File. Hospital, holding hands and bed with doctor, support and care together in a clinic after surgery.
David Bennett Jr. knelt by his bedside, phone in hand, anxiously awaiting a call that no one had ever received: The hospital was due to update him on whether his father was still alive after getting a new heart — from a pig.
It was the first time any living human had received a pig organ transplant.
“You never know what the news is, but my dad opened his eyes, and he was awake, and he was doing well. It was incredible,” Bennett Jr. said.
Bennett’s father, David Bennett Sr., had severe congestive heart failure and wasn’t a candidate for a human transplant. He knew he would likely die soon. There was nothing more to do — other than take a chance on a novel, cutting-edge surgery. Bennett Sr. and his son agreed it was worth the risk.
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The achievement made headlines around the world after the transplant surgery in January 2022. The results at first seemed promising, and some family members even began to entertain the idea that Bennett Sr. might eventually leave the hospital.
“There were definitely futuristic conversations, just about home setup and who was going to take care of him and how that would look,” Bennett Jr. said. “Everybody was very optimistic and hopeful.”
But two months later, Bennett Sr.’s body rejected the heart and he died at age 57. In a paper, his doctors at the University of Maryland Medical Center explained that his body had likely produced too many antibodies that fought off the new organ. A drug he’d been given may also have increased the odds of rejection, and a virus in the pig heart further complicated matters.
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Three other patients have followed in Bennett Sr.’s footsteps and received pig organs, most recently a pig kidney transplant in April. Together, they represent the pioneer patients of the burgeoning field of xenotransplantation. For their families, three of which spoke to NBC News about the experience, the journey came with a roller coaster of emotions, from uncertainty to blind hope — and, ultimately, admiration for their loved one’s decision.
“I would love to still have my dad here, obviously, but I know that his sacrifice wasn’t for nothing,” Bennett Jr. said.
None of the patients survived more than three months. To the public, that might seem like failure. But to the families, the transplants accomplished their goals: to buy their loved ones more time and advance research that could potentially save lives one day.
“Larry approached it in this way: He was going to die. It was inevitable, and it was coming soon,” said Ann Faucette, whose husband of nearly 38 years, Lawrence Faucette, was the second person to receive a pig heart. “So why not offer up his body as a test subject for them to get as much data, do as much research as they could, so in the future there’s that other option for people who need those transplants?”
The promise of xenotransplants lies in the shortage of available human organs. An estimated 17 people die in the U.S. each day waiting for an organ transplant, according to the Health Resources and Services Administration. Because pig organs are more readily available, doctors envision a future in which these operations are as common as a hip replacement.
But at this early stage, the Food and Drug Administration has only approved xenotransplants for patients on the verge of death with no other options.
Like Bennett Sr., Lawrence Faucette qualified for a pig heart because he was dying of heart failure. Ann Faucette said that after the surgery, her husband was able to play cards and do physical therapy on an exercise bike. It was a contrast to the day before the surgery, when his heart had stopped and needed to be revived with an internal defibrillator.
“We’re having full-on conversations. We’re watching football,” Ann said. “It’s like normal life, as normal as it can be in a hospital.”
She focused on the positives: “I was in denial. This was going to work. He was going to get better. He was going to come home,” Ann said.
Her two sons, now 29 and 31, “saw that the end could be at any point, so they made sure that they told Larry how they felt,” she added — that they loved him.
At her husband’s request, Ann bought a new chair for their house in Frederick, Maryland, in preparation for his return. The day it was delivered, she learned his condition had worsened.
“While I’m waiting for the chair, I get the call that they want to put Larry on ECMO,” she said, referring to a life-support device.
He died of transplant rejection roughly two weeks later, less than six weeks after the surgery.
His doctors said Faucette’s recovery was complicated by the fact that his strength had declined shortly before the operation.
The two xenotransplants after that followed a similar pattern: After surgery, the patients began to feel much better, then suddenly worsened after several weeks.
Brittany Harvill’s mother, Lisa Pisano, received a genetically modified pig kidney in April. Within a week, she had noticeably improved, Harvill said.
“She’s like, ‘I feel great.’ You could see the color in her face,” she said. “She looked like a whole new person.”
Before the surgery, Pisano could hardly walk due to shortness of breath and extreme fatigue. She had heart and kidney failure, so her surgery was more complicated than the others: Doctors implanted a mechanical heart pump eight days before the pig kidney. After the surgery, Pisano seemed more alert than ever, according to Harvill. She FaceTimed her grandchildren from the hospital, watched cooking shows and hung out with her daughter.
“I would bring pictures and then we would talk about what the kids were up to,” Harvill said.
But the demands of the transplant proved too much for Pisano’s other organs. Doctors prescribed blood-pressure medication, but it ultimately led to the rejection of the kidney. Pisano died in hospice care on July 7, around 12 weeks after the transplant.
Harvill said her mom was confident in her decision, but she still wishes Pisano had lived long enough to see her granddaughter, Olivia, go off to kindergarten.
“One thing that upsets me is that my mom would have loved to be there for that,” she said through tears.
Harvill believes the kidney transplant “100% would have worked” had it not been for her mom’s heart issues.
“Now I think the doctors definitely know, people that are as sick as my mom maybe aren’t the best people to do it,” she said.
Indeed, the surgeons who’ve done the xenotransplants and other experts in the field say these first four patients were not ideal candidates, since those on death’s door are likely to be too weak to support a new organ.
“If we could choose patients who are much more likely to do well, then we’d get a better idea about how successful it’s going to be,” said Dr. David Cooper, a physician investigator of transplant surgery at the Massachusetts General Research Institute, who did not perform any of the operations.
But for the FDA to approve such a transplant in a healthier patient, Cooper said, the agency wants to see more consistent one-year survival in studies done in animals. Privately, doctors had hoped that would be the case for the human patients.
“We hoped for six months, and maybe a year. Out of ignorance, we felt our animal data supported that. We actually thought we’d do better in the humans,” said Dr. Bartley Griffith, clinical director of the cardiac xenotransplantation program at the University of Maryland School of Medicine, who operated on Faucette and Bennett Sr.
The only xenotransplant patient who recovered enough to return home was Rick Slayman, who received a pig kidney at Massachusetts General Hospital in March. He had terminal kidney disease, diabetes, high blood pressure and heart disease.
Slayman’s family declined to be interviewed. According to his surgeon, Dr. Tatsuo Kawai, the dialysis Slayman had required before the transplant was no longer needed afterward, and his only struggle was climbing the three flights of stairs to his apartment.
Still, Slayman died less than eight weeks after his surgery, from what doctors suspect was a fatal arrhythmia. An autopsy showed that his heart disease was more advanced than his doctors had thought.
“The autopsy didn’t show any rejection or any abnormality in the kidneys, so in terms of transplant, we think this was successful,” said Kawai, who directs the Legorreta Center for Clinical Transplant Tolerance at Mass General.
The Bennett, Faucette and Harvill families do not regret their loved ones’ participation in the experimental transplants. Each saw any extra time as a gift, and they remain optimistic about xenotransplantation’s potential. Harvill compared the situation to the first human heart transplant in 1967. That patient died after 18 days, but thousands of such transplants are now performed in the U.S. each year.
The families are also aware of how much doctors learned from each surgery.
“The excitement in their voices and on their faces when they talk about the data that Larry was able to give them … it makes me grateful,” Faucette said.
On her wedding anniversary, she baked around 500 cookies for the hospital’s nursing staff.
Dr. Robert Montgomery, who did Pisano’s surgery and directs the NYU Langone Transplant Institute, said many people on the transplant waiting list are interested in a xenotransplant.
“I can’t tell you how many people call my office every week who want this. That’s what I think is underappreciated, is how desperate people are,” he said.
All of the researchers are eager to try another transplant as soon as they can find the right candidate and get FDA approval.
“We are at a place now where we feel 100% better informed,” Griffith said. “Whether that’ll translate to our next patient living a year, we’re not sure, but we moved from total ignorance to a really good idea of what our enemy is.”
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