht Frankfurt that stretched its record run without defeat to 48 games in all competitions.

Alonso was suspended for an accumulation of yellow cards, but he watched from the stands as his Bundesliga champions showed no tiredness from Thursday’s 2-0 win at Roma in the first leg of the Europa League semifinals.

“It was another perspective,” Alonso said after seeing Czech forward Adam Hložek set up three goals. “We played very seriously. Of course the result is super, but the performance was very professional.”

Alonso rotated the team with just Edmond Tapsoba, Robert Andrich and Granit Xhaka keeping their places from Rome. Brazilian winger Arthur made his first start after recovering from a serious thigh injury.

Xhaka fired the visitors in front in the 12th minute with a brilliant strike from distance.

Hugo Ekitiké equalized, but that was as good as it got for Frankfurt with Omar Marmoush blazing over when he only had Leverkusen ’keeper Lukáš Hrádecký to beat.

Patrik Schick powered a header past Kevin Trapp before the break and Exequiel Palacios made it 3-1 with a penalty after it.

Substitute Jeremie Frimpong capped a brilliant team move with the fourth goal in the 77th, and Victor Boniface completed the scoring with another penalty in the 89th. It was Leverkusen's 82nd goal in the Bundesliga this season, a new club record.

Leverkusen hasn’t lost a game in any competition this season. Its 48-game unbeaten start is a record across Europe’s “big five” leagues.

UNION IN TROUBLE

Union Berlin, which played Real Madrid in the Champions League this season, edged closer to relegation with a 4-3 loss at home to fellow struggler Bochum.

Bochum defender Maximilian Wittek scored twice in a game for the first time, before Keven Schlotterbeck made it 3-0 in the 37th.

Union coach Nenad Bjelica reacted with three changes at the break, sending on Yorbe Vertessen, Brenden Aaronson and Chris Bedia.

Vertessen pulled one back in the 59th, three minutes before Bedia got another, only for Union's defense to leave Philipp Hofmann free to head the visitors’ fourth.

Aaronson did brilliantly to set up Benedict Hollerbach for Union’s third in the 74th, but the equalizer never came.

Union, which was only promoted to the Bundesliga in 2019, played in the Champions League this season after an unlikely fourth-place finish last year. Summer transfers did not have the desired effect and the team let long-time favorite coach Urs Fischer go in November.

Before kickoff Sunday, Union president Dirk Zingler denied reports that the club was set to dismiss Fischer's replacement, Bjelica, at the end of the season.

“Bjelica has our full support,” Zingler said. “The season we've played hasn't been a good one. That has nothing to do with Bjelica, but with the first half of the season. We didn't play well then. As a club, we didn't deliver.”

Bochum (33 points) moved three points ahead of Union, which was just a point ahead of Mainz (29) in the relegation playoff spot. Mainz drew at Heidenheim 1-1 in the late game.

Union visits second-from-bottom Cologne (24) next weekend in what will be a must-win game for the home team to avoid being relegated alongside last-place Darmstadt.

Two rounds remain.

AP soccer: https://apnews.com/hub/soccer

Leverkusen's head coach Xabi Alonso smiles during an interview ahead of the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. (AP Photo/Michael Probst)

Leverkusen's head coach Xabi Alonso is seen during an interview ahead of the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. (AP Photo/Michael Probst)

Frankfurt's Robin Koch, Leverkusen's Patrik Schick and Frankfurt's goalkeeper Kevin Trapp, from left, challenge for the ball during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. (AP Photo/Michael Probst)

Leverkusen's Robert Andrich gestures during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. Left Leverkusen's Granit Xhaka who scored the first goal. (AP Photo/Michael Probst)

Frankfurt's goalkeeper Kevin Trapp reacts during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. Left Leverkusen's Granit Xhaka who scored the first goal. (AP Photo/Michael Probst)

Frankfurt's Niels Nkounkou, left, and Leverkusen's Nathan Tella challenge for the ball during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. (AP Photo/Michael Probst)

Leverkusen's Patrik Schick, right, celebrates his side's second goal during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. (AP Photo/Michael Probst)

Leverkusen's Granit Xhaka celebrates his side's opening goal during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. (AP Photo/Michael Probst)

Frankfurt's Niels Nkounkou, left, and Leverkusen's Nathan Tella challenge for the ball during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. (AP Photo/Michael Probst)

Leverkusen's Patrik Schick, right, celebrates his side's second goal during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. Left Leverkusen's Granit Xhaka who scored the first goal. (AP Photo/Michael Probst)

Leverkusen players celebrate their side's third goal during the German Bundesliga Soccer match between Eintracht Frankfurt and Bayer Leverkusen in Frankfurt, Germany, Sunday, May 5, 2024. (AP Photo/Michael Probst)

Philipp Hofmann, centre, of VfL Bochum celebrates with teammates after scoring their side's fourth goal of the game during the Bundesliga soccer match between 1. FC Union Berlin and VfL Bochum, at the An der Alten Forsterei stadium in Berlin, Germany, Sunday May 5, 2024. (Andreas Gora/dpa via AP)

Philipp Hofmann of VfL Bochum celebrates after scoring their side's fourth goal of the game during the Bundesliga soccer match between 1. FC Union Berlin and VfL Bochum, at the An der Alten Forsterei stadium in Berlin, Germany, Sunday May 5, 2024. (Andreas Gora/dpa via AP)