NBC News
David Bennett Jr. waited, kneeling by his bed with phone in hand, for a call no one had ever received before: The hospital was to inform him whether his father was still alive after receiving a new heart…from a pig.
It was the first time a living human had undergone a pig organ transplant. “You never know what the news is going to be, but my dad opened his eyes, he was awake and he was fine. It was amazing,” Bennett Jr. said.
David Bennett was suffering from severe congestive heart failure and was not a candidate for a human transplant. He knew he would probably die soon, and there was nothing else to do but risk undergoing a novel surgical procedure. Bennett and his son agreed it was worth the risk.
The achievement made headlines around the world after the transplant was performed in January 2022. At first, the results seemed promising, and some family members even began to consider the idea of Bennett leaving the hospital.
“There were definitely conversations going forward about what we were going to do at home and who was going to take care of him and how that was going to work,” Bennett Jr. said. “Everyone was very optimistic and hopeful.”
But two months later, Bennett’s body rejected his heart and he died at age 57.
In a scientific paper, his doctors at the University of Maryland Medical Center explained that his body probably produced too many antibodies that rejected the new organ. A drug he was given may also have increased his chances of rejection, and a virus in the pig’s heart further complicated the situation.
The sacrifice “was not in vain”
Three other patients have followed in Bennett’s footsteps and received pig organs, the latest being a kidney in April. All represent pioneering patients in the burgeoning field of xenotransplantation.
For their families, three of whom spoke to NBC News about the experience, the process was a roller coaster of emotions, from uncertainty to blind hope and, in the end, admiration for their loved ones’ decision.
“I would love to have my father here, but I know his sacrifice was not in vain”Bennett Jr. said.
None survived more than three months. To the public, that might seem like a failure, but to the families, the transplants served their purpose: giving their loved ones more time and spurring research that could one day save lives.
“Larry looked at it this way: He was going to die, it was inevitable and it was going to happen soon,” said Ann Faucette. Her husband of nearly 38 years, Lawrence Faucette, was the second person to receive a pig heart. “So why not offer his body as a test subject so they could get all the data and do all the research they could so that in the future there would be another option for people who need those transplants?”
The promise of xenotransplantation lies in the shortage of available human organs. An estimated 17 people a day in the United States die waiting for one, according to the Health Resources and Services Administration. Because porcine organs are easier to obtain, doctors envision a future in which these operations will be as common as hip replacements.
But at this early stage, the Food and Drug Administration has only approved them for patients on the brink of death with no other options.
Like Bennett, Lawrence Faucette was eligible for a pig heart because he was dying of heart failure. Ann Faucette said that after the operation, her husband was able to play cards and do physical therapy on a stationary bike. It was a contrast to the day before the operation, when his heart had stopped and he had to be resuscitated with a defibrillator.
“We are having full conversations. We are watching football,” he recalled. “It is like normal life, as normal as it can be in a hospital.”
She focused on the positives: “I was in denial. This was going to work. This was going to get better. This was going to come home,” Ann said.
His two sons, now 29 and 31, “saw that the end could come at any moment, so they made sure to tell Larry they loved him,” she added.
At her husband’s request, she purchased a new chair for their home in Frederick, Maryland, in preparation for his return. On the day it was delivered, she learned that Faucette’s health had worsened.
“While I was waiting for the chair, I got the call that they wanted to put Larry on ECMO,” she said, referring to a life-support device.
He died two weeks later after his body rejected the transplant, less than six weeks after the operation. According to his doctors, Faucette’s recovery was complicated by his diminished strength shortly before the surgery.
The next two xenotransplants showed a similar pattern: after the operation, the patients started to feel much better, but suddenly worsened after several weeks.
Brittany Harvill’s mother, Lisa Pisano, received a genetically modified pig kidney in April. Within a week, she had improved dramatically, Harvill said.
“He said, ‘I feel great.’ You could see the color in his face. He looked like a completely new person“, he said.
Before the surgery, Pisano could barely walk because he was short of breath and suffered from extreme fatigue. He had heart and kidney failure, so his operation was more complicated than the others: doctors implanted a mechanical heart pump eight days before the pig kidney transplant.
After the surgery, Pisano seemed more alert than ever, Harvill said. From the hospital, she FaceTimed her grandchildren, watched cooking shows and spent time with her daughter.
“I would bring him pictures and then we would talk about what the kids were doing,” Harvill said.
But the demands of the transplant were too much for Pisano’s other organs. Doctors put him on blood pressure medications, which eventually caused the kidney to be rejected. He died in hospice care on July 7, about 12 weeks after the transplant.
Harvill said her mother was confident in her decision, but wished she had lived long enough to see her granddaughter, Olivia, go to kindergarten. “One thing that saddens me is that my mother would have loved to be there for that,” she said through tears.
She believes the kidney transplant “would have worked 100%” if it weren’t for her mother’s heart problems.
“Now I think doctors know that people who are as sick as my mother may not be the best ones,” she said.
In fact, surgeons who performed the xenotransplants and other experts in the field say the first four patients were not ideal candidates, since those near death are likely too weak to support a new organ.
“If we could select patients who were much more likely to do well, then we would have a better idea of how successful the transplant would be,” said David Cooper, a transplant surgery researcher at the Massachusetts General Research Institute who was not involved in either operation.
Optimism about the future
But for the FDA to approve such a transplant in a healthy patient, Cooper said, the agency would like to see more consistent one-year survival in animal studies. Privately, doctors had hoped that would be the case for human patients.
“We were waiting six months, maybe a year. We ignorantly thought our animal data supported it. We actually thought we would do better in humans,” said Bartley Griffith, clinical director of the cardiac xenotransplant program at the University of Maryland School of Medicine, who operated on Faucette and Bennett.
The only xenotransplant patient who recovered enough to return home was Rick Slayman, who received a pig kidney at Massachusetts General Hospital in March. He suffered from end-stage kidney disease, diabetes, high blood pressure and heart disease.
Slayman’s family declined to be interviewed. According to his surgeon, Tatsuo Kawai, the dialysis he needed before the transplant was no longer necessary afterward, and his only hurdle was climbing the three flights of stairs to his apartment.
However, Slayman died less than eight weeks after the operation, leading doctors to suspect a fatal arrhythmia. An autopsy revealed his heart disease was more advanced than doctors had believed.
“The autopsy did not reveal any rejection or abnormalities in the kidneys, so we believe the transplant was a success,” said Kawai, director of the Legorreta Center for Clinical Transplant Tolerance at Mass General.
The families of Bennett, Faucette and Harvill have no regrets that their loved ones participated in the experimental transplants. They consider the extra time a gift and remain optimistic about the potential of xenotransplantation.Harvill compared the situation to the first human heart transplant in 1967. That patient died after 18 days, but thousands of such procedures are now performed in the United States each year.
Families are also aware of how much doctors learn with each operation. “The excitement in their voices and on their faces when they talk about the information Larry gave them, makes me feel grateful,” Faucette said. For their wedding anniversary, she baked about 500 cookies for the hospital’s nursing staff.
Dr. Robert Montgomery, who operated on Pisano and heads New York University’s Langone Transplant Institute, said many of those on the waiting list are interested in xenotransplantation.
“You don’t know how many people call my office every week wanting to do this. I think people underestimate how desperate they are,” he said.
Researchers are eager to try another transplant once they find the right candidate and get FDA approval.
“We’re at a point where we feel 100 percent better informed,” Griffith said. “We’re not sure if this will mean our next patient will live a year, but we’ve gone from total ignorance to having a good idea of who our enemy is.”
