The Jews — with good reason — are viewed as a contrarian people. Why does the Bible proscribe eating pork? Short answer: Because virtually everybody else in the ancient world ate it.
Swallowing pork is one thing. Swallowing porcine-to-human organ transplants (xenotransplants) is another. The issue isn’t much discussed, but there is still a fog of ignorance and uncomfortableness surrounding it. Are there any halachic prohibitions? Again: The short answer is “no.”
Perhaps surprisingly, xenotransplants are less controversial under halachic law than human organ transplants where, at least for some of the Orthodox, issues of time-of-death and corpse handling arise.
In 1987, Rabbi Yaacov Rakovsky of Hadassah University Hospital gave his blessing to predictions by a visiting British heart specialist that pig hearts would help overcome a shortage of human hearts for transplants. “They asked me in principle, and I said there is no prohibition. It’s forbidden to eat pork, that’s all. It’s permitted to use its organs to save human lives,” the rabbi said.
I raise the issue because a friend of mine is a pioneer in the field. Martine Rothblatt’s daughter, Jenesis, developed primary pulmonary hypertension (PPH), a lung disease that may require a transplant. The blood vessels in the lungs of PPH sufferers suddenly constrict; pushing the blood through the narrowed vessels puts the heart under great stress. There are drugs that temporarily control the symptoms, which include chronic lack of energy and breathlessness. Rothblatt, the futurist who co-founded a GPS systems firm and Sirius Satellite Radio and helped draft a proposed U.N. treaty to regulate the use of information collected by the Human Genome Project, branched out. In addition to her other academic degrees, she received a doctorate under the direction of professor Len Doyal of the University of London for exploration of the bioethics of xenotransplants.
As featured in the current issue of MIT Technology Review, there has been a breakthrough in genetically engineering pig-to-primate organ transplants that might also work in humans.
The researchers say they have kept a pig heart alive in a baboon for 945 days and also reported the longest-ever kidney swap between these species, lasting 136 days. The experiments used organs from pigs “humanized” with the addition of as many as five human genes, a strategy designed to stop organ rejection.
The genetically modified (GM) pigs are being produced in Blacksburg, Va., by Revivicor, a division of the biotechnology company United Therapeutics that has quickly become the largest commercial backer of xenotransplantation research.
Rothblatt says her goal is to create “an unlimited supply of transplantable organs” and to carry out the first successful pig-to-human lung transplant within a few years. In addition to GM pigs, her company is carrying out research on tissue-engineered lungs and cryopreservation of organs. “We’re turning xenotransplantation from what looked like a kind of Apollo-level problem into just an engineering task. We want to make organs come off the assembly line, a dozen per day,” she says. Plans are for a facility able to breed 1,000 pigs a year, complete with a surgical theater and a helipad so organs can be whisked where they are needed.
The challenge has been that animal organs set off a ferocious immune response. In 1984, a California newborn known as “Baby Fae” received a baboon heart that functioned for only three weeks. Pigs are there to be harvested, with organs about the right size. Yet pigs are more distant from humans than baboons, and a Los Angeles woman who got a pig liver in 1992 died within 34 hours.
The solution is GM animals. In 2003, Dr. David Ayares of Revivicor genetically “engineered out” of pigs a sugar molecular lining the blood vessels that had caused rejection. He produced modified pigs whose organs lacked a sugar molecule that normally lines their blood vessels. Since then, other modifications adding human genes have been made. Muhammad Mohiuddin, a transplant surgeon and researcher at the National Heart, Lung, and Blood Institute, in Bethesda, Md., says a heart from one of Revivicor’s pigs lasted 2 1/2 years inside a baboon. This surpassed the prior record of 179 days, achieved by Massachusetts General Hospital. At the University of Pittsburgh, a baboon has been kept alive with a pig kidney for more than four months, a record for the longest “life-sustaining” xenotransplant.
Much challenging work remains ahead. Cloned piglets are a next step.
When Martine Rothblatt says, “I’ve seen the future — and it works,” she should be taken seriously — nothing could be more kosher.
Harold Brackman is a historian and consultant for the Simon Wiesenthal Center.
