Deborah KotzIn the high-stakes world of transplant medicine, few breakthroughs have captured global attention like the xenotransplantation program at the University of Maryland School of Medicine (UMSOM). In December, UMSOM surgeon-scientists took yet another bold step into the future, sharing critical lessons from their second historic pig heart transplant in a landmark publication in Nature Medicine.
At the center of this story is Lawrence Faucette, a 58-year-old husband, father, and U.S. Navy veteran who faced terminal heart failure and was ineligible for a human heart transplant. In September 2023, he became the second person in the world to receive a genetically modified pig heart — a procedure performed by UMSOM’s world-renowned cardiac xenotransplant team at the University of Maryland Medical Center (UMMC). He lived for 40 days, enough time to deliver invaluable insights that are already reshaping the field.
Turning Loss in to Learning
“We have taken another important step forward in the quest to address the global shortage of donor hearts,” said Bartley P. Griffith, MD, lead surgeon for the first and second xenotransplants and co-lead author of the study. “Thanks to the bravery of Mr. Faucette and his loving family, we have a clearer understanding of modifications we can make moving forward to achieve longer-term success.”
The study revealed that despite careful selection — Faucette had low levels of pre-existing anti-pig antibodies — a surge in these antibodies occurred post-surgery, triggering immune rejection and leading to graft failure. The heart had shown strong function in the early days, but by the second week, subtle signs of rejection emerged. UMSOM researchers now believe future patients may require more aggressive strategies to suppress and manage antibody responses.
“We are humbled by our experience, not only because of what we have learned but also from witnessing the strength and grace of our two patients and their families,” said Muhammad M. Mohiuddin, MD, co-lead author, scientific director of the Cardiac Xenotransplantation Program at UMSOM and president of the International Xenotransplantation Association. “Their sacrifice yielded crucial scientific insights into how we and others should proceed to learn how to prevent graft failure from happening in future transplants.”
Transforming What’s Possible
For Faucette, who had no other options due to vascular disease and internal bleeding risks, the transplant was a final hope — and a generous act of scientific altruism. His decision opened a new chapter in transplant research and brought the world closer to solving one of medicine’s most persistent problems: the severe shortage of donor organs.
“Despite setbacks related to immunological rejection after a few weeks, xenotransplantation and living related organ donation remain our most viable pathways forward toward sustainable organ availability to meet the needs of our aging populations,” said Mark T. Gladwin, MD, the John Z. and Akiko K. Bowers Distinguished Professor and dean of UMSOM and vice president for medical affairs, University of Maryland, Baltimore. “We certainly faced similar challenges in the early days of solid organ transplantation. Our physician-scientists continue to work toward a better understanding of how to prevent porcine organ rejection despite aggressive immunosuppression and early successful surgical and hemodynamic outcomes.”
A Legacy of Courage and Innovation
UMMC President and CEO Bert W. O’Malley, MD, described the experience as a powerful example of the promise of academic medicine. “Academic medicine thrives on bold innovation, rigorous research, and the unwavering courage of patients and their families. The insights gained from Mr. Faucette’s journey, alongside the learnings from our first pig heart transplant recipient, serve as a beacon guiding our ongoing quest to overcome the hurdles of this transformative medical advancement.”
As xenotransplantation continues to evolve from possibility to practice, UMSOM remains at the forefront — not just as a hub of technical expertise, but as a place where science, empathy, and innovation come together in service of something greater: saving lives.
