Reprint: The Moral Amgiguity of Xenotransplantation

 

Putting pig organs in people is OK in the US, but growing human organs in pigs is not – why is that?

While research on human-pig chimeras is on an indefinite pause, xenotransplantation is moving ahead. wildpixel/iStock via Getty Images Plus

Monika Piotrowska, University at Albany, State University of New York

In a New York operating room one day in October 2025, doctors made medical history by transplanting a genetically modified pig kidney into a living patient as part of a clinical trial. The kidney had been engineered to mimic human tissue and was grown in a pig, as an alternative to waiting around for a human organ donor who might never come. For decades, this idea lived at the edge of science fiction. Now it’s on the table, literally.

The patient is one of six taking part in the first clinical trial of pig-to-human kidney transplants. The goal: to see whether gene-edited pig kidneys can safely replace failing human ones.

A decade ago, scientists were chasing a different solution. Instead of editing the genes of pigs to make their organs human-friendly, they tried to grow human organs – made entirely of human cells – inside pigs. But in 2015 the National Institutes of Health paused funding for that work to consider its ethical risks. The pause remains today.

As a bioethicist and philosopher who has spent years studying the ethics of using organs grown in animals – including serving on an NIH-funded national working group examining oversight for research on human-animal chimeras – I was perplexed by the decision. The ban assumed the danger was making pigs too human. Yet regulators now seem comfortable making humans a little more pig.

Why is it considered ethical to put pig organs in humans but not to grow human organs in pigs?

Urgent need drives xenotransplantation

It’s easy to overlook the desperation driving these experiments. More than 100,000 Americans are waiting for organ transplants. Demand overwhelms supply, and thousands die each year before one becomes available.

For decades, scientists have looked across species for help – from baboon hearts in the 1960s to genetically altered pigs today. The challenge has always been the immune system. The body treats cells it does not recognize as part of itself as invaders. As a result, it destroys them.

A recent case underscores this fragility. A man in New Hampshire received a gene-edited pig kidney in January 2025. Nine months later, it had to be removed because its function was declining. While this partial success gave scientists hope, it was also a reminder that rejection remains a central problem for transplanting organs across species, also known as xenotransplantation.

Decades of research have led to the first clinical trial of pig kidney transplants.

Researchers are attempting to work around transplant rejection by creating an organ the human body might tolerate, inserting a few human genes and deleting some pig ones. Still, recipients of these gene-edited pig organs need powerful drugs to suppress the immune system both during and long after the transplant procedure, and even this may not prevent rejection. Even human-to-human transplants require lifelong immunosuppressants.

That’s why another approach – growing organs from a patient’s own cells – looked promising. This involved disabling the genes that let pig embryos form a kidney and injecting human stem cells into the embryo to fill the gap where a kidney would be. As a result, the pig embryo would grow a kidney genetically matched to a future patient, theoretically eliminating the risk of rejection.

Although simple in concept, the execution is technically complex because human and pig cells develop at different speeds. Even so, five years prior to the NIH ban, researchers had already done something similar by growing a mouse pancreas inside a rat.

Cross-species organ growth was not a fantasy – it was a working proof of concept.

Ethics of creating organs in other species

Short Audiobook Review: Harper Lee's splendid early stories

 The Land of Sweet Forever, by Harper Lee (Harper)

I listened to the audio version of this compilation of Lee's early short fiction and later nonfiction, splendidly narrated by Ellen Burstyn, who is a marvelous actress and perfectly captures Lee’s authorial “voice.” This book is a collection of Lee’s early short fiction and later nonfiction pieces. The stories are explorations of characters, settings, and narrative style that later became To Kill A Mockingbird. They are witty, richly detailed, and courageous. Every one of them is, in its unique fashion, a gem.

Highly recommended.

 

Short Book Review: A Complex, Nuanced Redwinter Adventure

Traitor of Redwinter, by Ed McDonald (Tor)]

I fell in love with Ed McDonald’s “Redwinter Chronicles” from the very first chapter of the very first book. His protagonist, Raine, is at once brilliantly flawed, self-doubting, and heroic. Her capacity for compassion and her clear-eyed courage are matched only by her conviction that she is worthless and unlovable. As an unreliable but deeply sympathetic heroine, she’s unmatched.

All is not well in the world of this second Redwinter novel. The king is dying, and a war of succession is brewing. With famine gripping the north, rebellious lords scheme for the power of the Crown that protects the living world from the forces of evil. Raine thought she had found a home in Redwinter, where those with magical powers can learn and flourish. But her mentor, Ulovar, is suddenly struck by a mysterious illness that slowly saps the vitality from his body, and her new friendships prove unexpectedly fragile. Meanwhile, the darkness within her grows, fueled by a mystical book that should not exist and that would mean her death should it be discovered. Everything comes crashing down when her erstwhile friend, Ovitus, puts together a new alliance to challenge the existing politics and wrest all power to himself.

Traitor of Redwinter is a complex, nuanced fantasy novel that does not hold back from difficult choices and dark themes. It builds on the events and system of magic from the first volume, shattering the established world and challenging notions of good and evil. It’s a brilliant, moving, ultimately compassionate tour de force.

Highly recommended, with the proviso that it’s not a stand-alone. Read the first volume first.

Reprint: How Writing Builds Resilience

 As a writer, I find this to be doubly true for fiction. Except for the part about writing by hand. I think it's fine to compose stories, especially novels, on a keyboard.

Writing builds resilience by changing your brain, helping you face everyday challenges

Writing is a way of thinking and doing. AscentXmedia/iStock via Getty Images Plus

Emily Ronay Johnston, University of California, Merced

Ordinary and universal, the act of writing changes the brain. From dashing off a heated text message to composing an op-ed, writing allows you to, at once, name your pain and create distance from it. Writing can shift your mental state from overwhelm and despair to grounded clarity — a shift that reflects resilience.

Psychology, the media and the wellness industry shape public perceptions of resilience: Social scientists study it, journalists celebrate it, and wellness brands sell it.

They all tell a similar story: Resilience is an individual quality that people can strengthen with effort. The American Psychological Association defines resilience as an ongoing process of personal growth through life’s challenges. News headlines routinely praise individuals who refuse to give up or find silver linings in times of hardship. The wellness industry promotes relentless self-improvement as the path to resilience.

In my work as a professor of writing studies, I research how people use writing to navigate trauma and practice resilience. I have witnessed thousands of students turn to the written word to work through emotions and find a sense of belonging. Their writing habits suggest that writing fosters resilience. Insights from psychology and neuroscience can help explain how.

Writing rewires the brain

In the 1980s, psychologist James Pennebaker developed a therapeutic technique called expressive writing to help patients process trauma and psychological challenges. With this technique, continuously journaling about something painful helps create mental distance from the experience and eases its cognitive load.

In other words, externalizing emotional distress through writing fosters safety. Expressive writing turns pain into a metaphorical book on a shelf, ready to be reopened with intention. It signals the brain, “You don’t need to carry this anymore.”

Sometimes you can write your way through difficult emotions. Grace Cary/Moment via Getty Images

Translating emotions and thoughts into words on paper is a complex mental task. It involves retrieving memories and planning what to do with them, engaging brain areas associated with memory and decision-making. It also involves putting those memories into language, activating the brain’s visual and motor systems.

Writing things down supports memory consolidation — the brain’s conversion of short-term memories into long-term ones. The process of integration makes it possible for people to reframe painful experiences and manage their emotions. In essence, writing can help free the mind to be in the here and now.

Taking action through writing

The state of presence that writing can elicit is not just an abstract feeling; it reflects complex activity in the nervous system.

Brain imaging studies show that putting feelings into words helps regulate emotions. Labeling emotions — whether through expletives and emojis or carefully chosen words — has multiple benefits. It calms the amygdala, a cluster of neurons that detects threat and triggers the fear response: fight, flight, freeze or fawn. It also engages the prefrontal cortex, a part of the brain that supports goal-setting and problem-solving.

In other words, the simple act of naming your emotions can help you shift from reaction to response. Instead of identifying with your feelings and mistaking them for facts, writing can help you simply become aware of what’s arising and prepare for deliberate action.

Even mundane writing tasks like making a to-do list stimulate parts of the brain involved in reasoning and decision-making, helping you regain focus.

Making meaning through writing

Short Book Review: A Romance Writer's Murder Confession

The Ghost Writer, by Alessandra Torre (Thomas & Mercer)

I first met Alessandra Torre through InkersCon, which offers in-person and virtual conferences for writers, mostly but not exclusively self-published romance writers. I found the virtual events energizing and worthwhile, in no small part due to Alessandra’s passion and knowledge. She often references her own work, comprising romance, contemporary fiction, and suspense/thriller (as A. R. Torre), so I decided to check it out. I knew she could teach (and organize!), but was this an instance of “those who cannot do, teach”? The answer was a resounding “No!” The Ghost Writer came out in 2017 and falls under the loose category of “domestic thriller.” It’s a gripping page-turner fired by the obsession of the narrator, a romance novelist named Helena Ross. At the beginning, Helena lets us know that she is dying (from cancer for which she inexplicably refuses to undergo treatment), that she is an utter perfectionist who cannot tolerate frailty in either herself or others (like her agent or her rival to the title Queen of Romance), and that, in her words, her final book is not a novel but a confession. If that isn’t enough, she has only three months to live, and every day the cancer steals more energy and focus. The only thing to do is hire a ghost writer, and the most likely—the only viable candidate—is her rival. This description falls far short of Helena’s vivid, idiosyncratic voice, the steadily increasing dramatic tension, the whiplash turns and revelations, and the ultimately satisfying if tragic ending.

Torre doesn’t pull any punches; she plays fair with the reader every step of the way in both what she hides, what she reveals, and how she creates one delusional “down the rabbithole” path after another. The book is an exemplar of precisely timed, nuanced details, superb handling of dramatic tension, and compelling emotions.