How a family’s choice to donate a body for pig kidney research could help change transplants

Aug 19, 2023, 5:28 AM

NEW YORK (AP) — Mary Miller-Duffy was dazed and grieving. Her brother suddenly collapsed and days later was brain-dead. Now she faced a tough question: Would she donate his body for research?

That’s how the body of Maurice “Mo” Miller started its journey to a sunny corner of NYU Langone Health’s intensive care unit — and became part of the quest to one day ease the nation’s transplant shortage with organs from animals.

“He always wanted to help people,” said Miller-Duffy, who struggled with the choice but is proud of her brother’s last act. “This tragic death, this fast short death — something good has come out of it.”

Surgeons replaced Miller’s kidneys with one from a genetically modified pig on July 14. Then doctors and nurses cared for the deceased man like they would a living patient while anxiously ticking off the days.

Remarkably, over a month later the new organ is performing all the bodily functions of a healthy kidney — the longest a pig kidney has ever worked in a person. Now the countdown is on to see if the kidney can last into September, a second month.

The Associated Press got an inside look at the challenges of experiments with the dead that may help bring animal-to-human transplants closer to reality.


Getting an organ transplant today is a long shot. More than 100,000 people are on the national waiting list, most who need a kidney. Thousands die waiting. Thousands more who could benefit aren’t even added to the list.

“I had seven cardiac arrests before I even was sick enough” to qualify for a new heart, said Dr. Robert Montgomery, chief of NYU Langone’s transplant institute. He’s a kidney transplant surgeon — and was lucky enough to get his own heart transplant in 2018.

Filling the gap, he’s convinced, will require using animal organs.

After decades of failed attempts, now pigs genetically modified so their organs are more humanlike are renewing interest in so-called xenotransplantation. Last year, University of Maryland surgeons tried to save a dying man with a pig heart — and he survived for two months.

Montgomery is getting more practice in the dead before taking a chance with a living patient. A handful of prior experiments at NYU and the University of Alabama at Birmingham have kept pig kidneys and hearts working in donated bodies for a few days to a week, avoiding the immediate rejection that doomed many earlier attempts.

But the most common kind of organ rejection develops over a month. That pig heart in Maryland worked great for nearly 50 days until abruptly faltering. Watching how pig kidneys reach those timepoints in donated bodies could offer vital lessons — but how long could Montgomery expect a family to turn over their loved one?

“I’m in awe of someone who can make a decision like that at, you know, one of the worst moments in their lives and really think about … humanity,” he said.


In Newburgh, New York, an ambulance had raced Miller to the hospital after he collapsed, a mass in his brain. He never woke up from the biopsy, brain-dead at just 57. Next steps were up to his sister, his closest relative.

Miller-Duffy asked about donating his organs but he didn’t qualify. That biopsy had found cancer.

Only then did the organ agency broach whole-body donation. Miller-Duffy wasn’t familiar with that, but the goal of improving kidney transplants, “that kind of struck a chord.” Another brother had died of kidney disease as a toddler. Other relatives have kidney-damaging illnesses or even died on dialysis.

Flipping through family photos, Miller-Duffy recalled how her brother would adopt animals and once took care of a terminally ill friend. Still, she had questions.

In a video call, Montgomery explained the pig transplant to Miller-Duffy and her wife, Sue Duffy — and why it could make a difference. Montgomery’s compassion won them over.

“His body is not being hurt, you know,” Duffy said. “It’s just an incubation for the study to be done.”


The experiment served as a rehearsal for one day operating in a living patient. Montgomery finished removing Miller’s own kidneys as a helicopter headed for the hospital’s riverside landing pad. Drs. Jeffrey Stern and Adam Griesemer, fellow NYU surgeons, raced in kidneys they’d removed from a pig bred by Blacksburg, Virginia-based Revivicor.

Sewing a pig kidney into a donated body isn’t much different than a regular transplant, Stern said. Post-surgery immune-suppressing drugs are standard, too.

One twist: Tacked onto the pig’s kidney was its thymus, a gland that trains immune cells — and thus might help protect the organ.

Lots of extra steps come before and after surgery.

First, what pig to use: Some have up to 10 genetic changes but Montgomery is betting one is enough — removal of a single porcine gene that triggers an immediate immune attack.

While the pigs are housed in a germ-free facility, researchers performed extra testing for any hidden infection. Everyone in the operating room must have certain vaccinations and undergo blood tests of their own.

Surgery over, doctors wheeled Miller’s body into the same ICU room where five years earlier Montgomery had recovered from his heart transplant.

Next came more intense testing than living patients could tolerate. Every week doctors biopsy the kidney, putting samples under the microscope to spot any hints of rejection. Blood is continually monitored, the spleen got a peek, and nurses keep close watch that the body is being properly maintained on the ventilator.

The first few weeks, Griesemer checked lab test results and vital signs multiple times a day: “You’re like, OK, hopefully things are still good — but is this the day it starts to turn?”

And they’re shipping biopsy samples to research partners across the country and as far away as France.

“Our staff doesn’t sleep that much,” said Elaina Weldon, a nurse practitioner who oversees the transplant research. But with each passing week, “everybody is really now at the point of, what more can we do? How far can we push?”

She knows firsthand the huge interest: NYU quizzed community groups and religious leaders before embarking on research with donated bodies that might have sounded “a little bit more on the sci-fi side of things.”

Instead, many people wanted to know how soon studies in the living could start, something the Food and Drug Administration will have to decide. Dozens have written Montgomery, eager to participate.


Montgomery regularly calls Miller-Duffy and her wife with updates, and invited them to NYU to meet the team. And as the study’s initial one-month deadline approached, he had another ask: It was going so well, could they keep her brother’s body for a second month?

It meant further postponing plans for a memorial service but Miller-Duffy agreed. Her request: That she gets to be there when her brother is finally disconnected from the ventilator.

Whatever happens next, the experiment has changed Sue Duffy’s outlook on organ donation.

“Maybe I don’t need all my organs when I go to heaven,” she said. “Before I was a hard no. … Now I’m a hard yes.”


The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

National News

Phoenix heat...

Associated Press

Arizona’s sweltering summer could set new record for most heat-associated deaths in big metro

PHOENIX (AP) — America’s hottest metro area is on track to set an annual record for heat-associated deaths after a sweltering summer, particularly in Phoenix. Public health officials in Maricopa County, home to Phoenix and Arizona’s most populous county, said Friday that 289 heat-associated deaths were confirmed as of Sept. 16, with another 262 deaths […]

2 hours ago

FILE - President Joe Biden addresses the 78th session of the United Nations General Assembly at Uni...

Associated Press

Biden faces foreign policy trouble spots as he aims to highlight his experience on the global stage

WASHINGTON (AP) — This probably wasn’t how President Joe Biden envisioned his big foreign policy week ending. Biden spent much of the time trying to make the case to world leaders at the U.N. General Assembly as well as to Democratic donors and voters that his decades of foreign policy experience and demonstrated moral clarity […]

3 hours ago

Danielle Wilkes is seen by a dentist during a clinic visit Thursday, Sept. 7, 2023, in Nashville, T...

Associated Press

Many states are expanding their Medicaid programs to provide dental care to their poorest residents

NASHVILLE, Tenn. (AP) — For months, Carlton Clemons endured crippling pain from a rotting wisdom tooth. He couldn’t sleep, barely ate and relied on painkillers to get by. The 67-year-old from Nashville, Tennessee, could not afford to see a dentist on the $1,300-a-month his family gets in Social Security and disability payments. So he waited […]

5 hours ago

Associated Press

Florida siblings, ages 10 and 11, stopped while driving mom’s car on freeway 200 miles from home

GAINESVILLE, Fla. (AP) — A 10-year-old Florida boy and his 11-year-old sister who were running away to California drove 200 miles (320 kilometers) in their mother’s car before they were stopped by sheriff’s deputies on an interstate highway, authorities said. The Alachua County Sheriff’s Office says deputies spotted the sedan on Interstate 75 near Gainesville […]

6 hours ago

Associated Press

New Jersey house explosion hospitalizes 5 people, police say

WEST MILFORD, N.J. (AP) — Five people were transported to hospitals after an explosion at a New Jersey home on Friday night, police said. The house in West Milford was heavily damaged by the explosion around 9 p.m., the West Milford Police Department said in a statement. A sixth person at the scene refused additional […]

9 hours ago

Associated Press

Tropical Storm Ophelia moves inland over North Carolina as coastal areas lashed with wind, rain

ANNAPOLIS, Md. (AP) — Residents in coastal North Carolina and Virginia braced for potential flooding after Tropical Storm Ophelia made landfall near a North Carolina barrier island on Saturday morning, bringing rain, damaging winds and dangerous surges of water. The storm came ashore near Emerald Isle with near-hurricane-strength winds of 70 mph (113 kph) at […]

12 hours ago

Sponsored Articles

Swedish Cyberknife...

September is Prostate Cancer Awareness Month

September is a busy month on the sports calendar and also holds a very special designation: Prostate Cancer Awareness Month.

Ziply Fiber...

Dan Miller

The truth about Gigs, Gs and other internet marketing jargon

If you’re confused by internet technologies and marketing jargon, you’re not alone. Here's how you can make an informed decision.

Education families...

Education that meets the needs of students, families

Washington Virtual Academies (WAVA) is a program of Omak School District that is a full-time online public school for students in grades K-12.

Emergency preparedness...

Emergency planning for the worst-case scenario

What would you do if you woke up in the middle of the night and heard an intruder in your kitchen? West Coast Armory North can help.

Innovative Education...

The Power of an Innovative Education

Parents and students in Washington state have the power to reimagine the K-12 educational experience through Insight School of Washington.

Medicare fraud...

If you’re on Medicare, you can help stop fraud!

Fraud costs Medicare an estimated $60 billion each year and ultimately raises the cost of health care for everyone.

How a family’s choice to donate a body for pig kidney research could help change transplants