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Carl Zimmer
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Product availability varies by region. See app for details and we'll see you on the other side. Getting ready as a new man. Yes. On January 25, 2025. Wow. Look at that. Tim Andrews became a medical pioneer. Everything went well. He received a pig kidney transplant. Now, while he was not the first, he does hope that his and the contributions of many others means that he also won't be the last. Stepping forward, you're gonna 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 gonna be okay. We're gonna find a way. It's been an incredible journey of an incredible man and an incredible scientific achievement. And this may only be the beginning. I'm Dr. Sanjay Gupta and this is part two of Animal Farm. It's been just seven days since Tim Andrews received a pig kidney. I'mma cry. He's understandably emotional. Once tethered to a dialysis machine for survival, Tim is now free. Oh, it's nice air. It's fresh air. I love it. There's that great shot of you as you're walking out of the hospital. Fresh air. It almost seemed like you were breathing air for the first time. Yeah. Kind of felt like it had been a long time since I had been outside, really. And by leaving the hospital so soon, Tim was making history. You wanted to get out as quickly as possible. Yes. And you wanted to beat Tawana. Yeah. Beautiful. Tawana is Tawana Looney, a 53 year old Alabama grandmother who underwent a pig kidney transplant two months earlier. So how you feeling, Dr. Robert Montgomery was her surgeon. Know what the first thing I'm gonna do when I get home? What's that? Cook me some greens. Some greens. She had been on dialysis for nine years, waiting for an organ transplant. If you're on dialysis for five years, you have a 50% mortality. You start going beyond that and your likelihood of living gets less and less. All right? And the kidney's right inside this bag. Tawana volunteered for a xenotransplant. It was exciting. She wants to start a revolution too herself. I mean, she really believes in this. So much so that Tawana 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. Hearing her saying, you know, just trust God, just trust God, it'll be okay. That made me feel easier. 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. Yeah. No question about it, right? Absolutely. No question about it. What does that mean exactly? What feels better? Energy. I have energy. I'm a little wobbly though. Okay, we gotcha. But I feel so much better and clearer. None of this is easy. Taking 20mg F5s. I mean, every day, Tim sits at this makeshift mountain of medication guided by this big binder. It's a survival bible of sorts. This is the book tells you what you're going to take. We keep it in pencil because it changes a lot. 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. This is when it helps to be a 70s child ready. And several times a week, an anti rejection infusion directly into his blood. How are you? Fine. We were there for his two month checkup. You look good, you feel good. As he had a battery of tests to look for any signs of infection, rejection or reduced function. We can actually identify if there's any issues with the kidney. Worried about Tim's heart, the Boston medical team is also monitoring him 247 with this implanted loop recorder. It measures Tim's cardiac rhythm and warns of any potential abnormalities. We are of course being just extra careful and cautious and ensuring things are in the right direction. And the little pig is right there so I can pat it. 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. And it looks exactly like a human kidney. So we see all the blood flow throughout. Is there anything in there that makes it clear that it's a pig kidney? No, exactly like a human one. And not only does it look like one eight weeks post operatively, it's acting like one. 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 that blood work. That's awesome. Good stuff, isn't it? 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. In all the studies that we're doing, we're not only monitoring the patient, but their close contact, 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 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? Genetic engineering is a nice tool, but it's not 100% accurate yet. World renowned medical ethicist Art Kaplan. Is it a big enough concern to sort of derail? 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. I think it's a little bit of Russian roulette here. Kathy Guillermo is the senior VP at PETA, People for the Ethical Treatment of Animals. And she thinks this is a big issue. 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. Now, to be clear, there is nothing about xenotransplants that sits well with Kathy or anyone else at PETA. I don't think it could ever be okay 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 okay, even if it means a choice between a pig life or a human death. 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. 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. 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? It's somewhat contentious. I, however, don't think that you're going to see huge religious opposition. What you may see in some of the Islamic countries is human organs first, only go to the animal, last resort. I could see that a spiritual man. Tim also had his concerns. It's why he reached out to his church for guidance. I contacted the bishop and then the Vatican sent me a paper. Wow. 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. So will these new kidneys create a better and longer life. You look really good when we come back. This podcast is supported by Wonderful Pistachios. Whether you're running between meetings, dropping off the kids, or listening to a podcast, Wonderful Pistachios is the perfect healthy snack for when hunger strikes. Each 1 ounce serving of Wonderful Pistachios contains 6 grams of protein, giving you over 10% of your daily value. It's one of the highest protein nuts out there. The fact that Wonderful Pistachios is a complete protein, providing you with all nine essential amino acids is why these little green wonders pack such a protein punch. And that satisfying crack of opening each shell, that's like snack meditation. You can also do Wonderful Pistachios. No shells for that grab and go ease. 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So so you can fast forward through editing images, designing presentations, generating code, debugging code, running lots of apps without lag, creating live translations and captions, summarizing meeting notes, extending battery life, enhancing security, finding that file you were looking for, managing your schedule, meeting your deadlines, responding to Jim's long emails, leaving all the time in the world for more you time and for the things you actually want to do. No offense Jim. Get A new Dell AI PC starting at $749.99 at Dell.com AI PC how those ahead Stay ahead. This episode is brought to you by Temptations Cat Treats. Your cat will come running for the perfectly irresistible Temptations Creamy Puree and Temptations Lickable Spoon Cat Treats. The best time to feed Lickable Cat Treats to your cat is anytime. Feed by hand for a playful moment in a bowl for a creamy treat or as a topper to make mealtime fun. Visit temptationstreats.com to learn more. This 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. They're using a pig organ scaffold and re cellularizing that with human cells. Also Another group is 3D printing that scaffold, re cellularizing that with human cells. So multiple ways to generate a humanized organization for overcoming the shortage, the potential organs on demand. Could you get to the point where you could create a personalized organ for somebody? Absolutely. I think that's going to be the future. So an organ that would be designed for Robert 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. 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. The next facility will be Built will have an output of about 6,000 organs per year. But that's still, you know, less than 10% of the demand for the unlimited supply of organs. This is a brand new building built specifically for human clinical trials. 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. Yeah, 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. 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. 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. So the concern was if you're actually moving the pig, that's a source of potential contamination. Yep. 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? 100%, 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're going for two transplant, and 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, make sure it's all straight. That's the sort of testing that was done on the pig kidney transplanted into Tijuana and also on Raphael, Tim's kidney donor. That'll get everybody moving. A transplant that Tim is thankful for every day. Tim, welcome. Every Wednesday, he signs into this Zoom meeting from his kitchen table in New Hampshire. You really have to thank Tim for stepping forward. 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. That was my promise. Give me this, and I will spend the remainder of my life helping people get hope. It is the unspoken promise of pioneers. Pay it forward. I want you to look at me. If I can do it, the next person can. Do it. Tawana was the star at a recent medical conference, the Lake Nona Impact Forum. 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. You're welcome. Thank you. I was there, and I can tell you the audience loved her. You look really good. You feel as good as you look? Yeah, I do. My husband said, how do you feel about all this attention? She said, I love it. I want the word to get out. But the thing about firsts, about pioneers, is that at any moment, their lives can be suddenly thrown into jeopardy. 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 can see the remains of it there. Tim was hospitalized for three weeks to treat the infection and prevent his kidney from being rejected. It was a quite hard few days for him and for us as well. But fortunately, we were able to overcome and we're in a better spot now. We hope this kidney continues for a long time. Turns out as Tim won his fight to keep his kidney, Tawana lost hers. Like Tim, Tawana got an infection. But she also started to reject her pig kidney. So in April, doctors had to remove it. Tawana is back on dialysis. It had been 130 days. At the time, she was the longest survivor with a xenotransplant in history. But now, soon, that distinction could belong to Tim. 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 gonna have to get there. Science is like life. There are successes and there are failures. But you learn from both of them. 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. I think patients like Tim will be remembered as heroes. 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. 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? I think less than five years. Wow. Yeah. Less than five years. Do you. Do you imagine the future now? Yeah, I do. You visiting grandkids. Visiting grandkids is gonna be so much fun, you know? Cause they saw me at the lowest, and now they'll be able to see me alive and laughing and carrying on like Grandpa does. That's great. It's gonna be awesome. On June 5, Tim Andrews became the longest living human with a pig kidney transplant. It's even given him the chance to fulfill a lifelong dream. God knows where that ball's gonna go. Which was throwing out the first pitch for his favorite team, the Boston Red Sox. And more importantly, finally getting to see his grandkids again. Tim Andrews was. We all wish you well. Dr. Sanjay Gupta reports. Animal Farm is now available to stream on hbo. Max. We'll be back next week with a new episode of Chasing Life. Thanks for listening. The HBO original series the Gilded Age is back, and so is the official companion podcast. Are you curious about how they brought Gilded Age New York to life? I don't understand. Which bit is not clear? None of it is clear. Want to know where the writers branched off from history? Well, when you set your mind on a thing, no one can stop you. I take that as a compliment. Watch or listen to the official Gilded Age podcast wherever you find podcasts.