What happens to transplantation when the organ no longer has to come from another human being? In this episode, Gabe Schnickel, MD, MPH, sits down with transplant surgeon, scientist, and author Josh Mezrich, MD for a conversation about xenotransplantation, its remarkable history, and what the field may mean for patients waiting for an organ. Mezrich traces the story from early primate transplants and Baby Fae through the transition to pigs, Dolly the sheep, gene editing, CRISPR, and the first era of genetically modified pig organs being transplanted into humans. Along the way, Schnickel and Mezrich explore a deeper question: if xenotransplantation someday changes where our organs come from, how do we preserve the generosity, compassion, and human connection that have always been at the heart of transplantation? The conversation reflects on the pioneers who built modern transplantation, the personal cost of innovation, and Josh’s idea of the 'courage to succeed': the willingness to learn from failure and keep moving toward something others still believe is impossible. Key Topics Discussed What xenotransplantation is and why this moment feels different from earlier attempts The organ shortage and the promise of genetically modified pig organsHuman donation as an act of connection, generosity, and shared experienceThe early primate era of xenotransplantation, including Keith Reemtsma and Baby FaeWhy pigs became the preferred potential source of organsThe role of alpha-gal, cloning, Dolly the sheep, and CRISPR gene editingDavid Sachs and the scientists who sustained the field through decades of uncertaintyThe pioneers of transplantation, including Joe Murray, Tom Starzl, and Roy CalneThe emotional burden of innovation and what Josh calls the 'courage to succeed'Where xenotransplantation stands today: promise, uncertainty, and the need for realistic expectationsEthics, animal research, immunosuppression, and the path from experimental therapy to broader useWhy hope, community, and a sense of wonder remain central to transplantation Notable Quotes and Ideas “The courage to succeed.” Josh’s phrase for the persistence required not only to tolerate failure, but to keep believing that success is possible. “Another goddamn miracle.” Keith Reemtsma’s ritual at the end of a transplant, and Josh’s reminder not to lose the sense of wonder behind something that can become routine to those who do it every day. Resources Mentioned Every Living Creature: How Xenotransplantation Will Change Our Lives — Joshua D. MezrichWhen Death Becomes Life: Notes from a Transplant Surgeon — Joshua D. Mezrich The Puzzle People — Thomas E. StarzlThe Courage to Fail — Renée C. Fox and Judith P. SwazeyThe Wright Brothers — David McCulloughREIMAGINE Center — reimagine.ucsd.edu About the Guest Joshua D. Mezrich, MD, is a transplant surgeon, scientist, and author at the University of Wisconsin. His writing brings together the history and science of transplantation with the experiences of patients, donors, families, and the clinicians who care for them. He is the author of When Death Becomes Life and Every Living Creature, which explores the history, science, personalities, ethical questions, and promise of xenotransplantation. If this conversation moved you, share it with someone you think needs to hear it. Learn more about the REIMAGINE Center and support our work at reimagine.ucsd.edu. The REIMAGINE Podcast is produced by Leila Adler and Lyndsey Fedorko with music by Geoff Bowman. The views expressed by guests featured on the REIMAGINE Podcast are those of the individual and do not represent the opinions of UC San Diego.
