Monday, October 25, 2021

Will your new kidney come from a pig?


     Kidney from a case of dropsy (Courtesy of St. Bartholomew's Hospital Archives & Museum).

     As someone who recently tried to persuade Massachusetts General Hospital to take one of my kidneys — we’ll get to that — I noted with interest reports last week that a pig kidney has been successfully transplanted into a human.
     The pig-to-human factor isn’t even the most eye-opening aspect of this operation. Since people and pigs were not designed — by nature, by God, your pick — to swap organs, the donor pig was genetically engineered to make its kidney a better fit. The experiment worked. The transplanted kidney functioned for 54 hours.
     And because this cutting-edge procedure couldn’t be tried with one of the 90,000 people currently awaiting a kidney on the transplant list — including my Boston cousin, who was hoping for mine — the kidney was transplanted into a brain-dead patient, which I didn’t even know was a thing.
     The deceased person’s family gave consent, an act of astounding generosity that shouldn’t be overlooked in our what-about-MY-rights? age. Picture it: Your relative dies and is being kept alive on a ventilator.
     A gaggle of scientists rushes over and asks, “Umm, would you mind if we stick a pig kidney into your loved one to see what happens?” And you say “Go ahead.” That family deserves a medal.
     I’m jumping on this story, hoping to get ahead of the chorus of complaint. This medical triumph pokes several hot-buttons for outrage: 1) genetic modification 2) experimentation on animals 3) cross-species medical procedures 4) use of dead people to advance science.
     I’d better leap in with the decent, humane perspective before all the vegans, misanthropes and ministers get into the game.
     While practical application is still long off, this is a marvelous development. There were some 40,000 kidney transplants in the United States last year, but there could have been many more if only more kidneys were available. Half a million Americans, including my cousin, must undergo dialysis to stay alive, a time-consuming, unpleasant procedure. And dangerous: A dozen such patients die every day.

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  1. "Now they survive to become vegetarians." Irony alert! : )

  2. Dealing in hypotheticals here, of course, but if that team of doctors asked me, with Healthcare Power of Attorney, if they could use the aforementioned brain-dead relative for that testing, I'd say Sure without a moment's hesitation, for the simple reason that the body's previous occupant is now done with it. (I assume there would be some discussion of an endpoint to the test, though, to prevent endless postponement of the funeral.)

    I can, however, see the flipside of that scenario, where the family simply doesn't want to consider the request, but is stuck for a polite denial that won't give them a guilt trip over what might have been usefully learned.

    Perhaps the key to a solution here is not what is asked, but when. Publicize the whole pre-deceased testing program in general, and hope that folks will opt-in to it, organ-donor style. One could even argue that it's just for an opportunity to do some further testing, rather than raiding the deceased for spare parts, thus setting them even further away from the desecrating-a-body viewpoint.

    1. I think you have to be upfront about what you want the body for.

  3. As someone who has had two mechanical heart valves for 30 years, they have used pig valves for valve replacement surgery for years. I was young so they go with the mechanical valves, use blood thinner everyday. But from what I understand with the pig valves, they put those in older patients and they can avoid the blood thinners. But to my knowledge the mechanical will last much longer and you can avoid future replacements which can be inconvenient. So looking at the pig for parts isn't really new. We, pigs and humans, must be similar.


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