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CNN Special Reports
Dr. Sanjay Gupta Reports: Animal Pharm. Aired 8-9p ET
Aired May 18, 2025 - 20:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[20:00:00]
DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: For the humans as well. We're going to see how long this all takes. Clinical trials are starting now. But I asked every scientist for the documentary, how long do they think this is going to take, what's the timeline here, and the answer came back, around five years. Around five years for this to potentially be a real option for people who are waiting for organ transplants right now -- Jessica.
JESSICA DEAN, CNN HOST: "DR. SANJAY GUPTA REPORTS, ANIMAL PHARM," it's next only here on CNN.
In the meantime, thanks so much for joining me this evening. I'm Jessica Dean. We're going to see you right back here next weekend. Have a great night.
(BEGIN VIDEOTAPE)
GUPTA(voice-over): What you're about to see --
UNIDENTIFIED FEMALE: There she is.
GUPTA: -- is history in the making.
DR. ROBERT MONTGOMERY, DIRECTOR, NYU LANGONE TRANSPLANT INSTITUTE: I think it's a historic day.
UNIDENTIFIED FEMALE: There you go. Good girl.
SADIE HENNIG, DIRECTOR OF EMBRYO PRODUCTION, EGENESIS: This is many years in the making.
CHARA KEKONA, RECRUITING COORDINATOR, EGENESIS: It's a really big moment. There is a lot of emotions.
DAVID AYARES, GENETICIST, UNITED THERAPEUTICS: Deployed cell.
GUPTA: A medical first, a story of survival, bravery and heroism.
TIM ANDREWS, PIG KIDNEY RECIPIENT: I'm not a hero. I'm just a regular Joe.
GUPTA: All of it, to try and solve a crisis.
MONTGOMERY: Taking the clamp off the artery. Nice and pink. Yes. GUPTA: You see, at any given moment, more than 100,000 people are
waiting.
Seven cardiac arrests before he became eligible for a heart transplant.
DENYCE GRAVES, ROBERT MONTGOMERY'S WIFE: He wasn't sick enough, believe it or not.
GUPTA (voice-over): Waiting for an organ.
T. ANDREWS: I was ready to die in this chair.
GUPTA: It's hard to hear.
(Voice-over): And every day, 17 people will die waiting.
MONTGOMERY: For any organ that you name, only 10 percent make it on the list.
GUPTA: There's just not enough of them.
MONTGOMERY: There's just not enough.
GUPTA (voice-over): Now, the potential answer might sound crazy to many.
TOWANA LOONEY, PIG KIDNEY RECIPIENT: I have received a major, major groundbreaking organ transplant.
We did it.
(CHEERS)
GUPTA: Controversial to some.
KATHY GUILLERMO, SENIOR VICE PRESIDENT, PETA: For that animal, this is a life of deprivation. It's an early death. It's much suffering. I don't think that's ever OK.
GUPTA: Even blasphemous to others.
T. ANDREWS: Contacted the bishop, and then the Vatican sent me a paper.
GUPTA: Wow.
(Voice-over): But now more than ever, it's also incredibly promising. Could these animals be the answer? Is it right? Is it wrong? Can it really work?
That is an ultrasound of a pig kidney inside Tim. Something that very few people ever get to see.
(Voice-over): For the last two years, we've been searching for answers. It's powerful just to be here with these pigs.
(Voice-over): I'm Dr. Sanjay Gupta, and this is ANIMAL PHARM.
In the remote mountains of Patagonia, about as far from civilization as you can get, Robert Montgomery almost died.
MONTGOMERY: I had a cardiac arrest, and my son was doing CPR on me, and they put me in the back of a truck and drove me to a hospital. And they looked at me and said, we can't take care of this. They brought an ambulance up and continued resuscitation and drove me five hours to the closest hospital.
GUPTA: I've heard a lot of extraordinary stories throughout my career, but just the idea, the cardiac arrest, and then your son doing chest compressions on you.
MONTGOMERY: Yes. He saved my life, for sure. When I woke up, I couldn't do anything. I couldn't walk or talk. That was the hardest thing I ever did, recovering from that.
GUPTA (voice-over): That he even survived, it really is just so extraordinary. But still, the underlying problem. Something known as dilated cardiomyopathy, where the heart is just too weak to adequately pump blood, that was still with him, lurking, constantly threatening his life.
MONTGOMERY: Father died at 52 from cardiomyopathy, the same disease that I had. Brother dropped dead at 35. Another brother got a heart transplant at 39. And then me. I've basically accepted that I might not live a normal lifespan.
GUPTA: Almost every single man in his family sick or dying of this heart disease.
Was it your father's doctor who said that transplantation really wasn't going to be a solution or an answer?
MONTGOMERY: My mother was really begging him to come up with something, and he said, you know, he's too old. And --
GUPTA: Fifty-two.
MONTGOMERY: Fifty-two. And it doesn't work anyway, so you wouldn't want that. That was 1976.
[20:05:02]
GUPTA (voice-over): Now, even though the first successful heart transplant was back in 1967 in South Africa, it would take decades for it to become widely available. Not in time for Dr. Montgomery's dad. And so Robert Montgomery was given a mission, become a transplant surgeon, and hopefully one day save people just like his dad.
MONTGOMERY: All right. How does that look with the camera? GUPTA: It wasn't easy. By age 56, he'd had three near catastrophic
cardiac arrests himself. The only cure, he was told, was a heart transplant. But --
MONTGOMERY: For any organ that you name, only 10 percent make it on the list. I wasn't sick enough to get on the list. You have to get so sick before you would even qualify to be in the running to receive an organ. And it's just unacceptable.
GUPTA: And that's all because we have to ration organs. There's just not enough of them.
MONTGOMERY: There's just not enough of them.
GUPTA (voice-over): But then it was the summer of 2018 when Robert Montgomery suddenly became sick enough. Once again, he was overseas. This time it was Italy with his wife, Denyce.
GRAVES: He would go on to have four heart attacks that night.
MONTGOMERY: I just had one cardiac arrest after another. They gave me the last rites.
GRAVES: They revived him. He said, I will die if I don't get out of here.
MONTGOMERY: They left my IVs underneath my shirt and they gave my friend a bundle of pre-loaded resuscitation drugs and syringes and flew back.
GUPTA: Oh, my god.
MONTGOMERY: Because I knew that was my ticket.
GUPTA (voice-over): The odds of survival were still not in his favor.
MONTGOMERY: Hi, sweetheart.
GUPTA: You see, even after making it on the list, 17 people die every day while waiting. Remarkably, just three weeks later, a heart became available. But it came with a catch. His donor had died of a heroin overdose and the heart was infected with hepatitis C. In the transplant world, that is typically a no go. In fact, thousands of hep C infected organs are discarded every year. But Dr. Montgomery insisted that his doctors still give it to him.
MONTGOMERY: We had just done a study showing that you could take a hepatitis C positive organ and put it into hepatitis C negative recipient and treat them with these new antivirals. You could successfully treat the virus.
GRAVES: Robert wasn't worried and so I was.
GUPTA: It was a risk, transplanting an infected organ into someone who had his immune system suppressed. But you're probably starting to see a pattern here. Montgomery was once again willing to take the chance and prove that these infected hearts could be used safely.
MONTGOMERY: Hello to all my friends.
GUPTA: And it worked.
MONTGOMERY: Thank you for your kind thoughts and your prayers. And I'm making a very nice recovery.
GUPTA: Within weeks he was able to walk out of the hospital. Today he wants to show me the place he comes to treat patients just like him.
MONTGOMERY: It was in this room right around the corner. So I have good feelings about this place actually.
GUPTA: It's like hope.
MONTGOMERY: Yes. Hope.
GUPTA: Represents hope.
MONTGOMERY: Behind that door, yes.
GRAVES: He is a man on a mission. He wants to see this eradicated.
MONTGOMERY: If this were like a cancer drug, we wouldn't allow something to be rationed like this, right? We just don't have any choice right now. So we need another choice.
GUPTA: Another choice which Montgomery is now racing to find.
T. ANDREWS: I'll help you down.
GUPTA: Another choice hopefully for this man.
Tim Andrews has been living with diabetes since the 1990s, successfully managing it with insulin. Retired and happily married to his second wife, Karen, these empty nesters had big plans for their new life together, traveling the world until one day in 2022.
T. ANDREWS: I got tired. I was like, oh, my god, I'm going to fall asleep or something. So I was checked and they said, oh, you're stage three kidney failure. OK? And a month later they're telling me I am at end stage.
GUPTA: Wow. Just one month.
T. ANDREWS: Just one month. Just quit on me.
GUPTA: What were you feeling like at that point?
T. ANDREWS: I mean, I was told, literally told you have dialysis or you pick a box.
GUPTA (voice-over): It was a false choice. Certain death or dialysis, meaning being dependent on a machine for the rest of his life. T. ANDREWS: The first couple of months was like, hey, this is not
going to be so bad. As time went on, like six months in, I had a heart attack. It takes a toll on you emotionally and physically.
[20:10:00]
GUPTA: For more than two years, three days a week, like clockwork, this dialysis clinic kept him alive.
T. ANDREWS: Here we are.
GUPTA: It was a well set routine.
That's the machine.
T. ANDREWS: This is where I get to sit. Without it six weeks, eight weeks later, I'd be dead. It's a necessary evil.
GUPTA (voice-over): Necessary at least until he could get a kidney transplant. But again, just as with Montgomery, he knew that could take a while. Might never happen. And the clock was ticking.
T. ANDREWS: I was ready to die in this chair.
GUPTA: And that is when he learned about another option. Brand new, still relatively untested.
KAREN ANDREWS, TIM ANDREWS' WIFE: Some people said there's not enough information. Don't do this yet. Don't do this yet.
GUPTA: He was willing to be one of the first.
When we come back, Tim's path to making medical history. And you're about to have a front row seat.
(COMMERCIAL BREAK)
GUPTA: You can't really tell by looking at them, but these tiny piglets have been genetically engineered to make their organs more acceptable for transplantation into humans. It's something known as xenotransplantation.
So, Mike, how unusual is it for us to even be here?
MIKE CURTIS, CEO, EGENESIS: It's very unusual. We usually try to limit this to only the staff that takes care of the animals.
GUPTA (voice-over): Mike Curtis is the CEO of biotech company eGenesis. Never before has he let cameras onto this very special pig farm.
CURTIS: Everything is controlled like all the feed is clean, water is clean, the staff is clean.
GUPTA: And I should just point out that I walked into a room, turned on a filter, essentially cleaned the air for five minutes before I could then go shower. That's why my hair is wet. I put on everything new here, including underwear, socks, shoes.
(Voice-over): The goal is to protect the pigs from us.
Wow. Look. You know, I got to tell you, I did not know what to expect, but it's powerful just to be here with these pigs.
(Voice-over): After all, these pigs are among the most genetically modified mammals on the planet.
CURTIS: These piglets carry a total of 69 edits to their genome.
GUPTA: All alterations to their DNA.
CURTIS: We're trying to reduce the risk of disease transmission from the porcine donor to human. We're editing in a way that reduces or eliminates hyperacute rejection. And then we add human regulatory transgenes to control rejection.
GUPTA: Now, to do that, scientists take the unedited pig cells and use a gene editing tool called CRISPR. They add special CRISPR fluids to the cells, which splices out certain genes and adds other genes.
[20:15:04]
You can't really see anything with the naked eye, and it takes only seconds. But what is happening in this vial is truly remarkable. Let me take a second and explain.
First of all, remember this. All DNA is made up of four chemical bases, A, C, G, and T. That's your genetic blueprint. Now, this is a pig's DNA and over here a human's DNA. As you can see, they're actually not that different. But for example, take a look at this part of the sequence. It's known as the GGTA1 gene. That's responsible for a carbohydrate that forms around a pig's cell known as alpha gal.
Now, you put that into a human and it would cause almost instantaneous rejection. But by knocking out that sequence and then adding in others, scientists can make the pig's organs much more compatible for humans.
CURTIS: So in the freezer are all these cells that we've edited. We thaw that vial. We grow those cells. Then we take the nucleus from that edited cell and we transfer it. It's akin to what was done with Dolly back in the '90s, cloning.
GUPTA (voice-over): And that is the process by which they have created a modern-day assembly line of genetically modified pigs.
CURTIS: We've selected the Yucatan minipig because fully grown they're about 70 kilos, 150 pounds. So the organs are correctly sized for human recipient.
GUPTA: Ultimately you got to get the size right.
CURTIS: That's right. GUPTA (voice-over): Now, if the idea of using animals for human
transplants sounds familiar to you, it's because the concept has been around for a long time. There have been at least 48 cases reported in the medical literature since the 1900s. You may remember one of the most famous.
UNIDENTIFIED MALE: This is Baby Fae.
GUPTA: Little Baby Fae in 1984. She had a baboon heart that kept her alive for 20 days. But there was always the stubborn issue of rejection. And so for a long time, xenotransplants faded into the background.
MONTGOMERY: I think we've turned up the throttle significantly.
GUPTA: What's led to that do you think?
MONTGOMERY: What we did is transplanted one of these organs into someone who had wanted to donate their organs, was brain dead.
GUPTA (voice-over): You heard that right. The first human patients to receive the gene edited pig kidneys were brain dead. Why? In order to move the field forward without moving too fast. First, the scientists just wanted to prove that pig organs could survive in a human body. And what you're watching is Dr. Robert Montgomery performed that operation on Morris Miller, who was brain dead.
MONTGOMERY: We took the clamps off to let the blood go into the organ, and it turned this beautiful pink color and started to make urine immediately.
Pretty looking kidney.
That was mind blowing.
So it looks a lot like a human kidney.
GUPTA: In fact, when I first met Dr. Montgomery a few years ago, he was reviewing Morris Miller's kidney biopsy. Here's what they learned. About a month into the transplant, the pig kidney did begin to show signs of rejection.
MONTGOMERY: You see that red?
GUPTA: Yes.
MONTGOMERY: That's hemorrhage.
GUPTA (voice-over): But importantly, standard anti-rejection drugs did work.
And the kidney function is OK?
MONTGOMERY: Now it's back to normal. It gave I think the FDA some confidence that this was going to work in humans. GUPTA (voice-over): With all that research in the background in 2022,
the University of Maryland School of Medicine announced the first xenotransplant into a living recipient, someone who is not brain dead. It would be a pig heart into 57-year-old David Bennett.
UNIDENTIFIED FEMALE: Give me a high five, buddy. That was awesome.
AYARES: We saw two months survival of that patient and now incrementally seeing longer and longer survival in these compassionate use patients.
GUPTA: David Ayares is a giant of a man. Seeing him on this farm in Blacksburg, Virginia, you may not know that he is also considered one of the most widely regarded geneticists in the world.
AYARES: We have about 300 research animals here. We grow the designated pathogen-free pigs that were ultimately used for the decedent studies, as well as the patients that have received our organs for transplant both hearts and kidneys.
GUPTA: Today, he's taking me to meet some of the farm's newest arrivals.
AYARES: Watch your head. Maybe that's just me. Hey, mama.
GUPTA: There's the little piglets.
AYARES: Yes. Do you want to hold one?
GUPTA: Yes, sure.
AYARES: So these are 10 gene cloned piglets.
GUPTA (voice-over): Here at United Therapeutics, they perform 10 gene edits on their pigs. Now, remember, eGenesis in Wisconsin performed more than 60.
If you're doing six times as many edits, does that make it much better?
AYARES: I don't think more edits is necessarily better or worse.
[20:20:03]
The additional 50 edits that eGenesis has done are to inactivate an endogenous pig virus. We've actually addressed that by breeding.
GUPTA (voice-over): In 2024, the first pig kidney transplant was announced.
DR. LEONARDO RIELLA, MEDICAL DIRECTOR OF KIDNEY TRANSPLANTATION, MASSACHUSETTS GENERAL HOSPITAL: My name is Dr. Leo Riella, I'm medical director of the kidney transplant program at Mass General. Today we announce the successful gene edited pig kidney transplant into a living human.
GUPTA: Tim Andrews, still on dialysis, was watching all of this unfold.
T. ANDREWS: I'm like, oh, they're doing it at Mass General. And I was like, I have to be part of this. I'm not going to make it, but I'll make it to this and I'll tell you right up front, if it's one day and you learn something, thank God.
RIELLA: His eyes really sparked up and he said, tell me what I need to do. I'll do it.
K. ANDREWS: And they said, prepare your body for battle because it's going to be a battle. He had to do dental work. He had to go to physical therapy. We signed up for the gym. When he came back to see Dr. Riella, he had lost 22 pounds.
GUPTA: Did you have any doubts along the way?
T. ANDREWS: You know, there's always doubt with it, but I'm like, this is my chance to do something.
GUPTA: You're going to be in medical history books?
T. ANDREWS: Yes.
GUPTA: For forever.
T. ANDREWS: Kids are going to be taught how to do it. Watching me have one put in me.
GUPTA: But they'll know your name. They're going to know your name.
(Voice-over): Coming up, Tim Andrews sees the donor who may give him a second chance at life.
K. ANDREWS: Oh, my goodness.
T. ANDREWS: That's amazing. Huh? Given life. What a gift.
(COMMERCIAL BREAK)
[20:26:41]
GUPTA: It's a crisp January morning back at the eGenesis pig farm in Wisconsin.
UNIDENTIFIED FEMALE: There you go. Good girl.
GUPTA: It's been more than a year since our first visit.
HENNIG: This is many years in the making, so, Raphael, she'll be able to donate one of her kidneys to a man who's in dire need. And essentially, she's saving his life.
UNIDENTIFIED FEMALE: Go, Raphael.
KEKONA: It's a really big moment. There is a lot of emotions. We love our piglets like our own. Thinking about the purpose that Raphael is serving by getting to go and give someone a new lease on life is just such a gift.
GUPTA: That someone is Tim Andrews. Raphael will be his donor.
Would you like to see Raphael?
K. ANDREWS: Yes.
T. ANDREWS: I would love to see that.
GUPTA: All right, let's show it to you. Let's just go ahead and hit play right there whenever you're ready.
K. ANDREWS: Oh, my goodness.
T. ANDREWS: Oh, cool.
GUPTA: What was that like for you?
T. ANDREWS: That's amazing, huh? Given life. What a gift. Oh, God.
GUPTA (voice-over): As Raphael departs for the 17-hour trip to Boston, Tim settles in at Mass General.
T. ANDREWS: I knew I was in great hands.
GUPTA: Yes.
T. ANDREWS: These guys are just so good.
GUPTA: Were you nervous the morning of?
T. ANDREWS: A little.
RIELLA: And we'll see you on the other side.
T. ANDREWS: Awesome.
RIELLA: Getting ready.
T. ANDREWS: As a new man.
RIELLA: Yes.
We're all anxious and nervous about going through a procedure that has not been done before. And having that reassurance from him also brings a lot of positivity to the entire team.
GUPTA (voice-over): It's early morning, January 25th, when Dr. Riella and the surgical team travel about 50 miles outside of Boston to meet Raphael.
RIELLA: It was an OR very similar to what we see in the hospital, and the surgery to retrieve the organs occur there. It looked very similar to how we do procurements. I think the uniqueness is really that, you know, who was a donor, who was coming. It was a pig.
GUPTA: By 8:00 a.m. it's go time.
K. ANDREWS: It's a dance to get the pig kidney there and get him in the operating room.
GUPTA: Get coordinated.
K. ANDREWS: So a nurse came and said, OK, good to go. I'm like, wait, wait, wait, we haven't said goodbye. You can't say goodbye. Oh, yes, I can. So I actually made them wait and they said, we've got to go. I'm saying goodbye to my husband before he leaves for surgery and he may not come back.
UNIDENTIFIED FEMALE: It's a little chilly in here. OK, Tim?
T. ANDREWS: I like cold.
GUPTA (voice-over): The operation lasts a little over two hours, around the same as a traditional transplant, and take a look over here. This is the pig kidney. It looks, feels and functions very much like a human kidney. And here is when surgeons connect the pig kidney to Tim's artery and vein. After that, the moment of truth.
[20:30:02]
Surgeons released the clamps so blood can flow into the kidneys and the organ turns pink. And now this. Urine successfully flowing through the kidney.
RIELLA: Wow. Look at that.
We were very surprised. We were hoping they would start making urine within a day or two. But seeing the urine being produced right away was not what at least I expected to be happening that close.
Everything went well.
K. ANDREWS: They said they put the kidney on the table and started connecting him to the kidney, and he actually peed across the room. So they were very, very excited. Of course, I started bawling like a baby. We were all crying. I mean, we were all like, oh, my goodness. I mean, this is not the end, but we're getting there. We're getting there.
T. ANDREWS: I felt great, and all of a sudden I had energy and I was like, this is beyond what I thought I was going to get.
GUPTA: So right away, you felt that good.
T. ANDREWS: Right away I felt that. I was like, look at me, I'm a new man. It was like a new birth. I said, I have a new birthday. 1/25/25 is my new birthday.
GUPTA: That's your birthday.
T. ANDREWS: Because I was alive and I hadn't been for a long time. And I'm like, this is amazing. GUPTA (voice-over): But there was still a long way to go. This is
still so experimental after all. And Tim and Karen knew how quickly things could change.
LISA PISANO, PIG KIDNEY RECIPIENT: I'm having this procedure.
GUPTA: It was just a year earlier that Lisa Pisano also needed a kidney.
Did you and your mom used to walk around here?
BRITTANY HARVILL, LISA PISANO'S DAUGHTER: Yes.
GUPTA: Her daughter, Brittany Harvill, remembers just how sick her mother was.
HARVILL: It means no more dialysis hopefully.
GUPTA: Like Tim, she was an end stage kidney disease. But Lisa's heart was also failing. And that is why a traditional kidney transplant was not an option for her.
So in some ways she was too sick.
HARVILL: Yes, she was too sick.
GUPTA: To get a transplant.
HARVILL: Absolutely.
MONTGOMERY: Lisa Pisano was on death's door. I mean, she was not going to live. She was, you know, days to weeks from dying.
GUPTA (voice-over): So Dr. Montgomery, who was her surgeon, suggested a pig kidney.
MONTGOMERY: There are some people who are willing to take that chance. And she was one of them.
GUPTA: In the spring of 2024, Lisa Pisano became one of the first two patients in the world to receive a gene edited pig kidney transplant.
PISANO: I got more energy. I feel energized.
HARVILL: After her kidney transplant, I have to say, she looked the best that she looked in so long. I'd seen her so happy. It was definitely the healthiest I had seen her in a while.
GUPTA: She was doing well at that point.
HARVILL: Yes, we were so hopeful because I had seen her so much better. And I figured if anything was going to go wrong, it would have went wrong at that moment and not months later.
GUPTA (voice-over): Pisano developed several infections and never recovered enough to leave the hospital. HARVILL: I don't have regrets about the surgery. I just wish that she
could have had the opportunity to really enjoy it more.
GUPTA: I know it's probably hard to sort of think of it this way, but she was a real pioneer.
HARVILL: Well, one of the first things she said to me was, even if this doesn't work for me, it can work for someone else. And I think about that a lot.
MONTGOMERY: The first patient that we did was in this bed, in the bed that I was in. Lisa Pisano. You know, taking care of that one life. And if it were just that, that would be great. But then you have this opportunity to really impact maybe thousands, maybe millions of lives.
GUPTA (voice-over): Now, Tim knew Lisa's story. He knew that there was a tremendous amount of uncertainty.
T. ANDREWS: Stepping forward, you're going to do something for humanity. This is a way that we can bring this forward. And this is the hope for all these people that it's going to be OK. We're going to find a way, which is amazing to me. It was just, I have to be part of this.
GUPTA: Would it be a success for Tim? And what does this all mean for the 100,000 people currently waiting?
T. ANDREWS: There's bumps in the road.
GUPTA: That's next.
(COMMERCIAL BREAK)
[20:39:14]
GUPTA: It's been just seven days since Tim Andrews received a pig kidney.
T. ANDREWS: I'm a crier. They all know it.
GUPTA: He's understandably emotional. Once tethered to a dialysis machine for survival, Tim is now free.
T. ANDREWS: Oh, it's nice.
K. ANDREWS: Air.
T. ANDREWS: Fresh air. I love it.
GUPTA: There's that great shot of you as you're walking out of the hospital. Yes.
T. ANDREWS: Fresh air. Then I was like --
GUPTA: It almost seemed like you were breathing air for the first time. T. ANDREWS: Yes. It kind of felt like it had been a long time since I
had been outside really.
GUPTA (voice-over): And by leaving the hospital so soon, Tim was making history.
You wanted to get out as quickly as possible.
T. ANDREWS: Yes.
GUPTA: And you wanted to beat Towana.
K. ANDREWS: Yes. She was intimidating.
T. ANDREWS: Yes. I had to -- yes.
(LAUGHTER)
[20:40:05]
UNIDENTIFIED FEMALE: Beautiful.
GUPTA (voice-over): Towana is Towana Looney, a 53-year-old Alabama grandmother who underwent a kidney transplant two months earlier.
MONTGOMERY: So how are you feeling?
GUPTA: Dr. Robert Montgomery was her surgeon.
LOONEY: Know what the first thing I'm going to do when I get home?
MONTGOMERY: What's that?
LOONEY: Cook me some greens.
MONTGOMERY: Some greens?
LOONEY: Like your wife made me.
(LAUGHTER)
GUPTA: She had been on dialysis for nine years, waiting for an organ transplant.
MONTGOMERY: If you're on dialysis for five years, you have a 50 percent mortality. You start going beyond that, and your likelihood of living gets less and less.
All right. And the kidney is right inside this bag.
GUPTA: Towana volunteered for a xenotransplant.
MONTGOMERY: It was exciting. She wants to start a revolution to herself. I mean, she really believes in this.
GUPTA: So much so that Towana helped make Tim Andrews a believer as well. Because along the way, when Tim had had his doubts, he called the only living person in the world who had gone through this.
T. ANDREWS: Hearing her saying, you know, just trust God. Just trust God. It'll be OK. That made me feel easier.
GUPTA: It has now been 60 days since his transplant, and Tim is settling back into life in Concord, New Hampshire. Today we decided to bundle up and go for a walk.
It's interesting because you say you feel better.
T. ANDREWS: Yes.
GUPTA: No question about it, right?
T. ANDREWS: Absolutely. No question about it.
GUPTA: What does that mean exactly? What feels better?
T. ANDREWS: Energy. I have energy. I'm a little wobbly, though.
(LAUGHTER)
GUPTA: OK, we got you.
T. ANDREWS: But I feel so much better and clearer.
GUPTA (voice-over): None of this is easy.
T. ANDREWS: Taking 20 milligrams of fives.
GUPTA: I mean, every day Tim sits at this makeshift mountain of medication, guided by this big binder. It's a survival bible of sorts.
T. ANDREWS: This is the book that tells you what you're going to take. We keep it in pencil because it changes a lot.
GUPTA: Another reminder of how new this all is, there is a lot of experimentation with the right mix of meds and doses. In all, Tim takes 52 pills a day.
T. ANDREWS: And this is when it helps to be a '70s child. Ready?
GUPTA: And several times a week, an anti-rejection infusion directly into his blood.
How are you?
K. ANDREWS: Hi.
GUPTA (voice-over): We were there for his two month checkup.
Look good, you feel good?
(Voice-over): As he had a battery of tests to look for any signs of infection, rejection, or reduced function.
RIELLA: We can actually identify if there's any issues with the kidney.
GUPTA: Worried about Tim's heart, the Boston medical team is also monitoring him 24/7 with this implanted loop recorder. It measures Tim's cardiac rhythm and warns of any potential abnormalities.
RIELLA: We are, of course, being just extra careful and cautious and ensuring things are on the right direction.
T. ANDREWS: In the little pig is right there so I can pat it.
GUPTA: But today's visit is all about this moment.
Observing this ultrasound. That is an ultrasound of a pig kidney inside Tim. Something that very few people ever get to see.
RIELLA: And it looks exactly like a human kidney. So let me see all the blood flow throughout. So --
GUPTA: Is there anything in there that makes it clear that it's a pig kidney?
RIELLA: No. Exactly like a human one.
GUPTA (voice-over): And not only does it look like one eight weeks post-operatively, it's acting like one.
RIELLA: The level of kidney function is as good as we would expect from a human kidney transplant. We just are amazed. Every day we look at the blood work.
T. ANDREWS: Yes.
GUPTA: That's awesome.
T. ANDREWS: Good stuff, isn't it?
GUPTA (voice-over): Now, there is one complication they're watching for very carefully. Something that is unique to xenotransplants and could affect not only Tim, but his wife Karen as well. Maybe all of us.
One of the concerns is that if there is some sort of weird or strange virus in the pig and it gets into the human population through one of these transplants, might not only affect the patient, but people around the patient as well.
RIELLA: In all the studies that were doing, we're not only monitoring the patient, but their close contacts.
T. ANDREWS: Because we don't know to this day and we won't know for the rest of my life whether that can happen. So that's always in the background.
GUPTA (voice-over): Talking to scientists, this is one of their biggest concerns. Accidentally unleashing a pig virus onto a susceptible human population. To avoid that, they screen extensively. They even edit the genome of the pigs to inactivate those viruses. But the question is, is that enough?
[20:45:00]
ART CAPLAN, MEDICAL ETHICS PROFESSOR, NYU GROSSMAN SCHOOL OF MEDICINE: Genetic engineering is a nice tool but it's not 100 percent accurate yet.
GUPTA: World renowned medical ethicist Art Caplan.
Is it a big enough concern to sort of derail?
CAPLAN: No, I don't think so. I think it's a reason to be cautious, to really detect a problem early and then be able to shut it down or respond.
GUILLERMO: I think it's a little bit of Russian roulette here.
GUPTA: Kathy Guillermo is the senior VP at PETA, People for the Ethical Treatment of Animals, and she thinks this is a big issue.
GUILLERMO: I think when it comes to viruses and animals, there's so much that we don't know. There are people who, in addition to PETA, are opposed to these experiments for that reason.
GUPTA: Now, to be clear, there is nothing about xenotransplants that sits well with Kathy or anyone else at PETA.
GUILLERMO: I don't think it could ever be OK to use an animal as a source of spare parts. For that animal this is a life of deprivation. It's an early death. It's much suffering, and I don't think that's ever OK.
GUPTA: Even if it means a choice between a pig life or a human death.
GUILLERMO: This was a situation my father was presented with, and my father was over 80, so he was not eligible for a transplant. And my father did die of end stage renal disease, and he would not have taken an organ from a pig for ethical reasons.
CAPLAN: I think what the mainstream position will become among those caring about animals, loving animals, is that we're going to tolerate this. We're going to look for alternatives to it, that they would find more acceptable.
GUPTA: And then there are the religious concerns.
You have certain religions, Muslim religion, Jewish religion, who they won't eat pork, they don't eat pigs. Is transplanting a pig organ different in some way than consuming, you know, eating it?
CAPLAN: It's somewhat contentious. I, however, don't think that you're going to see huge religious opposition, but you may see in some of the Islamic countries is human organs first, only go to the animal last resort. I could see that.
GUPTA (voice-over): A spiritual man, Tim also had his concerns. It's why he reached out to his church for guidance.
T. ANDREWS: I contacted the bishop and then the Vatican sent me a paper.
GUPTA: Wow.
T. ANDREWS: They were working animals were put on earth. God put them on the earth to serve us. And if their service extends life and makes a better life, so be it.
GUPTA (voice-over): So will these new kidneys create a better and longer life.
You look really good.
(Voice-over): When we come back.
(COMMERCIAL BREAK)
[20:51:59]
GUPTA: What you're seeing is the future of transplantation. A heart, a liver, a kidney. These are organs that are grown not in the body, but in the lab.
AYARES: They're using a pig organ scaffold and recellurizing that with human cells. Also, another group is 3-D printing that scaffold recellurizing that with human cells. So multiple ways to generate a humanized organ for overcoming the shortage.
GUPTA: The potential, organs on demand.
Could you get to the point where you could create a personalized organ for somebody?
AYARES: Absolutely.
MONTGOMERY: I think that's going to be the future.
GUPTA: So an organ that would be designed for Robert Montgomery.
MONTGOMERY: Yes. Personalized organs where we don't have to use any immunosuppression. Somebody starts to develop kidney disease, we take some of their stem cells from a piece of skin or some blood, and we start to grow them up and then seed, you know, that scaffolding with that person's stem cells that then grow and mature, and then you have a designer organ for that person when they need it.
GUPTA (voice-over): Now, to be clear, what he's describing is still years away. And that is why the focus is for now on these genetically modified pigs.
Since the time we started investigating xenotransplantation about two years ago, things have taken off at a lightning pace, from compassionate use to a pilot study, and now an FDA approved clinical trial. Also, expect to see high-tech pig farms like these pop up in other places around the country and the world.
AYARES: The next facility we'll be built will have an output of about 6,000 organs per year. But that's still, you know, less than 10 percent of the demand for the unlimited supply of organs.
AARON ORTIZ, DIRECTOR OF XENO MANUFACTURING OPERATIONS, UNITED THERAPEUTICS: This is a brand new building built specifically for human clinical trials.
GUPTA: Aaron Ortiz is in charge of scaling up United Therapeutics' pig production. These are the highly specialized designated pathogen-free buildings, DPF. They're built using FDA guidelines. It's what they call a bio secure and pathogen-free environment.
This is not typical pig farm.
ORTIZ: Yes. It looks like a biotech facility, to be honest. And the mechanics behind it. The pigs are drinking cleaner water than the employees that are working here, and they're breathing cleaner air as well.
GUPTA (voice-over): And within this farm, there are also multiple sterile operating rooms. That's where transplant teams from around the country will come starting this summer to procure or harvest the organs.
ORTIZ: The reason we do the procurements here is to mitigate any variabilities that could occur during transport of the animal to the actual hospital site.
[20:55:00]
GUPTA: So the concern was, if you're actually moving the pig, that's a source of potential contamination.
ORTIZ: Yes.
GUPTA (voice-over): Again, this is ultimately the biggest concern we heard from so many people that we interviewed for this documentary. They all ask, can the spread of disease from these pigs to humans really be controlled? And that is crucial after all to protect the population at large.
Do you feel like at this point that is an achievable goal?
ORTIZ: Hundred percent, yes. We test them at day 30. We test them at day 60. We test them at day 90. We test them quarterly. When they put into quarantine, if they were going for transplant, we will test them when they're in quarantine. And then we'll test the animal again as we do the procurement of the organ.
MONTGOMERY: And make sure it's all straight.
GUPTA (voice-over): That's the sort of testing that was done on the pig kidney transplanted into Tewana. And also on Rafael, Tim's kidney donor. T. ANDREWS: That'll get everybody moving.
GUPTA: A transplant that Tim is thankful for every day.
UNIDENTIFIED MALE: Tim, welcome.
GUPTA: Every Wednesday, he signs into this Zoom meeting from his kitchen table in New Hampshire.
UNIDENTIFIED FEMALE: We really have to thank Tim for stepping forward.
GUPTA: Hundreds of people from all over the country want to talk to him about his transplant.
You know, it strikes me that you've done all this, but then you also take the time to do these calls.
T. ANDREWS: That was my promise. Give me this, and I will spend the remainder of my life helping people get hope.
GUPTA (voice-over): It is the unspoken promise of pioneers. Pay it forward.
LOONEY: I want you to look at me. If I can do it, the next person can do it.
GUPTA: Towana was the star at a recent medical conference, the Lake Nona Impact Forum.
MONTGOMERY: The system will never be able to deliver enough organs. This is the promise for the future. And thank you for making that future happen.
LOONEY: You're welcome. Thank you.
GUPTA: I was there and I can tell you the audience loved her.
You look really good. You feel as good as you look?
LOONEY: Yes, I do.
GRAVES: My husband said, how do you feel about all this attention. she said, I love it.
LOONEY: I want the word to get out.
GUPTA (voice-over): But the thing about firsts, about pioneers, is that at any moment, their lives can be suddenly thrown into jeopardy.
T. ANDREWS: I woke up one morning and I was hurting so bad I couldn't walk or anything. And sure enough, I had an infection. You could see the remains of it there.
GUPTA: Tim was hospitalized for three weeks to treat the infection and prevent his kidney from being rejected. RIELLA: It was a quite hard few days for him and for us as well, but
fortunately we were able to overcome and were in a better spot now. We hope this kidney continues for a long time.
GUPTA: Turns out, as Tim won his fight to keep his kidney, Towana lost hers. Like him, Towana got an infection, but she also started to reject her pig kidney. So in April, doctors had to remove it. Towana is back on dialysis.
It had been 130 days. At the time she was the longest survivor with the xenotransplant in history, but now, soon, that distinction could belong to Tim.
T. ANDREWS: I don't want people to look at that and say, well, that's it. It didn't work. It worked. It just wasn't perfected yet. We're going to have to get there.
GUPTA: Science is like life. There are successes and there are failures, but you learn from both of them.
MONTGOMERY: We stand on the shoulders of giants, for sure. It's extraordinary when you think about it. It took a lot of people, you know, doing their part to make this happen.
RIELLA: I think patients like Tim will be remembered as heroes.
T. ANDREWS: What this pig kidney has given me is freedom from this. And what I hope it gives you is hope. Don't give up. I see way too many people give up. Don't give up.
GUPTA: Tim's future looks bright and so does the future of this area of medicine.
When do you think this might be available for the average person?
MONTGOMERY: I think less than five years.
GUPTA: Wow.
MONTGOMERY: Yes.
GUPTA: That fast.
MONTGOMERY: Less than five years.
GUPTA: Do you imagine the future now?
T. ANDREWS: Yes, I do.
GUPTA: Visiting grandkids?
T. ANDREWS: Visiting grandkids. It's going to be so much fun. You know, because they saw me at the lowest, and now they'll be able to see me alive and laughing and carrying on like grandpa does.
GUPTA: Wow. That's great. T. ANDREWS: It's going to be awesome.
