Speaker 1: Hey, friends, just a heads up that we're talking about
Speaker 1: organ shortages today and will touch on topics like death
Speaker 1: and animal research. So decide if this is an appropriate
Speaker 1: episode for you or your kiddos. According to Donate Life America,
Speaker 1: over one hundred thousand people are on the organ transplant waitlist.
Speaker 1: Approximately every eight minutes, another person is added to this list,
Speaker 1: So while you are listening to our show, approximately five
Speaker 1: people will have been told that their life depends on
Speaker 1: receiving a new organ. That weight might be quite long.
Speaker 1: Some folks will wait years before that organ becomes available,
Speaker 1: and during that weight the quality of their life could
Speaker 1: be quite poor. And unfortunately, not everyone on this waitlist
Speaker 1: is going to get an organ in time. Every day,
Speaker 1: about thirteen people on the waitlist will pass away because
Speaker 1: an organ was not made available soon enough. So what
Speaker 1: are our options. Well, today we're going to talk about
Speaker 1: one of those options that's looking more and more promising
Speaker 1: every day, and that option is zeno transplantation. That is
Speaker 1: taking organs from a non human animal pigs in this case,
Speaker 1: and implanting them into humans. This requires a fair bit
Speaker 1: of genetic engineering, and today we'll chat about how that's done.
Speaker 1: Welcome to Daniel and Kelly's Extraordinary Universe.
Speaker 2: Hi, I'm Daniel. I'm a particle physicist, and me and
Speaker 2: my microbes consider myself one hundred percent human.
Speaker 1: Hi, I'm a Kelly Wiener Smith. I study parasites and space,
Speaker 1: and yes, the community that makes up me is all me,
Speaker 1: and I feel great about it.
Speaker 2: Some one wonder and ask Katrina this question whether my
Speaker 2: microbes would be offended to be considered human because you know,
Speaker 2: they don't have the human DNA, but they are part
Speaker 2: of me.
Speaker 1: Yeah, you know, I feel like you could actually have
Speaker 1: a pretty interesting philosophical argument about what you really means,
Speaker 1: because you know, when we had Katrina on the show,
Speaker 1: she was talking about how bacteria sort of communicate with
Speaker 1: our brain via the vagus nerve vegas nerve. We both
Speaker 1: know I don't pronounce things correctly, ever, and so you know,
Speaker 1: I had to what extent your well being and behavior
Speaker 1: is influenced by what kinds of bacteria you have at
Speaker 1: the moment. I think it is a fascinating question. And
Speaker 1: so I contain multitudes.
Speaker 2: And maybe if you had different multitudes, you could pronounce
Speaker 2: things differently or better. Even right, I don't.
Speaker 1: Think anything could help me with that. Ever, I've always
Speaker 1: been this way no matter what my microbiome was up to.
Speaker 2: I'm going to ask Katrina to engineer some superbug to
Speaker 2: help you with your pronunciation.
Speaker 1: I would happily pay for that. That would be a
Speaker 1: So when I have to do the audiobook readings for
Speaker 1: my books, I'm always like, ah, this is going to
Speaker 1: be a disaster.
Speaker 2: But in general, I love when questions in science bump
Speaker 2: up against philosophical issues, you know, that make us ask
Speaker 2: questions like what do we really mean by your body?
Speaker 2: And it's not that hard to get there, you know,
Speaker 2: you can just even ask like, well, where does your
Speaker 2: body end? You know, is it at your skin, at
Speaker 2: your hair, a millimeter past it? It's your fuzzy personal
Speaker 2: space boundary. You know, it's not that hard to get
Speaker 2: stuck in weird philosophical questions.
Speaker 1: Yeah, and organ transplants, whether it's from one human to
Speaker 1: another or zeno transplantation, which we're talking about today, which
Speaker 1: is when you take organs from a non human animal
Speaker 1: and put them into a human. You know, causes a
Speaker 1: lot of philosophical questions or at least a lot of
Speaker 1: sort of emotional turmoil. There are stories about people who
Speaker 1: have gotten face transplants, for example, just feeling very uncomfortable
Speaker 1: looking at their face in the mirror. There's a story
Speaker 1: of one person who had a hand transplant and he
Speaker 1: ended up wanting the hand remove moved because he just
Speaker 1: was like, this is not my hand and it's just
Speaker 1: too weird. I'm not emotionally, I can't handle this.
Speaker 2: You can't handle it nice.
Speaker 1: Oh I didn't even get how clever even when I'm
Speaker 1: not trying.
Speaker 2: Man, Well, I was just going to raise that issue,
Speaker 2: like it's really a ship of theseus question. You know,
Speaker 2: if you get somebody else's liver, you feel like you're
Speaker 2: still you. What if you've got somebody else's liver and
Speaker 2: pancreas and heart and legs and arms and everything else
Speaker 2: except the brain, would you still be you? I think
Speaker 2: we mostly consider ourselves to be our brain, which is
Speaker 2: I don't know if that's philosophically naive or sophisticated or not.
Speaker 2: But the face is weird. Right to be in somebody
Speaker 2: else's face. That must feel strange.
Speaker 1: Yeah, that must feel strange. I still feel like, you know,
Speaker 1: for a lot of people, it must be a huge relief,
Speaker 1: depending on what happened to them to put them in
Speaker 1: the position where they needed a face transplant.
Speaker 2: Oh right, Yeah, I thought you were just saying, like,
Speaker 2: I'm not that happy with my face either, so would
Speaker 2: be a relief to have somebody else's face over here.
Speaker 1: I spent too much time in the sun. I could
Speaker 1: use a face with less evidence of that. But this
Speaker 1: is the face I got, and I'm going to stick
Speaker 1: with it. But yeah, you know, I as somebody who
Speaker 1: is working their way through paramenopause, and there are days
Speaker 1: where I'm feeling grumpy. I'm so interested in this question
Speaker 1: about like what makes you who you are, and like
Speaker 1: how your hormones influence the way that you behave or
Speaker 1: maybe how the bacteria that are releasing stuff, how that
Speaker 1: influences the way you behave. I think it's a really
Speaker 1: fascinating question that ties in with this question of like,
Speaker 1: you know, to what extent does it matter if the
Speaker 1: you parts have your genome in their nucleus or not.
Speaker 1: It's complicated. What do you think if you had lungs, hearts, kidneys,
Speaker 1: liver from somebody else, how would you feel about that?
Speaker 2: I would feel a little bit like I had some
Speaker 2: of them inside of me. Yeah, and I wonder how
Speaker 2: parents feel when their children's organs are reused after a
Speaker 2: tried to accident. Do they feel like, you know, little
Speaker 2: Timmy's heart is still beating and so we have still
Speaker 2: some part of him, I wonder, or if they just
Speaker 2: feel like that was a gift to help somebody else live.
Speaker 2: I don't know.
Speaker 1: It's fascinating, yeah, yeah, no, fascinating, And it must be
Speaker 1: very emotionally complicated. I imagine lots of people have different feelings.
Speaker 1: I think if I was in that situation, I would
Speaker 1: be glad that other families were spared the pain that
Speaker 1: I was going through and that, you know, our family
Speaker 1: was able to give that to them. But it would be, yeah,
Speaker 1: really complicated. So today our topic is a bit of
Speaker 1: a downer, But a lot of.
Speaker 2: Those philosophical issues can be partially sidestepped if you're not
Speaker 2: talking about a human to human gift, right, If you're
Speaker 2: talking about getting an organ from another animal, and this
Speaker 2: different set of philosophical issues, right, if you're getting it
Speaker 2: from a pig or from a baboon, and are they
Speaker 2: sentient and can they consent? And do they have rights
Speaker 2: and all this sort of stuff, But you do avoid
Speaker 2: the question of like taking organs from another person and
Speaker 2: then being part of you. So tell us, Kelly, how
Speaker 2: do we get started on this question?
Speaker 1: Well, the reason we got started on this question is
Speaker 1: because a listener, Jane, who's a pastor, wrote and wanted
Speaker 1: to know what kind of philosophical issues come up when
Speaker 1: you're using you know, pig organs, transgenic pig organs to
Speaker 1: keep people alive. So let's go ahead and listen to
Speaker 1: Jane's question and then we'll jump into talking about what
Speaker 1: xeno transplantation is and how it works.
Speaker 3: Hi, Daniel and Kelly, this is Jane from Redcar, England.
Speaker 3: I've got a question which is more philosophical and scientific.
Speaker 3: There's been a lot of news about transgenic pigs created
Speaker 3: for transplantation. The idea is that their genome becomes more
Speaker 3: and more human so that they trigger less rejection. My
Speaker 3: question is, at what point do we need to start
Speaker 3: treating them as human and therefore with more respect. Not
Speaker 3: that we always treat other humans with the respect, but
Speaker 3: that's a different question. I'm excited by the opportunities this offers,
Speaker 3: but I'm also conflicted by the ethics. I look forward
Speaker 3: to hearing your take on this. Thank you, for a
Speaker 3: great show.
Speaker 1: All right, So Jane and I had a pretty interesting
Speaker 1: conversation over email about the you know, the ethics of
Speaker 1: this question. And I guess I'm a little bit of
Speaker 1: a negative Nelly. I'm not sure anything is going to
Speaker 1: put a dent in the way we treat animals that
Speaker 1: we also eat. But it made me want to do
Speaker 1: a whole episode on zeno transplantation because there has in
Speaker 1: the news recently been some pretty exciting updates in this field,
Speaker 1: and so I thought this would be a great chance
Speaker 1: to sort of catch up on that research.
Speaker 2: All right, so let's get started. Why do we even
Speaker 2: consider taking organs from pigs? I mean, obviously I would
Speaker 2: prefer human organ if I'm going to receive a transplant.
Speaker 2: Why do we consider other species?
Speaker 1: Well, there's just not enough of the human organs. So
Speaker 1: last year there were forty eight thousand transplants that happened
Speaker 1: in the United States, and so that's a lot, and
Speaker 1: that's fantastic, but it's less than fifty percent of the
Speaker 1: number of people who are on the list and need organs.
Speaker 1: So there's this massive difference between the number of people
Speaker 1: who get organs and the number of people who need them,
Speaker 1: and there's probably even more people who need them, but
Speaker 1: they're not on the weight list for a variety of reasons.
Speaker 1: It could be that it just seems unlikely that an
Speaker 1: organ that's the right match will come through for them
Speaker 1: on time, and so some people who would like new organs,
Speaker 1: you know, don't even put themselves on the weight list.
Speaker 1: So if we had a lot of organs, then there's
Speaker 1: a lot more people who would be in a good position.
Speaker 1: So where do we get the organs we have now?
Speaker 1: So this is something we've already sort of hinted at
Speaker 1: in this episode. When somebody passes away, for example, in
Speaker 1: a car accident, they're organs. The organs that you know
Speaker 1: are still in good shape can be given to other
Speaker 1: people who need them if you can find people who
Speaker 1: are a good match. So being a good match. We
Speaker 1: have different blood types, you know, if you go in
Speaker 1: to donate blood, they'll tell you what your blood type is. Essentially,
Speaker 1: we've got stuff that stick out on our cells, and
Speaker 1: if your stuff that sticks out on your cells looks
Speaker 1: different the stuff that sticks out on someone else's cells,
Speaker 1: then your body's going to recognize that as foreign and
Speaker 1: the immune system is going to go after it and
Speaker 1: kill it. So the organ that you get needs to
Speaker 1: look like an organ that would have been in your
Speaker 1: body to begin with. Otherwise the immune system is going
Speaker 1: to go nuts.
Speaker 2: Fascinating, And then does having a good match guarantee that
Speaker 2: the immune system is going to be cool or do
Speaker 2: you still need to take immune suppressants your whole life.
Speaker 1: You still need to take immunosupressants your whole life, which
Speaker 1: means you might be at greater risk of things like infections. Also,
Speaker 1: I think immunosuppressants make it slightly more likely that you
Speaker 1: could get cancer later in your life. But you know,
Speaker 1: if the surgery goes well, then your life will be extended,
Speaker 1: even though you'll have these problems to deal with.
Speaker 2: I remember, in our conversation about type one diabetes, Katrina
Speaker 2: was saying that you could cure type one diabetes by
Speaker 2: getting a pancreaus donation. But then you have immunosuppression, and
Speaker 2: that's pretty hard for somebody who's very young.
Speaker 1: Yeah, and even today sometimes we don't get that immunosuppression
Speaker 1: level completely correct. And so if you give people too
Speaker 1: many immunosuppressive drugs, then you know, people can get horrible
Speaker 1: diseases and then they can pass away from those diseases.
Speaker 1: It's a very delicate balance, and so a fair bit
Speaker 1: of your life from then on out goes towards trying
Speaker 1: to like modulate your immune systems so that you don't
Speaker 1: get sick, but you don't reject this organ.
Speaker 2: And what organs are mostly the ones being donated? Is
Speaker 2: it mostly like kidneys and livers?
Speaker 1: Yeah, mostly kidneys, and then after that livers, and sometimes
Speaker 1: you'll get lungs or hearts. I think kidneys are so
Speaker 1: common because if you have a problem with your kidney,
Speaker 1: you can stay on dialysis. So dialysis is essentially a
Speaker 1: machine that cleans your blood, does the job that kidneys
Speaker 1: would have done, and so you can stay alive for
Speaker 1: years on this machine. It's not a great quality of life,
Speaker 1: but you can wait for years for an organ to
Speaker 1: come along, whereas it's harder to get machines that replace
Speaker 1: our heart or our lungs or our liver. You can
Speaker 1: do that, but it's not the kind of thing that
Speaker 1: you can do for like years at a time. And
Speaker 1: so kidneys are an easy ish organ to deal with
Speaker 1: or to wait for replacement. And another way that we
Speaker 1: get organs are through living donors, and so if you
Speaker 1: happen to have an identical twin who you get along with,
Speaker 1: and they're willing to give you one of their kidneys.
Speaker 1: If you two are a blood match, which you would
Speaker 1: be if you were identical twins, then they can donate
Speaker 1: one of their kidneys to you and they can still
Speaker 1: live with just one kidney, and then you get one
Speaker 1: of their kidneys. But say you don't have an identical
Speaker 1: twin and it turns out that your siblings and no
Speaker 1: one in your family is a good match, then for
Speaker 1: a while there you were kind of out of luck.
Speaker 1: But recently this system has been created called matching markets.
Speaker 1: So essentially, if I needed a kidney and Zach was like,
Speaker 1: I'll give you one of mine, and he's not that nice,
Speaker 1: I'm not sure he would, but no, I'm kidding, No,
Speaker 1: I'm kidding, he'd give me his kidney. But so if
Speaker 1: Zach was like, well, I'll give you my kidney, but
Speaker 1: it turned out we weren't a match, we could enter
Speaker 1: our names into a matching market and if somebody else
Speaker 1: had a you know, a sibling, a boyfriend, whatever, who
Speaker 1: was a match to me, And it turned out that
Speaker 1: Zach was a match to them, then we could create
Speaker 1: that loop and we could switch the kidney, so I
Speaker 1: would get you know, that boyfriend's kidney, Zach would give
Speaker 1: his kidney to you know, the other boyfriend, and then
Speaker 1: we would manage to make the loop that way. And
Speaker 1: you can get really complicated loops where people are swapping
Speaker 1: organs and you know, I think more than twenty of
Speaker 1: these pairs have gone through these loops. And so by
Speaker 1: having a bunch of people who are willing to donate,
Speaker 1: you can make a lot of matches in this system,
Speaker 1: and so some of the matches come from that, but
Speaker 1: those can be a little bit complicated because if everybody
Speaker 1: owes a kidney to somebody else, then you want to
Speaker 1: try to do those surgeries as much as possible at
Speaker 1: the exact same time, so that nobody wakes up in
Speaker 1: the morning and is like, never mind, I'm too nervous,
Speaker 1: I'm not going to do it, and then one person's
Speaker 1: gotten a kidney, and now somebody else is sort of
Speaker 1: left in the lurch.
Speaker 2: You want to like them all in beds in a row.
Speaker 2: You're just like, ask the kidney.
Speaker 1: Over to the left, right, Yeah, something like that, And
Speaker 1: so I think two percent of the time, you do
Speaker 1: have an instance where somebody will come in and you know,
Speaker 1: it's not necessarily that they like they've changed their mind
Speaker 1: or they got too scared to go through with it.
Speaker 1: Sometimes it's just like, hey, actually, it turns out that
Speaker 1: we discovered they have I don't know, some disease, and
Speaker 1: so they can no longer donate that organ. And so
Speaker 1: there's good reason for not being able to do it.
Speaker 1: But every once in a while you get a good
Speaker 1: Samaritan who doesn't necessarily know somebody who needs a kidney,
Speaker 1: but they're just willing to donate one, and then you
Speaker 1: can get this whole match set off and you can
Speaker 1: start doing a bunch of kidney transfers between people. So
Speaker 1: anyway there is a bunch of people who are alive
Speaker 1: and donate their kidneys, and because we only need one,
Speaker 1: you can do this. It happens less often with livers,
Speaker 1: so you can live with just part of a liver,
Speaker 1: so you could donate part of it. But this surgery
Speaker 1: is a little bit more high risk, and so it's
Speaker 1: asking a lot more than just asking someone to give
Speaker 1: you one of their kidneys.
Speaker 2: And what are the ethics around this because people have
Speaker 2: these very valuable resources which can save somebody else's life.
Speaker 2: But obviously you need their consent, but it feels like
Speaker 2: they could all be pressured into it. It reminds me
Speaker 2: of the questions people raise around end of life stuff.
Speaker 2: Or it's like, yeah, it's great if people get to
Speaker 2: decide when they exit, but do you want grandma to
Speaker 2: be pressured into the grave by her nephew who needs
Speaker 2: the inheritance? Right? Right? And so there's tricky issues.
Speaker 1: There, aren't there, Yeah, really tricky issues. And there was
Speaker 1: for a while, all right. So I'm pulling way back
Speaker 1: in my memory from when I was writing soonish, I
Speaker 1: think I'm going to get all of this right. But
Speaker 1: I ran used to allow legal selling of organs, and
Speaker 1: it did seem to be the case that the poor
Speaker 1: were getting exploited, and they were often not getting paid
Speaker 1: very much for their organs, and then when they had
Speaker 1: trouble of their own, for example, maybe they had a
Speaker 1: problem with their remaining kidney, they couldn't afford the care
Speaker 1: that they needed, oh gosh, And so that system was
Speaker 1: not working very well. There are folks who recommend, you know,
Speaker 1: in the US, for example, you had a system where
Speaker 1: if somebody is willing to donate their kidney, it doesn't
Speaker 1: go to a person in particular, Like some super rich
Speaker 1: person couldn't say I want Daniel's kidney in particular, but
Speaker 1: Daniel could say, you know, for a million dollars, which
Speaker 1: is about the cost of dialysis for a year. So
Speaker 1: like you can imagine a insurance company maybe saying, all right,
Speaker 1: we'll give Daniel a million dollars so that this other
Speaker 1: patient of ours doesn't have to be on dialysis for
Speaker 1: three years, and we promise that if Daniel ever has
Speaker 1: a problem with his remaining kidney, he goes to the
Speaker 1: top of the list and he always gets free medical
Speaker 1: care for anything related to kidney problems. But there's this
Speaker 1: concept of repugnance in economics, and there's some trades that
Speaker 1: people feel comfortable with and some trades that people don't
Speaker 1: feel comfortable with, and trading organs sort of falls into
Speaker 1: the category of repugnant. People just kind of feel uncomfortable
Speaker 1: about it. For the reason that you identified. There's so
Speaker 1: many ways to do it that feel ethically complicated, and
Speaker 1: you can absolutely imagine that people who are the most
Speaker 1: likely to donate their organs, or people who are in
Speaker 1: financial straits and wouldn't be doing it otherwise, but absolutely
Speaker 1: feel like they need to do it to like, you know,
Speaker 1: pay their bills or something. So it gets complicated. But
Speaker 1: in the US you are not allowed to pay for organs.
Speaker 2: And do you think it happens anyway?
Speaker 1: Probably?
Speaker 2: I mean, it definitely happens in the dystopian science fiction
Speaker 2: that I read. I don't know if that means it
Speaker 2: happens in reality.
Speaker 1: Yeah. Well, you know, when I was reading the Space
Speaker 1: Settlement literature, they cited the expanse a lot as though
Speaker 1: that was actually happening. So if it's happening in dystopian
Speaker 1: science fiction, it's probably happening in real life.
Speaker 2: Well, since we're talking about science fiction, why can't we
Speaker 2: avoid this problem by figuring out how to grow organs ourselves?
Speaker 2: Like why do you need a whole human being just
Speaker 2: to create a human kidney. Why can't you just grow
Speaker 2: a kidney in a vat somewhere or like three D
Speaker 2: print a kidney or something like that.
Speaker 1: Yeah, so people are working on that. So the idea
Speaker 1: here is that you extract some cells from a person,
Speaker 1: you grow up their own cells, and then you like
Speaker 1: extrude them through a three D printer or do some
Speaker 1: other sort of complicated technique to create an organ out
Speaker 1: of their own cells. If this worked, you wouldn't need
Speaker 1: to be on immunosuppressive drugs. It would be amazing. But
Speaker 1: the problem is that our organs are exquisitely complicated, and
Speaker 1: even just things like delivering nutrients and removing waste, which
Speaker 1: you know we usually do with our vasculature our blood vessels,
Speaker 1: is really hard to recreate with a three D printer,
Speaker 1: like on the microscale, And so right now we're good
Speaker 1: at printing what are called organoids. They're like slabs of
Speaker 1: organ and so that's good for like testing out drugs
Speaker 1: and stuff. So you know, if your liver drug kills
Speaker 1: your little liver slab, you probably don't move on to
Speaker 1: the stage where you're trying it out on humans. But
Speaker 1: at the moment, it's not good enough to replace any organs.
Speaker 1: People are working on that. There's some really amazing work
Speaker 1: to create like vasculature out of like sinered sugar, So
Speaker 1: you fuse the sugar so it looks like vasculature, and
Speaker 1: then you seed it with blood vessel cells and those
Speaker 1: blood vessel cells grow around the sugar and then you
Speaker 1: put hot water through there and you dissolve the sugar away,
Speaker 1: and your left with vasculature whoa, and then you can
Speaker 1: put like liver cells around that.
Speaker 2: But all this talk of sugar, I'm just imagining like
Speaker 2: a cotton candy kidney or something.
Speaker 1: Yum. Oh, we got to we kind of got to cannibalism.
Speaker 1: I think you know.
Speaker 2: I tricked you into it.
Speaker 1: That's all right, that's right, Okay, So let's take a break,
Speaker 1: and then when we come back from the break, we'll
Speaker 1: talk about xeno transplantation, where you're forgetting about human organs
Speaker 1: altogether and instead we're just seeing if we can use
Speaker 1: organs from other animals. Okay, So, xeno transplantation, which is
Speaker 1: when you use organs from other animals in human bodies,
Speaker 1: has a pretty long history. We're going to stick with
Speaker 1: the history in the twentieth century. And you know, I
Speaker 1: should say that the history of this field is august
Speaker 1: and amazing, and the scientific work that's been done is fantastic.
Speaker 1: But I am going to start with the guy who
Speaker 1: was implanting testicles for anti aging, because I'm me and
Speaker 1: that's obviously where I had to start.
Speaker 2: But you're saying these experiments are maybe not representative of
Speaker 2: the scientific calimber of the whole field.
Speaker 1: I mean, it was pretty representative of science in the
Speaker 1: nineteen twenties. But you know, I don't want you to
Speaker 1: judge the whole field based on this story I'm about
Speaker 1: to tell, all right, tell us the story, all right.
Speaker 1: So Sergey Varnoff in the nineteen twenties and nineteen thirties,
Speaker 1: he was doing these experiments. He was a Russian emigray
Speaker 1: living in Paris, and he was implanting slices of chimp
Speaker 1: and baboon testicles into human males as an anti aging thing.
Speaker 2: Where into human males, like.
Speaker 1: Near the testicles, it would be like you'd get a
Speaker 1: little slice of chimp nard behind yours and sorry everybody.
Speaker 1: And there were some people who reported afterwards that they
Speaker 1: felt more virile and alive, and I suspect that that
Speaker 1: was entirely placebo effect. And they're lucky they didn't get
Speaker 1: massive infections in their testicles from these foreign cells being
Speaker 1: placed in that so delicate of an area.
Speaker 2: But were they like wired up with blood vessels and
Speaker 2: stuff so they could live or it was just like
Speaker 2: a chunk of dead.
Speaker 1: Flesh yeah, it was a chunk of dead flesh that
Speaker 1: was definitely going to die, super gross. It was not
Speaker 1: going to be like producing more testosterone or anything like
Speaker 1: that the way they had done it. And if you
Speaker 1: went to the US, there was like a charlatan who
Speaker 1: I believe he was pretending to be a medical doctor,
Speaker 1: and he was giving folks testicles from like super viral goats.
Speaker 2: This is like zombie goat testicles. This is not good.
Speaker 2: I don't understand why anybody would say yes to this.
Speaker 1: So, I mean, I don't feel like this is a
Speaker 1: metaphor we need to double down on. But I would say,
Speaker 1: these goat testicles aren't like coming back to life inside
Speaker 1: of this human, you know. I think they're just like
Speaker 1: they're they're in there and they decay away and if
Speaker 1: you're lucky, it won't cause a massive infection, right, and
Speaker 1: that's the best case scenario. All right. So then this
Speaker 1: got dropped for a while because this wasn't really working out.
Speaker 1: In the nineteen sixties, we try transplanting chimpanzees and bonobo
Speaker 1: kidneys into humans directly. One woman lived with the chimpanzee
Speaker 1: kidney for about nine months wow, which was a pretty
Speaker 1: long time to have your life extended. But in general
Speaker 1: these surgeries don't work because human immune systems reject these
Speaker 1: foreign organs, and so some people the rejection takes a
Speaker 1: little longer, others it happens more quickly. But it becomes
Speaker 1: clear that just straight up implantation of kidney and banobo
Speaker 1: organs into a human is not going to solve our problems.
Speaker 2: Well, we heard earlier that not even all human kidneys work. Right,
Speaker 2: if I need a transplant, I can't just get a
Speaker 2: random human. I need a specific human that's probably not
Speaker 2: going to trigger my immune system. So that makes it
Speaker 2: sound very unlikely that any chimp would work. But when
Speaker 2: they do this, do they like choose a chimp that's
Speaker 2: less likely to trigger an immune system, and do you
Speaker 2: have like a chimp match. You know, some chimps were
Speaker 2: better for donating kidneys.
Speaker 1: So at this point we didn't really understand blood types,
Speaker 1: and so we were just kind of hoping that chimpanzees
Speaker 1: were closely related enough to humans that this would work.
Speaker 1: It was a little bit after this where we started
Speaker 1: to figure out that oh, hey, even within species, like
Speaker 1: with dogs, if you transfer organs from one dog to another,
Speaker 1: sometimes it works. Sometimes it doesn't, and it took a
Speaker 1: while for us to figure out that that all depended
Speaker 1: on blood types. And so once we figured that out,
Speaker 1: I think it was in dogs. I read this great
Speaker 1: book called Spare about the history of organ transplantation. They
Speaker 1: talk about blood type and how we figured that stuff
Speaker 1: out in more detail if anybody's interested. But once we
Speaker 1: figured it out in humans, we realized, Okay, so this
Speaker 1: isn't going to work with chimpanzees. They're two distantly related,
Speaker 1: same with bonobos. Even with humans, you need to figure
Speaker 1: out blood types. But I told you at the start
Speaker 1: of the episode that we've made some progress in zeno transplantation,
Speaker 1: and the way that we've done that is by genetically
Speaker 1: engineering pigs so that they look more human.
Speaker 2: That's really interesting, Kelly. I wouldn't choose pigs necessarily. Tell me,
Speaker 2: why would we choose pigs to be our organ farmers.
Speaker 1: That's such a great question, Daniel. So chimpanzees and bonobos
Speaker 1: are more closely related to us, so they seem like
Speaker 1: a more obvious choice. But they've got a couple problems.
Speaker 1: So first of all, they're smaller than us, so their
Speaker 1: organs are smaller. And that was a problem in some
Speaker 1: of the surgeries that were tried earlier. The chimp kidneys
Speaker 1: were too small, chimp hearts too small. But additionally, people
Speaker 1: feel much more uncomfortable about euthanizing chimpanzees and bonobos because
Speaker 1: they're more closely related to us, So there was this
Speaker 1: idea that they would be more of an ethical backlash.
Speaker 1: But perhaps even more than that, chimpanzees and bonobos take
Speaker 1: a long time to reach sexual maturity, and then they
Speaker 1: only have a few babies at a time, so you'd
Speaker 1: have to scale up in a way that would be
Speaker 1: very difficult, and we've never really done before to have
Speaker 1: enough chimpanzees and bonobos to meet the knee.
Speaker 2: You're talking about chimped farming, right. You're saying that it's
Speaker 2: hard to get a big population. Yeah, wow, So you
Speaker 2: want something that grows quickly and has babies young so
Speaker 2: that you can get that exponential factor go it early.
Speaker 1: Yikes, right, and your face is telling me that you
Speaker 1: feel uncomfortable about this suggestion, which almost everybody else did.
Speaker 1: The final nail in the coffin is that those more
Speaker 1: closely related organisms are more likely to have diseases that
Speaker 1: could jump from them to us, making this a little
Speaker 1: bit scarier. So pigs are an organism that we already
Speaker 1: know how to grow in like sort of production level. Yeah,
Speaker 1: so they reach sexual maturity when they're young, they have
Speaker 1: lots of babies. We know how to keep them alive.
Speaker 1: We understand these organisms fairly well. We've got like their
Speaker 1: genome and their organs are like fairly similar in size
Speaker 1: to humans in a lot of ways, and so we've
Speaker 1: sort of settled on pigs as our best bet as
Speaker 1: starting material to tinker with to make organs to keep
Speaker 1: us alive.
Speaker 2: I don't know if that logic really holds. It's like,
Speaker 2: this is ethically dubious, so let's do it on a
Speaker 2: creature we're already mistreating ethically, right, Like we already treat
Speaker 2: pigs as if they're objects, and so therefore it's okay
Speaker 2: to treat them as objects, where it's not okay to
Speaker 2: treat chimps as objects because we don't do that already, yes,
Speaker 2: Or is it just about being closer to us? Is
Speaker 2: this another like speciesism thing? Like how much of humanity's
Speaker 2: rights do you get? Chimps get a little bit and
Speaker 2: pigs get almost none?
Speaker 1: Yes, I mean I think everything that you just said
Speaker 1: is uncomfortable but true. But you've told me in a
Speaker 1: previous episode that you have accepted that humans are just
Speaker 1: sort of like a level above the other animals and
Speaker 1: you are okay with eating them. And I feel like
Speaker 1: you're not consistently applying that philosophy right now.
Speaker 2: No, you're right, because consistently applying that philosophy means arbitrarily
Speaker 2: labeling humans as better. And the point you just made
Speaker 2: with chimps and bonobos is that there's a spectrum, right
Speaker 2: and like where do you draw the line? And now
Speaker 2: you have to have a fuzzy delineation of how much
Speaker 2: of this like special glowy rights that you put on
Speaker 2: people and how much do you not? And what if
Speaker 2: somebody had a half pig half human hybrid, what would
Speaker 2: they get? You know? And so yes, I am not
Speaker 2: prepared to answer these questions. My philosophical framework here is
Speaker 2: quite naive.
Speaker 1: Yeah, I do think a lot of this stuff is complicated.
Speaker 1: Like you know, if you go to some countries they
Speaker 1: eat guinea pigs and it's like nothing. But if you
Speaker 1: told a child in the US that you were gonna
Speaker 1: have guinea pig for dinner, they'd probably be very upset
Speaker 1: because we think of those animals as pets and not food.
Speaker 1: And so I think a lot of it depends on
Speaker 1: what you grew up feeling comfortable with. Like I know
Speaker 1: some people who won't eat bunnies because they're too cute,
Speaker 1: but they will eat pigs because they think they're not cute.
Speaker 1: But I think pigs are cute, and I think anyway,
Speaker 1: humans have very complicated feelings. But pigs are an organism
Speaker 1: that I think a lot of people have decided is
Speaker 1: okay to eat, although I know that there are you know,
Speaker 1: cultures and religions for which that's not the case.
Speaker 2: And at least we're not committing any more crimes. We're
Speaker 2: committing more crimes on each individual, but we're not committing
Speaker 2: crimes on more individuals. We're already raising these folks for meat,
Speaker 2: and so might as well harvest their organs.
Speaker 1: Yeah, it's not that easy actually, So in the US
Speaker 1: we're very uncomfortable with eating genetically modified foods, and in
Speaker 1: the European Union, I think it may even be completely prohibited.
Speaker 1: And so I don't actually know if these pigs, after
Speaker 1: having their organs harvested, would be sent out to become bacon.
Speaker 1: For example, I will say that if the companies that
Speaker 1: made these pigs said, you know, we're going to sell
Speaker 1: pork from these animals that we used their organs for transplants,
Speaker 1: and it's safe we eat it ourselves, then that would
Speaker 1: be the pork that I would buy. But I don't
Speaker 1: actually know that that's how it would play out, all right, So.
Speaker 2: Then the key concept is that these aren't just normal
Speaker 2: farm pigs. These are pigs have been genetically engineered to
Speaker 2: make fair organs better for transplanting into humans. How do
Speaker 2: you do that? Do you just like randomly breed pigs
Speaker 2: or can we actually go in and tinker with the DNA?
Speaker 1: Yeah, so you're gonna have to tinker with the DNA
Speaker 1: because if you don't tinker with the DNA, you're always
Speaker 1: going to have this immune system problem. And so recently
Speaker 1: we got this major advance in tinkering with DNA. I'm
Speaker 1: sure just about everybody has heard of this. This is
Speaker 1: the CRISPER CAST nine system. So CRISPER stands for clustered
Speaker 1: regularly interspaced short palindromic repeats. I'm sure everybody's going to
Speaker 1: remember that the women who found this Jennifer Dudna and
Speaker 1: Emmanuel Chapatier. What you do French stuff? Right? How do
Speaker 1: you say that name?
Speaker 2: That sounded pretty good.
Speaker 1: Yeah, okay, fantastic. You know I've I've been working on
Speaker 1: French and du a lingo.
Speaker 2: To your microbiome.
Speaker 1: Okay. So they got the Noball Prize for this work.
Speaker 1: And so essentially this system is snagged from bacteria's immune system.
Speaker 1: So the way this works is that bacteria remember, not
Speaker 1: the same way that we remember things, but they remember
Speaker 1: a virus that has infected them by essentially, when they
Speaker 1: find that virus, they grab a piece of the virus's
Speaker 1: genetic material and they stick it into their own genome.
Speaker 1: And now whenever that viral sequence is found in their
Speaker 1: body again, Crisper goes and cuts it to break it up.
Speaker 2: So it's like a little bacterial immune system that like
Speaker 2: a library of viral codes that they've seen before that
Speaker 2: they're like.
Speaker 1: This is bad, kill it, right, So you essentially have
Speaker 1: a system that can recognize certain sequences of genetic code
Speaker 1: and then it goes in there and it cuts it.
Speaker 1: And so it's like targeted molecular scissors. And so we
Speaker 1: can use this. We can say Okay, here's a pig,
Speaker 1: and here is the code for a gene that we
Speaker 1: want to tinker with. And so you can tell Crisper like,
Speaker 1: go in there and cut it at the spots where
Speaker 1: we want you to cut it, and now you can
Speaker 1: deactivate a gene or when it cuts a gene. The
Speaker 1: way the DNA responds is it repairs itself by sort
Speaker 1: of joining the two ends back together after you've made
Speaker 1: the cut. But you can before it joins itself back
Speaker 1: together sort of slip in a new gene or some
Speaker 1: new genetic code. And so in that way you can
Speaker 1: both remove things or add things in specific locations that
Speaker 1: you want.
Speaker 2: Man, biological engineering is incredible. I can't believe this ever
Speaker 2: works because it's not like I imagine you'd need like
Speaker 2: tiny little tweezers and you're like moving it into place
Speaker 2: just right. But you can't do that right. You just
Speaker 2: have like a test tube with solution and you jiggle
Speaker 2: it and you hope everything lines up. It's crazy.
Speaker 1: It's so crazy. I cannot believe that it works, but
Speaker 1: it does. It's absolutely amazing. But so the next step
Speaker 1: from there I found sort of confusing, and I was
Speaker 1: reading the scientific papers I wasn't following, So I wrote
Speaker 1: e Genesis, which is a company that makes genetically modified
Speaker 1: pig organs in addition to making a bunch of other stuff.
Speaker 2: This is non science fiction. They exist in our world.
Speaker 1: E Genesis exists in our world. That's right.
Speaker 3: Wow.
Speaker 1: And I wrote them. I wrote for you know, their
Speaker 1: media contacts or whatever. And I was like, I don't
Speaker 1: speak molecular biology. I can't figure out exactly what was
Speaker 1: done here. Can you connect me with someone who can
Speaker 1: explain it? And so they connected me to Wenning Chin,
Speaker 1: who was the senior author on the Nature paper described
Speaker 1: how they made these genetically modified pigs amazing. She was
Speaker 1: so fantastic to talk to and so excited about this research.
Speaker 1: So she told me that there's three different classes of
Speaker 1: genetic changes that they made.
Speaker 2: So first, wait, hold on, did you talk to her
Speaker 2: and see a video or just over the phone over zoom?
Speaker 2: And did you see her only like you know, chest
Speaker 2: up or full body chest up? Okay, So she could
Speaker 2: have had like you know, pig legs under the table
Speaker 2: and you wouldn't even know.
Speaker 1: I had no idea where you were going with this.
Speaker 2: I mean, you're talking to somebody at a company who's
Speaker 2: like doing cutting edge like human animal weirdness. So like,
Speaker 2: I mean, you're not curious.
Speaker 1: I had no reason to believe that she was anything
Speaker 1: other than a you know, woman with no animal parts,
Speaker 1: and she was wonderful. So all right, okay, they had
Speaker 1: made three different classes of edits. The first thing they
Speaker 1: did was they removed all the pervs.
Speaker 2: The what's pervs.
Speaker 1: The pervs. Pervs are poor sign anddogenous retroviruses. So the
Speaker 1: pig genome has some viruses in it, and most of
Speaker 1: the time those viruses are either helpful. For example, they
Speaker 1: help with things like placenta formation, and we're going to
Speaker 1: have cap Ohannan on the show in the future to
Speaker 1: talk about how that works. But they also have some
Speaker 1: other viruses that are able to start replicating themselves at
Speaker 1: like sort of random times that we don't really understand
Speaker 1: how they choose when they want to start replicating themselves.
Speaker 1: And we've put these viral particles in plates with human
Speaker 1: cells and it looks like they can infect those human cells.
Speaker 2: Yeah, so you.
Speaker 1: Really don't want to get a pig organ and then
Speaker 1: discover that you are filled with pervs and that you
Speaker 1: are going to die from those viruses.
Speaker 2: Nobody wants a purview organ for sure.
Speaker 1: No, no, absolutely not. No. There's so much material we
Speaker 1: could work with here, but anyway, we won't get to
Speaker 1: too gross. And so they cut out the poor sign
Speaker 1: anddogenous retroviruses to make it so that wouldn't be a problem.
Speaker 1: They had to be pretty clever about how they did
Speaker 1: the cutting, but they made it so that they feel
Speaker 1: like this is no longer a risk to people who
Speaker 1: get these organs. Then the next thing they had to
Speaker 1: do was remove stuff on the pig cells that our
Speaker 1: immune system could use to say, hey, that doesn't belong
Speaker 1: to me. So pig cells have some sugars on them,
Speaker 1: and that's because pigs and humans, you know, diverge something
Speaker 1: like eighty million years ago. We've gone on very separate paths,
Speaker 1: and so our cells look different. And so what they
Speaker 1: did was they went in and they removed these sugars
Speaker 1: from the cells. They essentially depigged these cells so that
Speaker 1: our immune system would be less likely to see it
Speaker 1: and be like, you don't belong here. And then the
Speaker 1: next set of changes that they made were essentially humanizing
Speaker 1: the pig cells. So now on the cells they added
Speaker 1: stuff to make them look more human again so that
Speaker 1: the immune system wouldn't respond. And so my question when
Speaker 1: she told me about that was, well, if we have
Speaker 1: to worry about our immune s system attacking cells with
Speaker 1: pig sugars, why don't you have to worry about the
Speaker 1: pig bodies attacking the human sugars when the pigs are
Speaker 1: growing these organs.
Speaker 2: That was my question too. Yeah, well, but it's such a.
Speaker 1: Cool answer, and I should have known the answer as
Speaker 1: someone who works sort of adjacent to immunology. But anyway,
Speaker 1: the answer is that if you are a fetus, the
Speaker 1: things that you're exposed to when you're a fetus are
Speaker 1: what your body expects. And so if you grow a
Speaker 1: pig from the starting point, like as an embryo, with
Speaker 1: these human sugars, it's immune system is like, oh sweet,
Speaker 1: these sugars belong here, and it doesn't attack them.
Speaker 2: There's no ingrained knowledge in the immune system is just
Speaker 2: trained on examples from when your fetus. It's like a
Speaker 2: blank neural network.
Speaker 1: That's right, that's amazing. Yeah, And so like if fraternal twins,
Speaker 1: so twins that aren't exactly identical, like if they share
Speaker 1: a blood supply, you're more likely to be able to
Speaker 1: do transplants between them because they had that stuff in
Speaker 1: the vironments, so their immune systems less likely to attack it. Incredible. Okay,
Speaker 1: so those are the three changes that were made. Let's
Speaker 1: take a break, and when we come back, I'll tell
Speaker 1: you about what they did once they had crispired all
Speaker 1: of that stuff into existence. All right. So what Egenesis
Speaker 1: did is they collected cells from the ears of one
Speaker 1: hundred different pigs. They ran their crisper magic to make
Speaker 1: all of those three different classes of changes we talked about.
Speaker 1: They ended up making sixty nine changes total. They took
Speaker 1: an egg from pigs, they pulled out the nucleus in
Speaker 1: the egg, and they put in the genetic material that
Speaker 1: they had just created so with all of the changes,
Speaker 1: and then they grew that up into a pig.
Speaker 2: All right. So because before we're talking about genetic information
Speaker 2: sort of in the abstract. It's just like you have
Speaker 2: DNA in a vial, but it's not part of a cell.
Speaker 2: You're just like writing the code. Now you got to
Speaker 2: load that code into the hardware, so like the whole
Speaker 2: pig cell runs it.
Speaker 1: Yes, cool, And so they did that, and so now
Speaker 1: they have pigs that are adults and are growing these organs,
Speaker 1: and they have all the genetic changes that they put
Speaker 1: in there. And now when these pigs have babies, they
Speaker 1: will also have these genetic changes. So now you have
Speaker 1: lines of pigs that are making organs that should be
Speaker 1: able to go into humans.
Speaker 2: All right, So the first pig is an adult as
Speaker 2: the normal like piggy pervy organs, but you've put cells
Speaker 2: into it that have the edited DNA, and its children
Speaker 2: will have that edited DNA and they will grow up
Speaker 2: and generate the organs without the pervy bits. Is that right?
Speaker 3: Yeah?
Speaker 1: Yeah, So you could take a cell from that pig's ear,
Speaker 1: use Crisper cast nine to make a bunch of edit
Speaker 1: it's inside of that cell. Then take the nucleus out
Speaker 1: of that cell and put it in an egg from
Speaker 1: any pig really could be the same one that you
Speaker 1: took the ear stuff from. Oh, and then you use
Speaker 1: that egg to grow up new pigs.
Speaker 2: All right, wow, and so does it work? Do we
Speaker 2: have baby pigs growing human kidneys or or human is kidneys.
Speaker 1: Well, so the way that you test this stuff, so
Speaker 1: first you tend to try these organs out in like
Speaker 1: macaques or baboons, so you try them out in closely
Speaker 1: related primates and if it works okay in them, then
Speaker 1: you can say, all right, maybe we're ready to jump
Speaker 1: to humans. Sometimes you have an additional step in between,
Speaker 1: where you have a human who has had an accident
Speaker 1: and they've experienced brain death, but their organs are still working,
Speaker 1: and so then you put them on life support and
Speaker 1: you can put a genetically modified organ in them and
Speaker 1: see how their body responds. And so that's a way
Speaker 1: to see.
Speaker 2: You treat them as like a science experiment. Wow.
Speaker 1: Yeah, that's a not so nice way of putting it.
Speaker 1: I would say, you know, if I were in that
Speaker 1: sea situation and someone has to decide, does Kelly's body
Speaker 1: get used to try to like figure out this life
Speaker 1: saving technique and that's her last contribution to the world, Like,
Speaker 1: I would hope that somebody would say yes, because that
Speaker 1: I mean, that feels like it sucks that I died,
Speaker 1: but it would be amazing if I could help build
Speaker 1: the argument that was needed so that we could start
Speaker 1: using this amazing life saving technique in other people.
Speaker 2: And so so yes basically.
Speaker 1: So yes, yes, but you know, families get asked ahead
Speaker 1: of time. You know, it's all of this stuff fascinating.
Speaker 1: It has complicated ethical approvals that are needed ahead of time.
Speaker 1: But so E Genesis did get permission from the Food
Speaker 1: and Drug Administration to try these organs out. I believe
Speaker 1: that they're still getting tried out under what's called compassionate use.
Speaker 1: So it's getting tried out on patients who I believe
Speaker 1: are not able to get on the wait list for
Speaker 1: one reason or another. Like you know, for example, to
Speaker 1: have a blood type that is pretty rare, it's hard
Speaker 1: to find someone who's compatible. The probability that they will
Speaker 1: be on the wait list for longer than and they're
Speaker 1: likely to survive is high. And so we're trying it
Speaker 1: out on these folks, yeah, because it's a good option
Speaker 1: for them given the options they have. And so these
Speaker 1: folks tend to be fifty five to seventy years old
Speaker 1: and they're unlikely to get an organ in the next
Speaker 1: five years. So two of these surgeries have been done,
Speaker 1: and so far both of the people have survived. I
Speaker 1: think these surgeries were done in like February or March,
Speaker 1: and it's June now, and as far as I could
Speaker 1: tell searching through Google, the folks who received these organs
Speaker 1: are still alive and still doing well, which is so amazing.
Speaker 1: And then there's another company called United Therapeutics, and they
Speaker 1: also have used Crisper to modify pig organs. They only
Speaker 1: did ten edits. It sounds like maybe they're keeping their
Speaker 1: fingers crossed that those retroviruses aren't a problem. I don't
Speaker 1: think they did as many edits to those, but this
Speaker 1: is all sort of information that isn't made public. Exactly
Speaker 1: what edits you make probably, so anyway, they've also done
Speaker 1: some transplant experiments using their organs. One of the patients
Speaker 1: who had one of these genetically modified organs had it
Speaker 1: for four months and then her body started to reject
Speaker 1: it for unknown reasons and it had to be removed.
Speaker 1: So it's possible some more tinkering is going to need
Speaker 1: to get done with the pig organs, or we need
Speaker 1: to do a little bit more work figuring out the
Speaker 1: right amount of suppressive drugs. But you know, these organs
Speaker 1: are being trialed out, and if these initial trials go well,
Speaker 1: then the pool of people who could join trials to
Speaker 1: test these organs out will expand. And so that's where
Speaker 1: we are right now. We're kind of trying it out
Speaker 1: to see if we figured out all the changes we
Speaker 1: need to make.
Speaker 2: This feels like we're on the cusp of something really big.
Speaker 2: I mean, if this works, it could really change what
Speaker 2: it means to wait for an organ. How many people
Speaker 2: die waiting for organs. Yeah, it could really change the
Speaker 2: experience of being human and the experience of being pig unfortunately.
Speaker 1: Yeah, yeah, yeah, So these pigs need to be grown
Speaker 1: in facilities where they are absolutely not going to encounter
Speaker 1: additional viruses. So, for example, sometimes the flu can jump
Speaker 1: from birds to people. Sometimes it can jump from pigs
Speaker 1: to people. So you want to make sure that your
Speaker 1: pigs are not encountering any new flu strains. So they
Speaker 1: need to be in these like incredibly biosecure facilities. But yes,
Speaker 1: once you grow up enough of them and you expand
Speaker 1: the facilities, hopefully, you know, with a lot of procedures
Speaker 1: that are ethically you know, compassionate for the lives of
Speaker 1: the pigs, you could have organs that are ready at
Speaker 1: just about any time. So you know, somebody who has
Speaker 1: kidney issues wouldn't have to face down a few years
Speaker 1: of dialysis with the quality of their life is much lower.
Speaker 1: You know, they could discover they need a new kidney
Speaker 1: and they could, you know, have it a month later
Speaker 1: or something like that.
Speaker 2: Yeah, these kidneys are not tailored to an individual human, right,
Speaker 2: they're generically modified so that they're more acceptable to humans broadly.
Speaker 2: But we know the humans are different, right, and some
Speaker 2: humans reject or accept different kidneys. Is it possible that
Speaker 2: some kinds of people will be able to accept pigkinnys
Speaker 2: and others won't.
Speaker 1: I think yes. I think that is a live option.
Speaker 1: So the the woman who had the United Therapeutics kidney
Speaker 1: who eventually rejected it, I think we don't understand why
Speaker 1: she rejected it. It could be that there's some incompatibility
Speaker 1: issue that you know, might be specific to her. Maybe
Speaker 1: we will need to personalize these organs a bit more.
Speaker 1: And I'm sure the three D printing people are saying,
Speaker 1: if you print with your own cells, this will never
Speaker 1: be a problem, when you know that technology isn't here
Speaker 1: yet either. So yes, it could be that more tinkering
Speaker 1: needs to get done. It would have been beautiful if
Speaker 1: everyone who got these genetically modified pig organs accepted them
Speaker 1: with no problems right from the start, But that's that's
Speaker 1: not where we are right now, and.
Speaker 2: Our pig's the only place this is happening. Is there
Speaker 2: any other species that's in contention?
Speaker 1: Nope, just pigs. Wow, as far as I can tell.
Speaker 2: Yeah, So maybe society will get divided in the future
Speaker 2: into people who can accept pig organs and people who can't,
Speaker 2: the piggy people and the non piggy people.
Speaker 1: That's right, that's right, a little bit of levity and
Speaker 1: our otherwise sort of bummer of an episode. But so
Speaker 1: I've got a question you might not know the answer to.
Speaker 1: So there are some cultures that can't eat pork. So
Speaker 1: my husband is Jewish and he's a vegetarian too, so
Speaker 1: it's sort of a non starter. But do you think
Speaker 1: there'd be any rules about accepting organs?
Speaker 2: That is a great question and what I don't know
Speaker 2: the answer to. And one reason that it's a great
Speaker 2: question is that I'm sure the Rabbis will have a
Speaker 2: lot of fun arguing about it, because Rabbis have a
Speaker 2: lot of fun arguing about stuff like this, you know, like,
Speaker 2: can you turn on the light switch on Saturday? No?
Speaker 2: Can you hire someone to turn on the light switch?
Speaker 3: No?
Speaker 2: But can you pay them to do something else and
Speaker 2: then they turn on the light switch. Yes, so there's
Speaker 2: all these like creative ways to like find loopholes to
Speaker 2: satisfy all the requirements, and I think they get a
Speaker 2: lot of joy in arguing about it. So this seems
Speaker 2: like a really juicy question for them.
Speaker 1: That's right, that's right, And I have to admit, like
Speaker 1: I feel a bit uncomfortable. Okay, So since I moved
Speaker 1: on a farm, I have had a much harder time
Speaker 1: eating meat because I encounter the animals that I'm eating
Speaker 1: a lot more, and I have been very surprised by
Speaker 1: how dynamic their personalities are, and how good they are
Speaker 1: with their babies, and how.
Speaker 2: They obviously feel joy and pain.
Speaker 1: That's right, Yes, yes, Seeing like goats get zoomies and
Speaker 1: frolic around a field, You're like, ah, I really enjoy
Speaker 1: you in my euro And now I feel complicated about that.
Speaker 1: But you know, if my daughter needed an organ and
Speaker 1: it was between a pig and my daughter, I wouldn't
Speaker 1: have a hard time with that choice. And I guess
Speaker 1: same with me. So Jane at the start of this
Speaker 1: episode asked if we were to start treating pigs with
Speaker 1: more respect if they became a major source for our organs. Don't. Actually,
Speaker 1: I don't see that happening, to be honest, I think the.
Speaker 2: Opposite is true. No, I think the more useful they are,
Speaker 2: the more we convince ourselves that they're just things and
Speaker 2: not like people.
Speaker 1: Yeah. So for me, the more I encounter farm animals,
Speaker 1: the more I want to either not eat them or
Speaker 1: only eat animals that had really good lives, Like I
Speaker 1: feel more and more uncomfortable about factory farms. But I
Speaker 1: think that most of us are not seeing or engaging
Speaker 1: with these animals that we end up eating or you know,
Speaker 1: that are part of the various processes for products that
Speaker 1: we use in our lives, like leather or whatever. And
Speaker 1: so I don't see us treating animals nicer as long
Speaker 1: as we are not encountering them more and like needing
Speaker 1: to see what it looks like to get this done.
Speaker 1: I hope that we'll treat them ethically. It does seem
Speaker 1: like over time there have been more rules for treating
Speaker 1: animals ethically and trying to give them a nice life
Speaker 1: for as long as they've got it. But I, yeah,
Speaker 1: I don't think this is going to change things.
Speaker 2: Well, let's take a positive view if we have pigs
Speaker 2: that can grow organs for humans. It means more humans survive,
Speaker 2: and it means more jobs for philosophers to figure out
Speaker 2: whether or not we are bad people, and jobs for
Speaker 2: rabbis to answer these questions. So everybody wins except the pigs.
Speaker 2: I guess.
Speaker 1: Yeah. Okay, Well, so I'd like to end on a
Speaker 1: slightly high notes. So first of all, I don't know
Speaker 1: if this is a high note, but we already eat
Speaker 1: a lot of pigs, so this is apparently something where
Speaker 1: for the most part, already comfortable with. But let's focus
Speaker 1: for a second on how much amazing stuff we had
Speaker 1: to learn to get where we are today. You know,
Speaker 1: like we are harnessing bacteria's immune response to create organs
Speaker 1: that could save the lives of like over one hundred
Speaker 1: thousand people who are on the wait list right now.
Speaker 1: It is amazing to me that we have figured out
Speaker 1: how to get this far, like just the many giants
Speaker 1: whose shoulders we had to stand on to get to
Speaker 1: where we are today. And if this works, the suffering
Speaker 1: of many, many, many people could be alleviated, a lot
Speaker 1: more people could survive, and the people who are waiting
Speaker 1: for organs would have a much higher quality of life.
Speaker 1: I can't help but be inspired. Even though you know
Speaker 1: everything that has to do with humans seems like it's
Speaker 1: ethically complicated.
Speaker 2: It does. Yeah. On the other hand, I want to
Speaker 2: live and I want my kids to live.
Speaker 1: Yes, amen, And this might be a path towards making
Speaker 1: that happen for a lot of people. So I'm wishing
Speaker 1: them luck. And thank you to Wenningchin for chatting with
Speaker 1: me and for making me even more excited about this.
Speaker 1: Your enthusiasm was contagious.
Speaker 2: And thank you very much to Jane for sending us
Speaker 2: your question. And if you have a question about any
Speaker 2: kind of science you'd like to hear us breakdown, please
Speaker 2: write to us questions at Daniel and Kelly dot org.
Speaker 1: And let's close out by seeing what Jane thought about
Speaker 1: our episode.
Speaker 3: Hi, Daniel and Kelly, I'm so glad that my question
Speaker 3: spot such a super interesting discussion. Did you answer my
Speaker 3: question well, yes, but by giving me even more ethical
Speaker 3: and philosophical conundrums to worry about. I can't comment on
Speaker 3: the rabbi's response, but as a Christian pastor, I hold
Speaker 3: a high view of humanity. I've been on the ukogn
Speaker 3: done a register for decades, and it really suddens me
Speaker 3: that there are not enough people willing to donate organs
Speaker 3: that they've finished with. I just worry that this will
Speaker 3: be one more exciting scientific breakthrough which is pushed through
Speaker 3: without serious ethical consideration. Thank you so much, Kelly for
Speaker 3: looking into this and sharing your wonder and enthusiasm with us.
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