Swine Of The Times: Pig-to-Human Organ Transplants On Track For 2021

Every day in the US, seventeen people die because they couldn’t get a organ transplant in time. An American biotech company called United Therapeutics is looking to pick up the lifesaving slack by producing a line of genetically-modified pigs for the purpose of harvesting their organs, among other therapeutic uses. United Therapeutics’ pig-farming subsidiary Revivicor is a spin-off of PPL Therapeutics, the company that gave us Dolly the cloned sheep back in 1996. They intend to start transplanting pig organs into humans as early as this year.

Baby Fae after transplant surgery. Image by Duane Miller-AP via Time Magazine

Although it sounds like science fiction, the idea of transplanting animal cells, organs, and tissue into humans has been around for over a hundred years. The main problem with xenotransplantation is that it usually triggers severe immune system reactions in the recipient’s body. In one of the more noteworthy cases, a baby girl received a baboon heart in 1984, but died a few weeks later because her body rejected the organ.

The leading cause of xenotransplant rejection is a sugar called alpha-gal. This sugar appears on the cell surfaces of all non-primate mammals. Alpha-gal is problematic for other reasons, too: a condition called alpha-gal syndrome usually begins when a Lone Star tick bites a person and transmits alpha-gal cells from the blood of animals they have bitten. From that point on, the person will experience an allergic reaction when eating red meat such as beef, pork, and lamb.

Pigs with Purpose

A litter of lifesaving piglets. Image via Revivicor

Pig heart valves have been used as replacements in humans since the 1960s, but in those cases, the tissue is chemically treated to kill off the cells including the alpha-gal sugar. Presumably, this won’t work for organs like kidneys, hearts, and livers, so they’re starting with the genes.

According to the interview with Future Human, Revivicor’s latest GMO pig has a total of ten modifications that are designed to aid in transplant acceptance. They turned off four pig genes including the one that produces alpha-gal, and added six human genes. One of the added human genes causes the pigs to produce an immune system-moderating protein called CD46.

Bridging the Gap

More people need a kidney than any other organ, so the company plans to start human trials with kidneys and move on to heart transplants in the future. In December 2020, the Food and Drug Administration (FDA) certified these so-called GalSafe pigs as fit for human consumption and therapeutic use. Although Revivicor doesn’t intend to produce GalSafe pigs for an allergy-free alternative for people with alpha-gal syndrome anytime soon, the door is certainly open for other companies to do so.

In 2016, Revivicor and researchers from the National Institutes of Health reported that they had been able to keep pigs’ hearts alive inside baboons for two and a half years. However, these weren’t direct transplant situations — the baboons kept their original hearts and hosted the pigs hearts in their abdomens.

Genetically modified alpha-gal-free pigs could help the organ transplant crisis, though it’s unclear at this point how long the organs will last once transplanted into humans. Revivicor and United Therapeutics hope they can last the rest of a person’s life, or at least long enough until they can get a human organ to replace it. Even if this only ends up being a stopgap until a better alternative arives, it could save many lives. What do you think?

73 thoughts on “Swine Of The Times: Pig-to-Human Organ Transplants On Track For 2021

    1. I think you misunderstand. It is the lone-star tick (and a tick from Sweden) which may cause the Mammalian Meat Allergy (MMA) due to direct to blood introduction of the disaccharide alpha-gal. As noted by the post, the meat of these pigs may actually be safe for suffers of MMA to eat.

      As an animal, I object to your desire to cause distress to another animal, as inducing MMA, as you seem to evince, would be inducing a life threatening conditioning in said animal.

      As an aside, I hope that you realize that your vegan outlook, taken to it’s logical conclusion, may result in the destruction of every animal that is dependent on humans. How very anti animal.

          1. I used to work on a lot of porcine animal studies for cardiac catheter testing, those pigs are so doped up during procedures that even if you only took the heart I don’t think anyone would want the meat that is full of euthanasia chemicals afterward. Sleeepy Bacon…. But Note, unlike a killing floor where the pig is brutally slaughtered, animals raised and used in animal studies usually have a baller life full of all you can eat super high fat diets and are put down gently. Doctors clearly understand they are taking the life of the animal and don’t feel good about it but realize it is a trade off for saving human lives down the road. Unlike bacon which is delicious and while people think they will die without it, they won’t.

          2. @ chaz: In the end any drug reaction is dose dependent and we know that some people intentionally consume high doses of psychopharmaca or sleeping medicines to “get high”. So we just need to sell the sleeepy bacon to the right customers :-)

      1. For me, it’s not the Vegan outlook per-se, it’s the outlook that his personal decision should be applied to others.

        Feel free to argue the position with facts and anecdotes, but note that virtually nothing is black-and-white. There are advantages and disadvantages to every decision, and your lifestyle choices might work for you, while at the same time be a poor choice for others due to differing circumstances.

        This is generally true for all life decisions, and we need to navigate our lives through compromise and the acceptance of the decisions of others.

        1. You are a better person than I, with that outlook. It has been my experience however, that the newly converted of any evangelical religion can be very fervent in the spread of said religion. I have absolutely no problems with vegetarians, but vegans have always struck me as being converts to a very evangelical religion. To misquote, your right to your beliefs end where they interfere with my own.

        2. Exactly!

          In the case of eating meat it seems to me stupid to suggest humans should never ever do so, you can’t grow all the crops needed for a healthy vegan diet everywhere, you have to manage the number of deer etc anyway so its stupid to waste that resource. In some areas of the world its only eating the local animals that can keep the local humans alive, its how nature is…

          If you want to choose something for yourself that is fine, but to suggest pushing that on others is a bad idea. By all means talk to them about it, show them how you live the way you do, its pro’s and con’s, you may convince them.

          But a pig being a hopefully useful organ supply as well as food and leather supply seems to me just makes eating them more likely, why waste anything?

      1. Same. I even feel like I should probably go vegetarian for ethical and health reasons, but that vegan “one of us” outlook is so similar to extremist religion that it turns me off to the whole idea. Vegans probably turn more people off of vegetarianism than they convince.

  1. “it’s unclear at this point how long the organs will last once transplanted into humans”

    Which is precisely why they need to perform transplants, to find out. Then they find the next “alpha-gal” and make more modifications. Rinse and repeat until all genetic compatibility issues have been overcome.

      1. Hehe, like the idea, but do remember that paragon of fun and foresight Douglas Adams and his case study of the telephone sanitizers an entire civilisation lost, and a mess of a new one created…

        How about just put them in the folks that need organs, and sign up to be ‘beta’ testers knowingly as they may just get to live longer out of it, rather than rounding up the useless windbags for testing.

        (Though I would value some CEO rather more than you – the good ones understand the product they are creating, are good at the organisation and decision making type stuff. Like or loath Musk for example there is no doubt he’s been part of creating some impressive stuff…)

      2. If you were given a choice between a GM pig organ and certain death, wouldn’t you “pig out”?

        In many cases, using humans as guinea pigs is the most reasonable and ethical choice.

        1. I certainly would accept my death as unavoidable. Looking at the low success rate and low quality of life of most people with transplanted organs I decided long time ago that I would neither be a donor or accept a donor organ in my body.

          1. Well, I’d like to hear from you again, if you would ever in the position to decide: die, or transplant, even if that means lower life quality. Might be still higher than no life.

            But lets hope, neither you nor me (nor anyone else) have to ever make that decision .. (might save some pigs too).

            But reality is, many people are hoping for it, as it would still improve their life.

    1. The part of the Islamic and Jewish law that you are referring to is about the consumption of “unclean” food. I guess it will depend on if an organ transplant would be considered consumption. As I understand it, it is only a small portion of the Christian religion that currently considers human blood transfusion (blood transplant?) consumption of human flesh and as such, disallowed by their version of a religious text.

      1. I asked a muslim once ans she told me that its acceptable to accept a pig valve transplant in the heart if it could save your life. She was not very fanatic so maybe this is not the mainstream opinion.

      2. Muslims and Jews object to pork, and it’s the animal, not the consumption, which is the issue. These animals are unclean for them.

        Christians have no objections to specific animals.

        7th day Adventists (which are more or less a spin-off cult from Christianity, and very definitely not mainstream) object to eating blood and blood transfusions, because blood is seen as carrying the life/essence of a creature – this stems from prohibitions in the Bible against cultic rituals involving blood (which varied from the “if I eat the tiger’s blood I will gain it’s strength” type, to human sacrifice). However, the context of these is clearly about worship, and not culinary or medicine, so black pudding and blood transfusions are not prohibited by the Bible.

        Most Christians object to medical products made from embryonic stem cells, because these involve the destruction of an embryo. This is because christians believe that humans are human from conception, rather than magically becoming human at 24 weeks or during the birth. Thus destroying them is murder, or at best akin to drugging people and stealing their kidneys. They have no objection to adult stem cell therapies (except where they’re confused).

        1. 7th day adventists don’t object on blood transplants (they even have a blood donation program), and last time I checked, they have around 25 million members worldwide – so that’s would count as mainstream on my book.

  2. I’m pretty sure I remember reading that this was right around the corner in the early 1990s. And that’s about as far back as I would have been reading that kind of article. Is there something new here? Is it really happening now?

    1. It was probably a case of seeing the path but not having the money. Genetic sequencing was a super high dollar thing then, they would have needed the resources of maybe half a dozen supercomputers, and genetic splicing methods were primitive, so it would have been very trial and error. So then probably required billions of dollars to do, now probably 10 million got the ball rolling. Sequencing the human genome was reckoned to be a $5 billion in 2020 dollars project, which took until 2003 to do. Pig genome got sequenced by 2012, for a heck of a lot less I presume.

    2. The new part would be identifying a feature of non-primate mammal tissue that may causes allergic reactions in primate mammals combined with some more powerful genetic manipulation capabilities. It would be my guess that an allergic reaction to transplanted tissue would lead to transplant rejection. I’m not researching it right now, but I remember the Mammalian Meat Allergy and possible trigger with respect to alpha-gal being post 2000 kinda thing.

  3. “the baboons kept their original hearts and hosted the pigs hearts in their abdomens.” Where exactly does science cross a line? Worked at a school venting one of their labs in the basement many years ago, at night so as not to disturb the students, in said basement among the laboratories. In the labs, even in the halls outside the labs, were cages with some sort of monkey inside, under various restraints, with some of them having their entire body in the cage with only their head poking up through the top of the cage. From there, part of the head was shaved with various sensors embedded into the skull through what looked like a surgical procedure, as they weren’t sticky sensors. I am wondering, what if we really knew the extent of experiments done in the name of science, loosely tied to in the name of humanities future, how far could science go before one says ” that doesn’t seem right”.

    1. It does seem gruesome, for sure. But you’ll note that what they didn’t do was significantly worse — removing the baboon’s heart and testing it that way.

      “Science” tries to minimize damage to animals, and there are a ton of alternatives to actually using animals these days — better models and so on.

      “how far could science go?”

      For the public: https://grants.nih.gov/grants/policy/air/NIH_ensure_welfare.htm
      And the actual rules, for scientists: https://grants.nih.gov/grants/policy/air/training_events.htm

      1. “How far can science go?”

        We do what we must because we can
        For the good of all of us
        Except the ones who are dead

        In all seriousness, whilst testing this kind of stuff on primates when there’s a significant chance to save human lives is fine – though should still be minimised as much as possible – the risk is that we can become desensitised to it, and start animal testing cosmetics or doing increasingly tenuous experiments because they “might” find something.

  4. I think that before transgenic pigs become available, it would be better to change the law in every country, so one must sign a document/card that he/she wishes not to donate organs. And this declaration should be included on the ID. Many people don’t care either way and are too lazy to do the paperwork anyway. Most organs are rejected anyway for one reason or another…

    There is a good book that covers early transplantology, “Patients” by Jurgen Thorwald. I highly recommend all his books on history of surgery…

    1. Read up on the CCP’s highly successful organ “transplant” industry. No shortages of transplant organs and no burdensome permission paperwork. In fact, there’s no need for genetically modified pigs when there are so many political dissidents available to part out.

    2. So, basically, if the get an ER patient, with no paperwork, it’s okay to harvest?

      Any surgery, has associated risks. Even human donations, get rejected, or fail. We naturally tend celebrate the success stories, and hope to forget the failures. They are modifying the pig DNA, to get a product to sell. But, are the modifications going to benefit the pig in anyway, or cause problems? Not that it really matters to the pig, since it will get slaughtered, soon as the product is ready to use. The sugar coating serves some purpose to the pig’s health, other than preventing their organs being harvested for transplant. Wouldn’t turning off some genes, activate others, to compensate? I get the impression, that the only way to figure these things out, is to randomly poke around a little, and see how it works out. A little reckless in the approach, but what else are you going to do.

    3. No.

      Firstly, my organs are my organs, not the state’s. If I choose to donate, that’s my choice, but it should never be assumed.

      Secondly, this treads a quick path to doctors prematurely harvesting organs to help better paying / politically favoured / younger / whiter / etc patients.

    4. It’s the case in France, well in theory.
      They changed the law to requires opposition instead of explicit donation.
      In effect it gives the deceased family the power to object at will…

  5. I had a double lung transplant 12 years ago and unfortunately I’m not able to receive another because my 1 year survival rate is too low. If there were more organs then my dying wouldn’t be such a problem and we’d take the risk.
    A problem that comes after your first, second or even third transplant is by that stage other organs have started to fail due to the immunosuppressive drugs. These drugs are very often nephrotoxic to the kidneys.
    After living with poor lung function for so long, some people also need a heart transplant as the heart has been working too hard causing walls to thicken or chambers to widen (Cardiomegaly). Think about it, if you’re breathing with less than half lung function, your heart has to work that much harder to maintain your SpO2, so your HR might be like 90-110 resting.
    I used to live near a piggery 🤔

  6. I’m curious as to whether Revivicor is investigating using the colons from their GMO piggies in humans. I’d bet there are plenty of colon cancer survivors who would love to skip their bag changing rituals. Yes I know about J pouch surgery but its only a “good” option because its the only option besides shitting in a bag for the rest of your life.

  7. Seems ideally we’d want to genetically engineer the pigs to be genetically more identical to the recipients in regards to the rejection concern, so having the least amount of complications and maintenance post transplant. I mean, outside of autograph methods of harvesting, culturing and growing our own organs in healthier/healthiest states… where actually, just repairing our organs to a younger state seems the most logical and least morbid.

    That would be a novel idea… grow your own organ sources. The industry would be based on the service of engineering the desired organs for the recipients and the surgical and pre- and post op system.

    Big greedy unethical pharma won’t like that… though they’ll still be able to get a cut out of the system.

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