Chronicling Sachs’ Organs

If you were going to die of organ failure waiting for an organ from a cadaver, would you accept a pig organ instead?

David H. Sachs ’63 is hoping you will.

Over the past two decades, Sachs has surrounded himself with a handful of the world’s most skilled surgeons and immunologists, as well has two dozen baboons and several hundred inbred miniature pigs.

In “The Xeno Chronicles,” G. Wayne Miller recounts his two years spent in Sachs’ laboratory at Massachusetts General Hospital, where Sachs is the director of the Transplantation Biology Research Center. The result is a revealing look at Sachs’ attempts to transplant organs from pigs into baboons, hoping that if a baboon won’t reject the organ, humans won’t either. And this is where Sachs’ research efforts lie: investigating new ways to prevent baboons’ immune systems from attacking the foreign organs, a task that comes with painstakingly slow progress.

The peek into Sachs’ research group is enlightening at times and disappointingly stiff at others. Miller profiles each of the major players in the field: Kazuhiko “Kaz” Yamada, the Japanese master surgeon; David K.C. Cooper, the old-school British surgeon; and Sachs himself, a New York native who was nearly crippled by polio in the 1940s. But, save a few revealing outbursts in group meetings, Miller has trouble getting any of the players to go off-message, quoting formal-sounding statements in multi-paragraph chunks. They escape from their interviews with their press armor intact.

Miller casts a wide net of narrative, jumping somewhat discordantly between scenes of surgery, group meetings, and debilitated patients who, it’s no surprise, would probably stand to benefit from xenotransplantation technology. There are, however, areas where the narrative excels. He recounts an entertaining history of early attempts at xenotransplantation, most notably the exploits of traveling doctor John R. Brinkley, a snake-oil pusher of the 1920s. Brinkley’s scam was convincing hundreds of American men that they could cure impotence (and restore their all-around vitality) through implanting goat testicles alongside their own gonads.

“The Xeno Chronicles” raises several interesting questions, but, in a slim 206 pages, Miller manages an honest stab at only a few of them. What issues of identity would a pig-organ recipient face? What are the ethics of growing and harvesting pigs solely for their organs—and should we transplant said organs into humans who, having brought themselves to their knees before the medical community, are sick in the first place because they’ve eaten too many pork chops?

Wisely, Miller extensively ponders the arguments of the animal rights crowd in a careful analysis of the ethics of xenotransplantation. In the end, he appears to come down squarely in Sachs’ camp—that such experiments are not only ethical, but probably moral as well, given that they advance the human condition. Still, Miller is appropriately respectful of the opposite position.

“The Xeno Chronicles” leaves the reader with little clue of what the future of xenotransplantion will hold, and whether xenotransplantation or stem cell-generated organs will win the race to supply our species with replacement organs. (The scientific community generally believes that at least one technique will be successful over the long haul.) The cliffhanger is warranted, since a snapshot of scientific research, as Miller provides, will generally give a murky picture of the future, especially, as in Sachs’ case, when funding is running perilously low.

But most disappointingly, Miller dances around perhaps the most important question raised in an examination of biotechnology research. In a society with limited resources for medical research, should we primarily fund treatments and short-term cures, such as xenotransplantation, or should we fund research for preventive measures and long-term cures, such as stem cell technology? This question is at the center of today’s debate on biomedical budgeting, and Miller gives it short thrift. Still, Miller makes us ponder several sticky questions that face all of medical research, and learning them through xenotransplantation is at least an interesting path.

—Staff writer Matthew S. Meisel can be reached at meisel@fas.harvard.edu.