“I also find your sense of entitlement trying,” Jack said. “I suppose you think it’s entirely appropriate to have me shanghaied out of your hospital and brought here whether I wanted to come or not and then forced to listen to a lecture about your business problems. The irony is that I did want to come, but not under these circumstances. I’m interested in the deaths of two young women and the possibility of a new pandemic with a heretofore unknown virus.”
“I’m getting to that,” Wei retorted.
“You could have fooled me,” Jack snapped back.
For a few beats the two men looked daggers at each other across the small table. The tension in the air was as palpable as static electricity. Jack in particular was struggling to rein in the churning emotions that had been honed to the breaking point. The helplessness he felt in the face of Emma’s plight combined with the events of the past week—being forced out on leave, having to deal with his in-laws, being manhandled out of a community hospital, and possibly being shot at—had him on the edge of the precipice. Getting harangued by someone he was beginning to believe was probably a narcissistic megalomaniac was almost too much to bear.
“Maybe we should have beers instead of pomegranate juice,” Wei said, breaking the tense silence. He got up, went to the refrigerator, and retrieved two bottles of Tsingtao. Returning to the table, he pushed one in front of Jack, then popped the top on his. Although Jack questioned the advisability of alcohol in his state, he went along. They both took long pulls.
“Okay,” Wei said. “Back to how many people die every day in this country waiting for an organ. The answer is about twenty to twenty-two people. There are over a hundred thousand people on the UNOS waiting list, and almost one hundred fifty are added to the list every day. All of them are suffering. Why this is such a tragedy is that there is a solution to this problem. It is pig organs.”
“Xenotransplantation?” Jack said. “It’s been tried. The rejection phenomena make it prohibitive.”
“That was before CRISPR/CAS9 was available,” Wei told him. “This new gene tool is a game-changer.”
Jack suddenly put his beer down on the table and eyed Wei. His jaw slowly dropped open. He was stunned. “Are you trying to tell me that Carol Stewart and Margaret Sorenson were transplanted with pig hearts?”
“No,” Wei said. “They were transplanted with human hearts grown in pigs.”
“Good God!” Jack exclaimed. He was aghast. “Did these women have any idea of what was happening to them? Did they know they were getting pig hearts?”
“Correction,” Wei said. “As I already said, they were getting human hearts grown in pigs. There is a huge difference, and it is all thanks to CRISPR/CAS9. Essentially these were not only human hearts, but they were customized human hearts immunologically matched to the recipients.”
“But did Carol and Margaret know where the hearts were grown?” Jack asked.
“Absolutely,” Wei said. “We were totally up front with the women. They were both very smart and understood everything. They werescrupulously apprised of the work we have been doing for the last three to four years, including our extensive baboon experiments that started with appropriate-size pig hearts being transplanted into the baboons’ abdomens as assist devices and then later into the chests as full cardiac transplants. We also were able to do some chimpanzee work in my Chinese institute, where we could still get away with it. As astounding as it may sound, we had no fatalities with either species over the entire period.”
“I’m having trouble believing all this,” Jack mumbled.
“Using pig organs for human transplantation is not some way-out idea,” Wei said. “It’s been touted in the scientific journals, and there are a number of companies here in the USA working on this technology at this very moment. Everyone knows it is going to happen. It’s a horse race, and the spoils are going to go to the first company out of the gate. Knowing this, I committed our company to being the winner.”
“So that I completely understand, both Carol Stewart and Margaret Sorenson agreed to be guinea pigs unbeknownst to anyone other than you and your people.”
“That’s correct,” Wei said.
“This is insane,” Jack said. “Why would they be willing to do this?”
“They believed in the evidence we were able to show them,” Wei said. “They also knew that the chances of their getting a donor heart were small to none. Both had been on the UNOS waiting lists for over a year. With the rare blood types of AB-negative and A-negative, they knew their chances were nil, while we could engineer a perfect match.”
“Why was Carol Stewart’s transplant done under somewhat strange circumstances at Manhattan General Hospital?” Jack asked.
“That was an unfortunate timing issue. The reason was that her clinical condition deteriorated rapidly and necessitated she get her transplant prior to Dover Valley Hospital receiving its certification. We didn’t have any choice if she was going to live.”
“So the donor heart she got didn’t come from James Bannon,” Jack said.
“You are correct,” Wei said. “Her new heart came from a cloned pig. We were forced to come up with an alternate story because the procedure was done at MGH, even though it was performed by our Dr. Stephen Friedlander. We were not prepared to announce our breakthrough until we could present both cases five or six months post-operatively.”
“So the Bannon story was all an elaborate ruse to avoid a potential violation investigation by United Network for Organ Sharing,” Jack said disdainfully.
“I suppose you could say that.”
“Good grief!” Jack exclaimed. He ran a nervous hand through his hair. He was dumbfounded about what he was learning. His mind was struggling to comprehend it all while his emotions were like an overstretched, taut piano wire. After a short pause he said, “I was brought out here today purportedly to make a comparison between Carol’s and Margaret’s donor hearts,” he continued. “Dr. Friedlander said that there were technical differences between the two cases but didn’t explain. Was that true, or was that another ruse merely to get me back here?”
“It was true,” Wei said. “With the help of CRISPR/CAS9 we have developed two fundamentally different ways to produce human transplant organs in pigs. Our research has not proved one better than the other. Are you interested in the details? It requires a bit of technical genetic understanding. Would you like to hear? A few minutes ago, you were complaining your patience was waning.”
“Let’s give it a try,” Jack said. He was interested and listening, but he was also getting concerned about being caught in the web of Wei’s world.
“I’ll try to make it brief,” Wei began. “The basic idea in both approaches is to use CRISPR/CAS9 to alter the genetic makeup of pigs to create a customized organ. We started by using the same cloning techniques as were used with Dolly, the first cloned sheep. Once we had created an embryo, we used CRISPR/CAS9 to knock out all sixty-two known porcine retroviruses, called, appropriately enough, PERVs. Fromthis embryo we created a line of pigs with no retroviruses, which we raised in a pathogen-free environment. Are you with me so far?”
