'Xeno' takes a memorable trip to the cutting edge of transplants

The Xeno Chronicles: Two Years on the Frontier of Medicine Inside Harvard’s Transplant Research Lab, By G. Wayne Miller, Public Affairs, 233 pp., $26

You might be disappointed if you discover ''The Xeno Chronicles" at your bookstore and think it is about a beautiful Amazon woman. But not for long. ''The Xeno Chronicles" is a carefully wrought day-to-day journal by G. Wayne Miller, staff writer for The Providence Journal, about the successes and failures of xenotransplantation, ''the use of live animal tissues and organs to heal sick people." ''Xeno," a Greek prefix, means ''guest or stranger." Despite progress in the lab, the practice has not been perfected.

Miller, who has also written books about molecular biology and open heart surgery, got permission from Dr. David H. Sachs, director of the Transplantation Biology Research Center, a division of Massachusetts General Hospital and an affiliate of Harvard Medical School, to monitor what Sachs is doing in this field. Sachs is responsible for conventional transplantations and is, according to Miller, ''the leading figure in xeno." The author was permitted unlimited access to Sachs's lab, people, and to the doctor himself. He stayed for two years. The only thing he couldn't do was take photos of the baboons. Sachs feared ''that animal rights activists might get pictures of them and alter them for their use in their cause."

Xenotransplantation controversies are obvious. ''What would such a person be -- part animal, part human?" Miller asks. There is the threat of disease from transmission. There may be a previously unknown virus. Animal rights activists oppose exploitation. Then there's the issue of extending life beyond what some call ''God's plan." The Catholic Church has given its view through its Pontifical Academy for Life: ''The sacrifice of animals can be justified only if required to achieve an important benefit for man, as is the case with xenotransplantation."

Money is a factor. To sponsor such experimentation, big business requires what is known as ''bringing a product to market" -- a Salomon Brothers study estimated it could be a $6 billion market by 2010.

To continue his experiments, Sachs settled on ''Goldie," a 21-pound miniature swine. Goldie was, Miller writes, ''cloned from a cell genetically engineered to remove or 'knock out' both copies of a gene that produces a sugar molecule that sets off a violent rejection when organs are transplanted into another species. A pig was chosen because its organs are approximate to humans' in size and function. Also, more than 100 million are slaughtered in the US each year without a major outcry from anyone." Thus, ''Goldie offered hope to more than 80,000 Americans awaiting organ transplants."

What did Goldie give up? Her heart, kidneys, thymus, and bone marrow were transplanted into four baboons, Miller records. In these cases, as well as with humans, the Holy Grail is tolerance, Miller reports: ''eliminating the lifelong need for immunosuppressive drugs that a recipient must take to prevent rejection." Dr. Kazuhiko Yamada, one of Sachs's senior fellows, puts it best: ''To achieve this goal -- to find the best regimen to induce tolerance -- will be very hard. . . . It's trial and error, trial and error."

Sachs takes the long view. He sees the process as a developmental one. ''I love to think what will happen -- all that we are doing, transplantation, will disappear someday because we'll have ways of regenerating organs."

Dr. Samuel Johnson had James Boswell, and Dr. Sachs has G. Wayne Miller. The author has written a page-turner with good humor and elan, a memorable account of a fine scientist and his team on the cusp of life-saving research.