Heart of the Matter
Frederick Man Saw Experimental Transplant as Hope for Himself and Others
By Lisa Gregory
Photography by Turner Photography Studio
Lying in his hospital bed last October, surrounded by family and medical staff as his life ebbed away, Larry Faucette, the world’s second genetically modified pig heart transplant recipient, apologized.
“Larry wrote a note to us,” says Bartley Griffith, the surgeon who performed the transplant at the University of Maryland Medical Center in Baltimore. “He scratched it out on this little clipboard because he couldn’t speak. He still had a tube connected in the middle of his throat. He wrote three lines. The first line said, ‘I’m very sorry.’ The second line said, ‘I tried hard.’ And the last line he looked around at us and then wrote, ‘I love you.’”
For the Frederick resident, it was never just about himself. Yes, he welcomed the possibility of the experimental transplant offering more time with the wife he adored and his two grown sons. But Larry, himself a scientist, also believed in the contribution he could make to medical research and the help and hope it could give others. “He saw what the advantage could be to the world,” says his wife, Ann. “He felt that if his life was going to end, then why not help others?”
In the United States, more than 100,000 people are waiting for an organ transplant. But there aren’t enough donors to meet the demand, and 17 people die each day while waiting for a transplant. But medical advances have presented other options. Xenotransplantation, for example, is the process of grafting or transplanting organs or tissues between members of different species.
“It has huge potential,” says Muhammad Mohiuddin, professor of surgery and scientific/program director of the Cardiac Xenotransplantation Program at the University of Maryland School of Medicine.
Earlier attempts have included a baboon heart transplanted into a child in 1984. The patient lived for 21 days. According to Mohiuddin, primates would not prove to be the best source for xenotransplantation. “We found out that diseases from these non-human primates can be transmitted to humans,” he says. “One example is HIV.”
Another problem is the number of available organs. “Like humans, non-human primates give birth to one or two offspring typically,” says Mohiuddin. “Then it takes 20 years or so for that non-human primate to grow to a size that will match a human adult organ size.”
As a result, “We started looking for other options.”
“LET’S DO THIS.”
Pigs. They have similar anatomical and physiological characteristics to humans and can give birth to a litter instead of one or so pigs at a time. Also, pig heart valves have been used to repair human hearts for years. There is, however, the lingering issue of rejection as well as the possibility of the pig organ carrying an undetected virus that could infect its human recipient. But medical science has made many advances in recent years. The CRISPR-Cas9 gene-editing tool allows pig organs to be modified and made more adaptable to the human recipient while attempting to reduce the chance the organ could be rejected.
Larry’s procedure was the second attempt by Mohiuddin and Griffith. (Griffith is clinical director of the Cardiac Xenotransplantation Program at the medical school.) David Bennett Sr. of Hagerstown was the first pig heart recipient two years ago and survived for two months after surgery.
Larry agreed to the procedure knowing he had no other options. In late-stage heart failure, his peripheral artery disease and other health issues made him ineligible for a human heart transplant. The U.S. Food and Drug Administration granted an emergency authorization for the cardiac xenotransplant surgery as required. Preparing for the transplant, which took place last September, Ann says she was hopeful. “I was like, ‘Let’s do this,’” she says. “It might give us more time.” However, “Larry said, ‘You know that it is a species-to-species procedure.’ He encouraged me to learn more about it and then we discussed it.”
He and Ann were onboard. The couple, who would have celebrated their 38th wedding anniversary just two weeks after Larry died, began the most unusual medical journey together, just as they have always been. “He was the love of my life,” says Ann.
“WAS HE HIDING IT FROM ME?”
The two met while both were attending the U.S. Army’s school of laboratory sciences in San Antonio, Texas. Upon seeing Ann for the first time and yet to meet her, Larry told a friend, “I’m going to marry her,” Ann says with a grin. Ann did indeed say yes after only knowing him a month and a half. “We were both 19,” she says. They were married six months later.
Larry had come from a hardscrabble background growing up in New Hampshire. “They didn’t have running water for much of his childhood,” says Ann. But Larry was bright and determined. He went on to spend 20 years in the Navy as a corpsman, laboratory technician and histopathology technician, and spent time on the USNS Mercy during Operation Desert Shield. After retiring from the Navy in 2004, Larry began working as a contractor for the National Institute of Allergies and Infectious Disease.
The couple had moved to Frederick in 2001. A devoted father, Larry would go to work before dawn so he could come home early to spend more time with his sons. A favorite pastime was building and racing go-karts together.
“He loved his boys,” says Ann. “Larry did everything for his children.”
Life seemed good. But there had been signs that not all was well with Larry’s health in general and his heart specifically. According to Ann, during his second year in the military Larry was diagnosed with left bundle branch blockage, a disruption to the electrical impulse that controls the heartbeat and makes it more difficult to pump blood efficiently. At 39, he had a heart attack and required angioplasty and the placement of two stents. By age 45, he underwent a quadruple bypass.
“Then he had an incident at work,” says Ann. “He passed out.” This resulted in Larry retiring at 50. It was not an easy transition. “Larry loved what he did,” says Ann. But he made the best of it, keeping himself busy “cooking and doing the shopping,” she says.
In December 2021, Larry, who had also been diagnosed with blood clots and an abdominal aneurysm, developed what he thought was a cold. “He was congested,” says Ann. “He would use the humidifier and get better. But it always came back.”
By February 2022, he was having so much trouble breathing that he went to the emergency room where it was discovered he had had another heart attack. Even as he recovered, though, something was different this time, says Ann. “He said it was like his whole body seemed heavier,” she says. “I think he was retaining fluid.”
Larry had a mini stroke in June. “With no residual effects from it,” says Ann. Despite the medical obstacles, they continued their life, embracing it. “We went tubing in Jamaica,” she says. “We went on a hike in Costa Rica.”
Pausing for a moment, she says, “Was he hiding it from me? Was I in denial? In retrospect, I think he was much sicker than he let me know. I think he was protecting me.”
“IT’S JUST THE BEGINNING.”
Larry continued to retain fluid and have issues. “He carried 20 pounds of fluid at one point,” says Ann. So, began the doctor’s talk of needing a heart transplant. Unfortunately, that wasn’t an option for Larry, and he agreed to undergo the experimental procedure.
“I don’t think he thought he would make it through the surgery,” says Ann. “He was that sick.”
But he did. The day after he was sitting up supported in his hospital bed. Ann recalls them being shown X-rays. “The doctor says, ‘If he was just a person not undergoing the pig heart transplant, we would have never done surgery on him because his lungs were so full of fluid.’ Then the X-ray she was showing us afterwards, his lungs were almost clear. His heart was working.”
The X-rays weren’t the only test results Larry was reading. “He was a scientist who could read and interpret his own biopsies,” says Mohiuddin. Larry was an active participant in what was taking place in his body, even having a sense of humor about it, as well.
“He asked for a T-shirt that said, ‘Call Me Wilbur,’” says Ann referring to the pig in the book Charlotte’s Web. “He wanted to embrace it.”
He was also very protective of those caring for him. “Larry didn’t want us to talk about the transplant on social media,” says Ann. “He didn’t want anyone to know because if something went wrong, it might look bad against Dr. Griffith and his team.”
Initially the pig heart performed well. In fact, Larry was participating in physical therapy and enjoying playing cards with Ann. He was also beginning to set goals for himself outside of the walls of the hospital. “He wanted to sit on his deck and have a cup of coffee,” says Griffith. “And we wanted to give that to him.”
But eventually, the heart began to show signs of rejection. “He was having trouble breathing,” says Ann. Larry, with the understanding that he would never go home again, chose to end his battle. “After an hour or so of crying and talking, I went to speak with Dr. Alison Grazioli, the critical care doctor,” says Ann. “She started the notification that Larry was going to refuse any additional care.”
Larry lived six weeks with the pig heart.
He didn’t get his coffee on the deck but he did get a last coffee with Ann. “Larry told someone that he needed to have a cup of coffee with me,” says Ann. “Someone headed to Starbucks and got Larry and I coffees so we could have our coffee together for the last time.”
Larry Faucette lost his battle, but he leaves a legacy of hope for others. “His last wish was for us to make the most of what we have learned from our experience, so others may be guaranteed a chance for a new heart when a human organ is unavailable,” says Griffith. Adding, “People see the news and say, ‘Oh, he died. End of the story.’ But that’s not true. It’s not the end. It’s just the beginning.”