The first successful transplantation of a pig heart into a human was made possible by a gene-editing process; the pig’s heart was modified so that it would be more likely to be taken on by the patient’s body as “self” rather than as “foreign.”
In the early hours of January 7th, the cardiothoracic surgeon Bartley Griffith, unable to sleep, went to his kitchen to make coffee. It was about 2. His usual mug is tall, and he had to remove the stand from his Krups machine in order to fit it. “Next thing I realized, I had coffee all over the floor. I had forgotten to put the cup under,” Griffith told me. “You get a bit wiggly, a bit superstitious.
After Mohiuddin’s team extracted the pig heart, they placed it in a box resembling a high-end automatic breadmaker; the box keeps a transplant heart cold and metabolically active. It pumps a fluid through the heart that is made up of saline, cocaine, and a few other components. The box and the solution were developed by researchers in Sweden. “Every time we import one of these boxes, I have to fill out special forms from the D.E.A.,” Mohiuddin said.
An Irish tale tells of a ruler who loses an arm in battle. Once maimed, a king cannot rule. But a doctor shows up at the king’s door. The doorkeeper, who is half-blind, won’t let him in. The doctor replaces the doorkeeper’s blind eye with a cat’s eye, curing his sight. The doctor then replaces the ruler’s missing arm with a swineherd’s. The doorkeeper with the cat’s eye is said to stay awake at night thereafter, looking for mice.
Transplanting human parts didn’t really get going until the middle of the twentieth century. How could fresh organs be ethically obtained? A kidney, unlike a heart, can be taken from a living donor, and kidney transplants developed earlier. The first kidney transplant with long-term success was performed on the identical twins Ronald and Richard Herrick, two days before Christmas in 1954, by Joseph Murray, in Boston.
Mohiuddin moved to the United States from Pakistan in 1991, when he was twenty-six, to train in cardiac surgery. His first mentor asked him to think about how many patients he could help as a cardiac surgeon, and then asked what he would think if he was told about a field that would help a hundred times more patients. “That was the first fish thrown at me,” Mohiuddin told me. He began research work transplanting organs from hamsters to rats. “And, since then, I have not looked back.
Using baboons in scientific research is itself anathema to many people. Protesters sometimes demonstrated outside the N.I.H. when Mohiuddin worked there. His current lab has no direct entrance from outside the building, and there is security. In 1984, a baboon heart was transplanted into Baby Fae, an infant with congenital heart defects. Baby Fae lived for only twenty days afterward.
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