The Organ Transplant Revolution Starts Here

Summary

Summary of "The Organ Transplant Revolution Starts Here" - Chasing Life Podcast by CNN

Release Date: June 20, 2025

Dr. Sanjay Gupta, renowned neurosurgeon and CNN reporter, delves into the groundbreaking advancements in organ transplantation in the episode titled "The Organ Transplant Revolution Starts Here." This detailed exploration addresses the critical shortage of donor organs, the innovative field of xenotransplantation, and the personal stories of individuals at the forefront of this medical revolution.

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1. The Organ Transplant Crisis

The episode opens by highlighting the dire state of organ transplants worldwide. Dr. Gupta outlines the grim statistics: "At any given moment, more than 100,000 people are waiting for an organ transplant, and every day, 17 people die waiting" (00:25). The scarcity of available organs has led to heartbreaking compromises, with only 10% of those on the transplant list ever receiving a needed organ.

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2. Robert Montgomery’s Personal Journey

Robert Montgomery emerges as a central figure, embodying both the desperation and hope within the transplant community. His personal battle with dilated cardiomyopathy, a condition where the heart becomes too weak to pump blood effectively, is a driving force behind his mission to revolutionize organ transplantation.

• Family Tragedy: "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 basically accepted that I might not live a normal lifespan" (04:28).

Determined to prevent others from facing the same fate, Montgomery dedicates himself to becoming a transplant surgeon, aiming to expand the availability of donor organs.

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3. The Promise of Xenotransplantation

Amidst the organ shortage, xenotransplantation—transplanting organs from animals to humans—emerges as a potential solution. Dr. Gupta introduces this controversial yet promising field, questioning its ethical and practical viability.

• Tim Andrews’ Perspective: "I have received a major, major, groundbreaking organ transplant" (02:10), reflecting both the hope and uncertainty surrounding animal-to-human transplants.

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4. Genetic Engineering of Pigs for Transplants

A significant breakthrough in xenotransplantation involves genetically modifying pigs to make their organs more compatible with the human body. Lead scientist David Ayers explains the process:

• "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." (14:38)

Using CRISPR technology, scientists splice specific genes to prevent the human immune system from rejecting the pig organs. This meticulous genetic engineering ensures that organs like kidneys and hearts can function seamlessly within human recipients.

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5. Early Transplant Attempts and Successes

The first steps in xenotransplantation involved transplanting pig organs into brain-dead individuals to study organ viability without ethical complications. Dr. Montgomery recounts the successful transplant of Maurice Miller’s kidney:

• "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." (17:08)

The initial success provided crucial insights, demonstrating that genetically modified pig organs could survive and function in a human body with manageable rejection risks.

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6. Tim Andrews’ Journey to Transplantation

Tim Andrews, a long-term dialysis patient, becomes a pioneer recipient of a pig kidney transplant. His journey encapsulates both the desperation of waiting for an organ and the hope that xenotransplantation offers.

• Facing End-Stage Kidney Disease: "I was ready to die in this chair." (10:49)

Upon learning about the innovative transplant option, Tim decides to undergo the procedure, fully aware of the experimental nature and potential risks involved.

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7. The Transplant Procedure and Immediate Impact

The operation, performed by Dr. Leo Riella and his team, marks a historic moment in medical history. The successful connection of the pig kidney resulted in immediate functionality, surpassing expectations.

• Surgeon’s Reaction: "They said they put the kidney on the table and started connecting him to the kidney and he actually peed across the room... we were all crying." (24:55)

• Tim Andrews’ Experience: "I felt great. And all of a sudden I had energy and I was like, this is beyond what I thought I was gonna get." (25:21)

Tim’s newfound vitality underscores the transformative potential of xenotransplantation, offering a lifeline to those previously confined to machines.

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8. Challenges and Setbacks

Despite initial successes, the field faces significant hurdles. The case of Lisa Pisano, another recipient, highlights the fragility of early xenotransplant efforts.

• Post-Transplant Complications: "Pisano developed several infections and never recovered enough to leave the hospital." (27:30)

These setbacks emphasize the need for ongoing research and refinement of techniques to ensure long-term viability and safety of animal-derived organs in humans.

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9. Future Implications and Hope

Looking forward, Dr. Gupta and the experts interviewed express cautious optimism. The advancements in genetic engineering and surgical techniques pave the way for broader application of xenotransplantation.

• Robert Montgomery’s Vision: "If there were just that, that would be great. But then you have this opportunity to really impact maybe thousands, maybe millions of lives." (27:54)

The episode concludes by affirming the monumental potential of xenotransplantation to alleviate the global organ shortage, save countless lives, and revolutionize the field of transplantation medicine.

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10. Ethical Considerations and Public Perception

Throughout the episode, ethical questions are interwoven with scientific advancements. The use of animals for organ transplants raises moral dilemmas, prompting discussions on the balance between human salvation and animal rights.

• Sanjay Gupta’s Reflection: "Even if this doesn't work for me, it can work for someone else. And I think about that a lot." (27:48)

These reflections highlight the personal sacrifices and moral complexities inherent in pioneering medical innovations.

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Conclusion

"The Organ Transplant Revolution Starts Here" offers a comprehensive and engaging exploration of the critical shortage of donor organs and the innovative solutions emerging to address this crisis. Through personal narratives, expert insights, and a balanced discussion of ethical considerations, Dr. Sanjay Gupta illuminates the path toward a future where life-saving transplants are more accessible and effective. This episode not only underscores the scientific breakthroughs but also the human stories that drive the relentless pursuit of extending and enhancing human life.

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Notable Quotes

• Robert Montgomery: "I think it's a historic day." (01:09)
• Tim Andrews: "I have received a major, major, groundbreaking organ transplant." (02:10)
• Sanjay Gupta: "Even if this doesn't work for me, it can work for someone else." (27:48)
• Dr. Leo Riella: "We were very surprised. We were hoping they would start making urine within a day or two... This is not the end, but we're getting there." (24:55)

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Key Takeaways

• Organ Shortage Crisis: Over 100,000 individuals await transplants, with daily fatalities due to inadequate organ availability.
• Advancements in Xenotransplantation: Genetic engineering, particularly CRISPR, has made the transplantation of pig organs into humans a viable possibility.
• Personal Stories Highlight Impact: Narratives of Robert Montgomery and Tim Andrews illustrate both the challenges and the life-changing potential of these medical advancements.
• Ethical and Practical Challenges Remain: Despite successes, issues like organ rejection and infection persist, necessitating further research and ethical deliberation.
• Hope for the Future: Continued innovation holds promise for significantly increasing organ supply, potentially saving millions of lives globally.

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Timestamp Reference Key:

• 00:25: Organ transplant crisis overview
• 01:09: Robert Montgomery's historic day
• 02:10: Tim Andrews on receiving a transplant
• 04:28: Montgomery’s family history
• 10:49: Tim’s dire condition
• 14:38: Genetic engineering details
• 17:08: First successful transplant observation
• 24:55: Immediate transplant success
• 25:21: Tim’s physical improvement
• 27:48: Sanjay Gupta on ethical perspectives

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Note: This summary excludes advertisements, irrelevant intros, outros, and non-content segments to focus solely on the substantive discussions and narratives presented in the episode.

Transcript

[Narrator]

Chasing Life is supported by the World as yous'll Know It, a podcast about the forces shaping the future. In this season, host and science journalist Carl Zimmer speaks to some of the most respected scientists in the field of aging research about the massive changes in human longevity and what comes next. Is our lifespan set? Or will a breakthrough add decades to our lives? Can older brains be rewired to function like younger ones? Which so called biohacks actually work? The world as you'll know it is available now.

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[Narrator]

What you're about to hear. Here she is. Is a story of history in the making.

[Robert Montgomery]

I think it's a historic day.

[Advertiser]

This is many years in the making.

[Sanjay Gupta]

It's a really big moment. There's a lot of emotions.

[Robert Montgomery]

Diploid cell that you inject.

[Narrator]

A medical first. A story of survival, bravery and heroism.

[Tim Andrews]

I'm not a hero. I'm just a regular Joe.

[Narrator]

All of it to try and solve a crisis.

[Robert Montgomery]

Taking the clamp off the artery. Nice and pink. Yeah.

[Narrator]

You see, at any given moment, more than 100,000 people are waiting. Seven cardiac arrests before he became eligible for a heart transplant.

[Sanjay Gupta]

He wasn't sick enough, believe it or.

[Narrator]

Not, waiting for an organ.

[Tim Andrews]

I was ready to die. In this jail, that's hard to hear.

[Narrator]

And every day, 17 people, sadly, will.

[Robert Montgomery]

Die waiting for any organ that you name. Only 10% make it on the list.

[Narrator]

There's just not enough of them.

[Robert Montgomery]

There's just not enough.

[Narrator]

Now the potential answer to this problem might sound crazy to many.

[Tim Andrews]

I have received a major, major, groundbreaking organ transplant.

[Narrator]

Controversial to for that animal, this is.

[Sanjay Gupta]

A life of deprivation. It's an early death. It's much suffering. I don't think that's ever okay.

[Narrator]

Even blasphemous to others.

[Tim Andrews]

Contacted the bishop and then the Vatican sent me a paper.

[Narrator]

Wow. But now, more than ever, it's also incredibly promising. Could animals be the answer? Is it right? Is it wrong? Can it even work? That is an ultrasound of a pig kidney inside Tim. Something that very few people ever get to see. For the last two years We've been searching for answers. It's powerful just to be here with these pigs. I'm Dr. Sanjay Gupta, and here is part one of Animal Farm. In the remote mountains of Patagonia, about as far from civilization as you can get. Robert Montgomery almost died.

[Robert 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.

[Narrator]

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.

[Robert Montgomery]

Yeah, he saved my life for sure. When I woke up, I couldn't do anything. I couldn't walk or talk.

[Narrator]

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.

[Robert 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 basically accepted that I might not live a normal lifespan.

[Narrator]

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?

[Robert Montgomery]

My mother was really begging him to come up with something, and he said, you know, he's too old and doesn't work.

[Narrator]

52.

[Robert Montgomery]

52. And it doesn't work anyway, so you wouldn't want that. That was 1976.

[Narrator]

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.

[Robert Montgomery]

All right, how does that look with the camera?

[Narrator]

It wasn't easy. By age 56, he had had three near catastrophic cardiac arrests himself. The only cure, he was told, was a heart transplant.

[Robert Montgomery]

But for any organ that you name, only 10% 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.

[Narrator]

And that's all because we have to ration organs. There's Just not enough of them.

[Robert Montgomery]

There's just not enough.

[Narrator]

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 Denise.

[Sanjay Gupta]

He would go on to have four heart attacks.

[Robert Montgomery]

That night, I just had one cardiac arrest after another. They gave me the last rites.

[Sanjay Gupta]

They revived him. He said, I will die if I.

[Narrator]

Don'T get out of here.

[Robert Montgomery]

They left my IVs underneath my shirt, and they gave my friend a bundle of preloaded resuscitation drugs and syringes and flew back. Because I knew that was my ticket.

[Narrator]

The odds of survival were still not in his favor.

[Robert Montgomery]

Nice to meet you, Harvey.

[Narrator]

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.

[Robert Montgomery]

Love you. See ya.

[Narrator]

Peace. But Dr. Montgomery insisted that his doctors still give it to him.

[Robert Montgomery]

We had just done a study showing that you could take a hepatitis C positive organ and put it into a hepatitis C negative recipient and treat them with these new antivirals, you could successfully treat the virus.

[Sanjay Gupta]

Robert wasn't worried, and so I was.

[Narrator]

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.

[Robert Montgomery]

Hello to all my friends.

[Narrator]

And it worked.

[Robert Montgomery]

And thank you for your kind thoughts and your prayers and making a very nice recovery.

[Narrator]

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.

[Robert Montgomery]

I was in this room right around the corner, so I have good feelings about this place, actually.

[Narrator]

It's like hope.

[Robert Montgomery]

Yeah, it's hope. Represents that behind that door.

[Dr. Leo Riella]

Yeah.

[Narrator]

He is a man on a mission.

[Sanjay Gupta]

He wants to see this eradicated.

[Robert 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.

[Narrator]

Another choice. Which Montgomery is now racing to find.

[Tim Andrews]

I'll help you down.

[Narrator]

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. And these empty nesters had big plans for their New life together, traveling the world. Until one day in 2022, I got tired.

[Tim Andrews]

I was like, oh, my God, I'm gonna fall asleep or something. So I was checked and they said, oh, you're stage three kidney failure. Oh, okay. And a month later, they're telling me I am at end stage.

[Narrator]

Wow. Just one month.

[Tim Andrews]

Just one month. Just quit on me.

[Narrator]

What were you feeling like at that point?

[Tim Andrews]

I mean, I was told, literally told, you have dialysis or you pick a box.

[Narrator]

It was a false choice. Certain death or dialysis, meaning being dependent on a machine for the rest of his life.

[Tim Andrews]

The first couple of months was like, hey, this is not gonna 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.

[Narrator]

For more than two years, three days a week, like clockwork, this dialysis clinic kept him alive.

[Tim Andrews]

Here we are.

[Narrator]

It was a well set routine. That's the machine.

[Tim Andrews]

This is where I get to sit. Without it, six weeks, eight weeks later, I'd be dead. It's a necessary evil.

[Narrator]

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.

[Tim Andrews]

I was ready to die in this chair.

[Narrator]

And that is when he learned about another option.

[Dr. Leo Riella]

Kidney.

[Narrator]

Brand new, still relatively untested.

[Sanjay Gupta]

Some people said there's not enough information. Don't do this yet. Don't do this yet.

[Advertiser]

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[Mike Curtis]

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[Narrator]

You can't really tell by looking at them, but these tiny piglets have been genetically engineered to make their organs more acceptable for transplant. Transplantation into humans. It's something known as xenotransplantation. So, Mike, how unusual is it for us to even be here?

[David Ayers]

It's very unusual. We usually try to limit this to only the staff that takes care of the animals.

[Narrator]

Mike Curtis is the CEO of biotech company E Genesis. Never before has he let cameras onto this very special pig farm.

[David Ayers]

Everything's controlled. Like, all the feed is clean, water's clean, the staff is clean.

[Narrator]

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. The goal is to protect the pigs from us. Wow. You know, I gotta tell you, I did not know what to expect, but it's powerful just to be here with these pigs. After all, these pigs are among the most genetically modified mammals on the planet.

[David Ayers]

These piglets carry a total of 69.

[Narrator]

Edits to their genome, all alterations to their DNA.

[David Ayers]

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.

[Narrator]

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. 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 that all DNA is made up of Four chemical A, C, G and T. Think of that as your genetic blueprint. Now, a pig's DNA and a human's DNA, they actually look pretty similar. But there are some important differences. For example, the GGTA1 gene that is responsible for a carbohydrate that forms around a pig cell known as Alpha Gal. Now if you put that into a human, it would cause almost instantaneous rejection. But by knocking out that specific sequence and then adding in others, scientists can make the pig's organs much more compatible for humans.

[David Ayers]

So in the freezer are all these cells that we've edited. We saw that vial, we grow those cells and 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.

[Narrator]

And that is the process by which they have created a modern day assembly line of genetically modified pigs.

[David Ayers]

We've selected the Yucatan mini pig because fully grown, they're about 70 kilos, 150 pounds. So the organs are correctly sized for a human recipient.

[Narrator]

Ultimately you gotta get the size right.

[David Ayers]

That's right.

[Narrator]

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. This is Baby Fay, 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.

[Robert Montgomery]

I think we've turned up the throttle significantly.

[Narrator]

What's led to that, do you think?

[Robert Montgomery]

What we did is transplanted one of these organs into someone who had wanted to donate their organs was brain dead.

[Narrator]

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. Dr. Robert Montgomery performed that operation on Maurice Miller, who was brain dead.

[Robert 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.

[Narrator]

In fact, when I first met Dr. Montgomery a few years ago, he was reviewing Maurice 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.

[Robert Montgomery]

See that red? Yes, that's hemorrhage.

[Narrator]

But importantly, standard anti rejection drugs did work and the kidney function is okay.

[Robert Montgomery]

Now it's back to normal. It gave I think the FDA some confidence that this was going to work.

[Narrator]

In humans 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 has not brain dead. It would be a pig heart into 57 year old David Bennett.

[Sanjay Gupta]

Give me a high five buddy. That was awesome.

[Robert Montgomery]

We saw two months survival of that patient and now incrementally seeing longer and longer survival in these compassionate use patients.

[Narrator]

David Ayers 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.

[David Ayers]

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.

[Narrator]

Today he's taking me to meet some of the farm's newest arrivals.

[David Ayers]

Watch your head. Maybe that's just me.

[Narrator]

Oh, there's a little piglets.

[David Ayers]

Yeah. Do you want to hold one?

[Narrator]

Yeah, sure.

[David Ayers]

So these are 10 gene cloned piglets.

[Narrator]

Here at United Therapeutics. They perform 10 gene edits on their pigs. Now remember, E Genesis in Wisconsin perform more than 60. If you're doing six times as many edits, does that make it much better?

[Robert Montgomery]

I don't think more edits is necessarily better or worse. The additional 50 edits that E Genesis has done are to inactivate an endogenous pig virus. We've actually addressed that by breeding.

[Narrator]

In 2024, the first pig kidney transplant was announced.

[Dr. Leo Riella]

My name is Dr. Leo Riella. I'm medical director of the kidney transplant program Mass Channel. Today we announce the successful gene added paid kidney transplant into a living human.

[Narrator]

Tim Andrews, still on dialysis, was watching all of this unfold.

[Tim 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 gonna 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.

[Dr. Leo Riella]

His eyes really sparked up and he said, tell me what I need to do, I'll do it.

[Sanjay Gupta]

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. Reala, he had lost 22 pounds.

[Narrator]

Did you have any doubts along the way?

[Tim Andrews]

You know, there's always doubt with it, But I'm like, this is my chance to do something.

[Narrator]

You're gonna be in medical history books.

[Tim Andrews]

Yeah.

[Narrator]

For forever.

[Tim Andrews]

Kids are gonna be taught how to do it. Watching me have one put in me.

[Narrator]

They gotta know your name. They'll know your name. It's a crisp January morning back at the Egenesis pig farm in Wisconsin. There you go. Good girl. It's been more than a year since our first visit. This is many years in the making.

[Advertiser]

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.

[Sanjay Gupta]

Go, Raphael.

[Narrator]

It's a really big moment.

[Sanjay Gupta]

There's a lot of emotions. We love our piglets like our own. Thinking about the purpose that Rafael is serving. Like getting to go and give someone.

[Advertiser]

A new lease on life is just such a gift.

[Narrator]

That someone is Tim Andrews. Raphael will be his donor given life.

[Tim Andrews]

What a gift. Oh, God.

[Narrator]

As Rafael departs for the 17 hour trip to Boston, Tim settles in at Mass General.

[Tim Andrews]

I knew I was in great hands. Yeah, these guys are just so good.

[Narrator]

Were you nervous the morning of?

[Tim Andrews]

A little.

[Dr. Leo Riella]

And we'll see you on the other side.

[Tim Andrews]

Getting ready as a new man.

[Robert Montgomery]

Yes.

[Dr. Leo Riella]

We 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.

[Narrator]

It's early morning, January 25th, when Dr. Riella and the surgical team travel about 50 miles outside of Boston to meet Rafael.

[Dr. Leo Riella]

It was an or very similar to what we see in the hospital. And the surgery to retrieve the organs occur there. They looked very similar to how we do procurements. I think uniqueness is really that, you know, who was a donor who was coming was a pig.

[Narrator]

By 8am it's go time.

[Sanjay Gupta]

It's a dance to get the pig kidney there and get him in the operating room.

[Narrator]

Gotta coordinate it.

[Sanjay Gupta]

So a nurse came and said, okay, gotta go. I'm like, 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 gotta go. I'm saying goodbye to my husband before he leaves for surgery, and he may not come back. A little chilly in here. Okay, Tim?

[Tim Andrews]

I like cold.

[Narrator]

The operation lasts a little over two hours. Around the same as a traditional transplant. And the pig kidney, it looks, feels, and functions very much like a human kidney. And here is when surgeons connect the pieces, pig kidney to Tim's artery in vein. After that, the moment of truth, Surgeons release the clamp so blood can flow into the kidneys and the organ turns pink. And now this urine successfully flowing through the kidney.

[Robert Montgomery]

Wow, look at that.

[Dr. Leo Riella]

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.

[Sanjay Gupta]

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.

[Tim Andrews]

I felt great. And all of a sudden I had energy and I was like, this is beyond what I thought I was gonna get.

[Narrator]

So right away you felt that?

[Tim 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.

[Narrator]

That's your birthday.

[Tim Andrews]

Because I was alive and I hadn't been for a long time. And I'm like, this is amazing.

[Narrator]

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. I'm having this procedure. It was just a year earlier that Lisa Pisano also needed a kidney. Did you and your mom used to walk around here?

[Sanjay Gupta]

Yes.

[Narrator]

Her daughter, Brittany Riddell, remembers just how sick her mother was.

[Sanjay Gupta]

It means no more dialysis, hopefully.

[Narrator]

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.

[Sanjay Gupta]

Yeah, she was sick to get a transplant.

[Narrator]

Absolutely.

[Robert Montgomery]

Lisa Pasano was on death's door. I mean, she was not going to live. She was, you know, days to weeks from dying.

[Narrator]

So Dr. Montgomery, who was her surgeon, suggested a pig kidney.

[Robert Montgomery]

There are some people who are willing to take that chance, and she was one of them.

[Narrator]

In the spring of 2024, Lisa Pasano became one of the first two patients in the world to receive a gene edited pig kidney transplant. I got more energy. I feel energized.

[Sanjay Gupta]

After her kidney transplant, I have to say, she looked the best that she looked in so long. I've seen her so happy. It was definitely the healthiest I had seen her in a while.

[Narrator]

She was doing well at that point.

[Sanjay Gupta]

Yeah. We were so hopeful because I had seen her so much better, and I figured if anything was gonna go wrong, it would have went wrong at that moment and not months later.

[Narrator]

Pisano developed several infections and never recovered enough to leave the hospital.

[Sanjay Gupta]

I don't have regrets about the surgery. I just wish that she could have had the opportunity to really enjoy it more.

[Narrator]

I know it's probably hard to sort of think of it this way, but she was a real pioneer.

[Sanjay Gupta]

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.

[Robert Montgomery]

The first patient that we did was in this bed, in the bed that I was in. Lisa Passano, you know, taking care of that one life. And if there were just that, that would be great. But then you have this opportunity to really impact maybe thousands, maybe millions of lives.

[Narrator]

Now, Tim knew Lisa's story. He knew that there was a tremendous amount of uncertainty.

[Tim Andrews]

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, which is amazing to me. It was just, I have to be part of this.

[Narrator]

So would this be a success for Tim? And what does it all mean for the hundred thousand people currently waiting?

[Tim Andrews]

There's bumps in the road.

[Narrator]

We'll dive into that when we come back next week with part two of Animal Farm. Thanks for listening. Hi, I'm Omar Jimenez, correspondent for cnn. And we believe that to understand the world, you need the truth. It's why we follow the facts every day, wherever they may lead. Follow CNN and [e-mail] subscription.