Jill Rollet; Jayme Locke, MD , 2025-05-09 13:52:00
Jayme Locke, MD, MPH, FACS, FAST, always thought big. As a child she expressed interest in becoming a pediatrician or maybe a circus ringmaster.
In November, Locke was part of the surgical team that performed one of the first xenotransplantations of a genetically altered pig kidney into a living human recipient, at NYU Langone Health, where she is an adjunct professor of surgery. In April, she joined United Therapeutics, the company that developed the xenokidney, as vice president of medical development for xenotransplantation.
Locke is this year’s recipient of the National Kidney Foundation’s Excellence in Kidney Transplantation Award.
Thinking even bigger, Locke said she expects that with continued development efforts xenotransplantation will be widely available in the next 10 years.
“At the end of the day, we need this,” Locke told Healio. “We have been doing human-to-human transplantation now for well over 60 years, and we don’t have enough organs. [Xenotransplantation] is a chance for end-stage kidney disease patients to live more normal lives, free from the chains of dialysis.”
Locke talked with Healio about the need for children to see who they can become, her decision to tackle inequities in kidney care and the patient who played a huge role in her quest.
Healio: What was the defining moment that led you to your field?
Locke: When I was a kid, I just really wanted to help people. I was good at science. My parents aren’t physicians or anything like that, but it was an area of interest for me. I thought I’d be a pediatrician, because that’s the only doctor I ever knew growing up in eastern North Carolina.
It’s hard to become things you haven’t seen or don’t even know exist. I remember when I got to medical school just seeing all of these different fields that I didn’t have context for. I fell in love with surgery.
It was in medical school that I became aware of inequities in access to care and the burden of end-stage kidney disease, which was rampant in North Carolina. I had the privilege on my surgery service to be able to see a kidney transplant — you put this organ in, and there and then, it starts making urine. The person is cured. Once bitten by that bug, the ability to affect that kind of change, I want to do that, and I want to help people in that kind of tangible way.
Healio: How did you come to participate in a pig-to-human kidney transplant?
Locke: During my tenure at the University of Alabama at Birmingham, I had been asked to help think through how we might translate xenotransplantation from the lab into the clinic. Prior to that I hadn’t had exposure to xenotransplantation, so I had a lot of homework to do. I tried to think about it from a patient perspective and a patient-doctor relationship perspective: How might I approach a patient and feel comfortable consenting them for such a procedure? That’s how I got involved.
There were certain questions I felt we still needed answers to. It was in trying to address those questions that we went down the path of developing the Parsons model, which is a model in which we’ve leveraged human brain death as a preclinical human model — understanding that some of the non-human primate work, while formative and critical, didn’t translate to humans. Thankfully, humans are immunologically distinct enough from monkeys, which is a good thing, but we needed a human model that we could test things in without actually risking harm to a living person, and that’s really where the Parsons model came in.
That was when I got really involved in xenotransplantation, trying to understand what the optimal immunosuppression might be, understanding the physiology and whether a pig kidney could support an adult human. These were questions I wanted answers to, and we were able to demonstrate a lot of those answers. Key safety questions were answered, and I thought it was time to start thinking about how to get this into the clinic.
All of that coincided with meeting Towana Looney, who is a patient of mine at the University of Alabama at Birmingham (UAB). She has told her story, so I can share these things with you that she’s previously disclosed. She donated her kidney to her mother in the late 1990s to save her mother’s life. She went on during the course of pregnancy to develop preeclampsia and later full-blown hypertension. She managed that disease for a long time until around 2016 or so when it progressed to the point that she required dialysis.
But it was really through pregnancies that Towana became highly sensitized, and sensitization determines how easy it is to find [an organ] match.
In Towana’s case, [a match was unlikely], and we enrolled her in everything. She didn’t have another living donor, but every time we had an altruistic donor, we tried to match her. We put her in trials trying to desensitize her and just nothing ever worked.
She heard on the news about some of the pig kidneys, and she asked about it. It turned out that she matched the xenokidney from a 10-gene-edited pig, and she said, “I want that.”
In 2023, we started the process of filing for a compassionate use investigational new drug application. In May 2024, it was finally approved. It was during a career transition for me — I was changing positions — and it also coincided with UAB deciding they weren’t ready to move forward with that.
I trained under Robert Montgomery, MD, and spent a decade at Johns Hopkins. Dr. Montgomery was doing this groundbreaking work, and I reached out to him and he said he would run it by NYU leadership and the FDA. Everyone agreed that we could transfer the IND to NYU, and I asked Towanna, “So, what do you think about New York?” She said, “I’ve always wanted to go.”
That is the long story of how we got there, and on Nov. 25 last year, I got a license and privileges at NYU. Dr. Montgomery and I, along with several other colleagues — the operating room was full, as you might imagine — performed the xenotransplant. I remember when it reperfused and made urine on the table.
Healio: Where do you think we’re going in the next 10 years in kidney care?
Locke: I think over the next 10 years we will see xenotransplantation widely available, and we will have approved xenograft products. That is all completely within the realm of not possibility, but within the realm of reality.
I think the field is going to continue to evolve. There are so many exciting developments going on in the organ alternative space, and of course, there’s still the holy grail of tolerance out there. All of us would love to see that happen because that would eliminate the need for immunosuppressants.
At the end of the day, we need this. We have been doing human-to-human transplantation now for a well over 60 years, and we don’t have enough organs. From my perspective as a provider, it is just so crushing to meet people in clinic and to know they’re more likely to die than they are to get a transplant, or to have to tell someone they’re not a candidate and I have relegated them essentially to death. That’s not why I went into medicine.
Healio: What would you be doing if you weren’t a researcher and a physician and a surgeon?
Locke: I don’t know that I’ve ever been that good at anything else. When I was a little kid, according to my parents, the first thing I wanted to be was the ringmaster of a circus — I must have seen one. But what would I be doing? Probably not that. I would love to be a singer, but the truth is I can’t carry a note. I think I found my right lane.
Healio: Do you have any good ideas?
Locke: Yes, I think I do. The world is full of great ideas, but it’s also important to focus. I think xenotransplantation is one of the best ideas around, and we should focus on that and commit to seeing it across the finish line in an ethical and responsible way — so we can offer this to the thousands of people not just in the U.S., but around the world. Our supply barely meets 10% to 15% of the global need. So, this is the idea we need to move forward.
For more information:
Jayme Locke, MD, MPH, FACS, FAST, can be reached at jayme.locke@nyulangone.org.
Sources/Disclosures
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Healio Interviews
Disclosures:
Locke reports serving as vice president of medical development for xenotransplantation at United Therapeutics.
