Radiolab - Return of Alpha Gal

Episode Date: July 24, 2026

Several years ago, in 2016, we told a story about Amy Pearl. For as long as she could remember, Amy loved meat in all its glorious cuts and marbled flavors. And then one day, for seemingly no reason, her body wouldn’t tolerate it.  No steaks. No brisket. No weenies. It made no sense: why couldn’t she eat something that she had routinely enjoyed for decades?  It turned out Amy was not alone. And the answer to her mysterious allergy involved maps, a dancing lone star tick, and a very particular sugar called Alpha Gal.  In this update, we discover that our troubles with Alpha Gal go way beyond food. We go to NYU Langone Health hospital to see the second ever transplant of a kidney from a pig into a human, talk to some people at Revivicor, the company that bred the pig in question, and go back to Amy to find out what she thinks about this brave new world. The original episode was reported by Latif Nasser, and produced by Annie McEwen and Matt Kielty. Sound design and scoring from Dylan Keefe, Annie McEwen, and Matt Kielty. Mix by Dylan Keefe with Arianne Wack. The update was reported and produced by Sarah Qari. It was sound designed, scored, and mixed by Jeremy Bloom.  Support Radiolab by becoming a member today at Radiolab.org/donate.    Sign up for our newsletter!! It includes short essays, recommendations, and details about other ways to interact with the show. Signup (https://radiolab.org/newsletter)! Radiolab is supported by listeners like you. Support Radiolab by becoming a member of The Lab (https://members.radiolab.org/) today. Follow our show on Instagram, Twitter and Facebook @radiolab, and share your thoughts with us by emailing [e-mail] support for Radiolab’s science programming is provided by the Simons Foundation and the John Templeton Foundation. Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Hello, it's Lulu. It's summer here in the Northern Hemisphere, which means the ticks. The ticks are out. And also the barbecues are out, you know, hot dogs, hamburgers, ticks and burning meat, which made me think of today's episode, which combines the two into a wildly eerie, scary, but perhaps hopeful, ethically complex tale. It's one of my all-time favorite radio labs and we're going to play it for you. you today. It is 10 years old, but lucky for you. It has a pretty thrilling scientific update at the end. So here we go. Wait, wait, you're listening. Okay. All right. Okay.

All right. You're listening to Radio Lab. Radio Lab. From W. N. Y. C. See? Yeah. Rewind. Good. Okay. Is your mic on? Yeah. I'm getting. This is making me nervous.

Maybe I should get my epipen. Are you allergic to radio greatness? Not that I know of. I haven't been really exposed to it yet. Anyway, well, let's go. Are we rolling? We're good. We're going.

We're rolling. Okay. I'm Robert Crilwich. This is Radio Lab. And today we're going to begin with a conversation between Dan Pashman. Okay. Host of a podcast here at WNYC called The Sporkful. It's about food.

And Amy Pearl. Amy. Yes. A digital producer here at the station who likes food. And the conversation they had was about something that happened to Amy, which she never expected, certainly didn't want, and yet it could happen to any of us at any time. So years ago before any of this happened to you,

just tell me what was your relationship with meat? My relationship with meat. Yeah. Well, you know how when you're little and your mom is like, you can have any special dinner for your birthday? my dinner was meatballs. And she was like, except meatballs, they're so hard to make. So it was pot roast.

And then Peter Lugar, you know, Peter Lugar is? Famous steakhouse in Brooklyn. Yeah. I used to go there quite often and I live there. And I have a Peter Lugar credit card. Are those hard to get? You know, I don't know how they give them out, but nobody seems to have one. I don't think they give them out anymore.

But, I mean, I was very into Peter Lugar. I was living in Williamsburg. And it just opened at like one o'clock every day. And you could just walk in at one. They had an amazing bar. There's no tablecloths on the table. These old German waiters. They bring out your porterhouse for three.

They put a little plate upside down and then put the big platter on top of it so it's tilted and all the juice runs to the end. And then they like have the special double spoon thing that they somehow like scoop juice onto your steak. And oh, so good. And also, like, the smell of burning fat from a hamburger. What about hot dogs? Oh, my God. I love hot dogs so much. When you bite into them and they're like, clack and have, like, a snap.

And, like, having a weenie roast out in the open air is just, it's like the, oh, God, it's so good. Anyway, I was always very into meat. What changed? Oh, my God. It was terrible. It was, what happened was, I was having this. beautiful. It was springtime. I was having a beautiful leg of lamb with some neighbors, and we put it on the grill, and it was just a delicious, beautiful dinner, and I had served with it some

ramps that I foraged in my mom's yard. A ramp, by the way, is just a wild onion. And so we had this delicious meal, and then, you know, I went home, and I was going to sleep at, like, midnight, like a few hours later, and I just felt weird. I was like, God, something's wrong. I feel like really anxious. Like something's wrong with me. And I went in the bathroom and I like look in the mirror. And my face was like all weird looking.

And I was like, I kept laying down and be like, I'll just sleep it off, whatever it is. But every time I lay down, I felt like I was going to faint. So I was like prop myself up. And I was like, oh, God, I'm having terrible, like, stomach cramps and just like a weird feeling of impending doom. You know, but just like anybody, I'm just like, just get a good night's sleep. This will pass. I like splash a little water on my face. I mean, I don't know what made me think this, but I thought like maybe a snail, a tiny snail, was on one of the ramps that I ate.

And it was like poisoning me somehow. You know, snails, I mean, they probably poison us. So I called my friends in the morning. I was like, hey, how are you guys doing? How was dinner? And they were like, oh, so great. And I was like, really? So great.

Nothing weird? No horrific panic attacks? And they were like, oh, that was so lovely. Thank you so much. Let's do it again. Bar-b-b-b-ba. And I was like, wow, I really had a rough night. But I didn't think anything of it, and I went on with my life, you know, just like, whatever.

And then, about a week or two later, I made some cheeseburgers. And I ate a cheeseburger. And I was watching Goodbye Mr. Chips, really tear-jerking movie and a good book, too. And about a couple of hours after I ate, I was like started to feel really weird. Again, I was like feeling like I had to stand up. I was like, I think I'm going to faint. I feel really lightheaded. I can't catch my breath.

I feel like really woozy. But if any time I lay down, I really felt like I was going to faint. So I was like trying to stay sitting upright. And I was like, oh, my God, this is very similar. I ran into the bathroom and I was like looking in the mirror. And lo and behold, I had hives all over my stomach. And then they started coming out of my hands. and I was like, oh my God, something's happening.

And at one point I did get up and unlock my door because I did feel like I'm going to pass out, call an ambulance, and then they're not going to be able to get in. So, I mean, I was a little bit afraid of what was happening. And when I woke up in the morning, the first thing I did was Google sudden meat allergy because I was like, this seems like an allergy. And the only thing that was the same was meat.

And I'm going through, and like, the second thing that came up was this article that was like, Florida man has sudden meat allergy. I was like, oh my God, I think is it possible I could have this? And so I made an appointment with my doctor. I brought in the article. I'm like, I'm going to be this person, but I can do it. I had the article in my pocket.

What person? You know, the person who goes to their doctor was something I found on the internet. So I brought the article. It was in my pocket. And like I got through the whole like checkup. And I was too chicken. I went when I was paying the receptionist, I pulled it out and gave it. to the receptionist, and I was like,

could you give this to the doctor? So that was like the best I could do. And then I did call my doctor and had a conversation with him on the phone, asking him if I could get tested. And he was like, no, there's no such thing as a meat allergy, blah, blah, blah. So some people think allergies are just like in your head. This is science writer Peter Smith.

We got in touch with him after we heard Amy's story because Peter is an investigator of many things, including strange allergies. And people are like, mushrooms hurt them, or they think... Wi-Fi hurts them. Yeah, Wi-Fi hurts them. And I don't know. And when our producer, Latif Nasser and I got into the studio

and we told them about Amy's story, he said... Yeah, all right. I know exactly who you need to talk to. Hello? Yeah, hi. Thomas Platt's Mills. This is Thomas Platt's Mills. That's right.

How are you? I'm very well. Dr. Plats Mills is down at the University of Virginia in Charlottesville. He's a professor, and he works at an office. The allergy clinic. An allergy clinic, we are constantly sifting through stories, which not only you don't believe, but are actually nonsense. And he told us in the last 10 years or so, he started hearing lots of stories just like Amy. Right.

Somebody shows up at the office, convinced that they're allergic, all of a sudden, for no apparent reason, to red meat. The first time I heard it was probably as early as 2004. And every single time he heard the story, he would tell them. patient exactly what Amy's doctor told her. No. No, no, no. It's not possible. Right.

So what was wrong with these complaints, you know, in an orthodox medical way? Oh, everything. Everything. Adults don't become allergic to something they've eaten for 40 years out of the blue and certainly not red meat. So you're basically saying to these patients, I think you must be making this up because I can't explain it. Well, I don't use language like that.

I say there, there's there. I was trying to give you your inner voice. Oh, you don't want to know what doctors are thinking in their inner voices. You know, you often think in the middle of an interview, is it possible that he's got, you know, some ghastly disease? Mad cow. Yeah, you know. The point is that when he'd hear a story like Amy's, he just didn't believe it.

But then everything changed. Thanks, oddly enough, to a cancer drug. this new cancer drug called Sitoxymab. In New York today, Martha Stewart was indicted on criminal charges relating to... This is the very drug that got Martha Stewart in all that trouble for insider trading. Remember that? I went to jail for six months? Yeah. Anyway, very promising, exciting new drug. But then...

Doctors were giving people this injection, and they would just, like, end up on the floor of the doctor's office. In shock? Yeah, they would be an an anaphylactic shock. Their hearts would start beating faster. They'd get short of breath. It'd get stomach cramps. Their immune system would start to overreact to something new, an alien, that came in with the drug.

Basically, a classic allergic reaction. So the mystery lands on Thomas Plotz and Mills' desk. Yes. So we were asked to look at cetucamount to see if they could figure out what was causing the reaction. And he tests two groups of blood, a control sample, and then people that have this allergy. And he quickly zeroed in on a particular. molecular molecule, a sugar that was part of the drug.

This sugar, galactose, alpha-13 galactose, or alpha-galgal. Alpha-gal? Yeah. As in a particularly great lady? Yeah. Better than the beta or gamma-gal? It's like alpha male, but alpha-female didn't quite have a ring to it. It's the alpha-gal.

Anyway, it seemed like alpha-gal was the culprit. Yeah, and if you told me four years earlier, that there's a whole lot of people out there who are allergic to this sugar, I'd have thought you were smoking, you know, vaping again. Because not only does this sugar alpha-gal show up in the cancer drug, and this is where we get back to Amy, it also shows up in the blood of mammals. All non-primate mammals. So every time you eat lamb or beef, goat, camel, even tripe, or pigs' kidneys, you're also eating alpha-gal. So I'm reading this article and it says like, it's this thing called alpha galactase or alpha gal or whatever. So it made no sense that someone like Amy who'd been eating meat all her life would suddenly somehow be allergic to alpha gal.

I just was like, this was so stupid. So one day. It's getting to be barbecue season. I usually have like a couple of barbecues where I just do a whole pork butt and a brisket and like hang out all day doing it. And I was like very wanted to do that. And I was like, I'm just going to not eat meat and not even know. So I was like, forget it. My doctor will test me.

I'm going to test myself. So I was like going to be very careful. I got a thing of Benadryl. And I was like, I'm not going to do it alone. I'll do it with my mom. My poor mom. And so I went up to my mom's and she's like really into food too. So she was like, oh, this is so exciting.

I got two porterhouse steaks on salad stews. Did you explain to her what you were testing? Yeah, I did because I had talked a little bit about it with their. So, like, fire up the grill, do the porterhouse. I even think I, like, Instagrammed it as a joke. Like, ha, ha, ha, this might be the last time you hear from me. But so, you know, we're having a nice summer day, just me and my mom having our steak. I only ate, like, a couple bites because I was slightly nervous.

And I was, like, sitting in the grass with my dog and reading a book and trying to think, like, do I feel normal? which try it, folks, it's hard to figure out when you start asking yourself, do I feel normal? Does this, am I breathing? Is my stomach hurt? Is something wrong? And I was like, after a while I was like, I feel pretty good. And the neighbor came over and was like chatting with us. And it was in the middle of that conversation where I was like, I kind of feel like I have to go to the bathroom.

But maybe I just have to go to the bathroom. So I went to the bathroom and I was sitting there and I was like, oh, God, something feels bad. And then I was like, oh, God, I definitely, this is not right. Something's wrong. And I went in to get the Benadryl and I took the Benadryl and I went on my bed and in the guest room at my mom's. And I was like sitting on there and I was like, whew, I just don't feel right. Maybe I just take a deep breath. I'll just stand up.

Maybe I just put my hands over my head like this. Oh, that does feel. feel slightly better, I think. And then I was finally like, I think we should go to the hospital. And I went outside. I was like, Mom, I think you have to drive me to the hospital. She was like talking to her neighbor like, what? Oh, my God, honey, what?

Let me go change my clothes. Change my clothes. Like, Mom, you know, she's not wearing the hospital level clothes. So I'm like, okay, hurry up, mom. Mom, are you ready, mom? And then I was like, while she was changing her clothes, I suddenly was like, oh my God, got my wallet out and my cell phone. And I, like, threw it toward my mom's bedroom door.

And I was like, here's my insurance card, call an ambulance. And I just, like, hit the floor. Eventually, the ambulance arrives, and I got stabilized. I was strapped to the thing. I was in the emergency room. Like, they were shooting me full of, I don't know what, epinephrine and adrenaline. And the little, like, 12-year-old emergency room doctor runs in. And he was like, I looked it up on the Internet.

Alpha-gal, fascinating. What? That's terrible. I've never heard of that. Could it be true? Yes, it's true. Like, they're all having this discussion there. Then when I went back to my doctor after that, and I was like, hey, just get out of the emergency room because they tested me for alpha-gal and I'm allergic to meat. So this is an allergy? Yeah. So all of a sudden you're looking at the, quote, crazies, and they're not so, quote, crazy anymore? Absolutely. We suddenly had a blood test. And of course, what turned out is all these patients, who'd been telling us this story, were allergic to alpha-gall.

But it's still like a mystery. Right. Thomas Platt's Mills couldn't figure out why people like Amy, who had lived for 40 years eating Porterhouse steaks at Peter Lugers with a credit card, why would she suddenly develop an allergy now?

There had to be some kind of trigger. Yes. So we were looking for anything that could explain it. It could be a mold. It could be a nematode. A worm. or a fungus.

But then he looked again and noticed that all the people who had had bad reactions to the cancer drug... They were in a particular area of the country. It was Virginia, North Carolina, Southern Missouri, Arkansas. No cases in Salt Lake City,

no cases in Denver. Just smattering's down the west. So he turned to his technician, Jake, and he said, I said, you've got to Google every map you can find and say, what matches that area? Creatures. or diseases that appear wherever the allergy appears. So Jake starts Googling.

Googling and Googling and Googling and... And eventually, he comes across a map that matches where the cases are very beautifully, the maximum area for Rocky Mountain spotted fever. So he made this little map and it's like the shaded dark areas of the country or places with Rocky Mountain spotted fever, and then there's like some stars where this allergy had appeared. Yeah. And they overlap.

Oh, very interesting. And then all of a sudden, it clicks. Rocky Mountain spotted fever is a tick-borne disease. This is the distribution of the lone star tick. And actually just a little before this, it turns out an allergist down in Australia, Cheryl Van Nuen. First name Cheryl, S-H-E-R-Y-L, Van Nuinen, V-A-N, and then N-U-N-N-E-N-N. And I'm from the tick-induced allergies research and awareness center in Sydney. New Australia. She says she was now being visited by all kinds of people who claimed suddenly

to be allergic to me. And whenever I take a history, so for example, I'd ask them, was there a family history of rhinitis, exma, asthma, stinging insect allergy, and they say they've all been bitten by ticks. When we started asking patients, we suddenly heard the stories just out the kazoo. But at this point, Dr. Platz Mills, all he has is a map, stories at a hunch. Right. So what does he do? He decides, well, maybe I'll just do this to myself.

He does what? He decides to test it on himself. Oh, my God. He sort of like denies that he did it intentionally. I know I had no intention. I mean, I think he also likes to walk and amble and think about things. Right. So he goes for a long walk along the Blue Ridge Mountains.

And I knew I wanted to be off trail because I'm actually rather allergic to humans. So he's walking and walking and walking. And along the way, he bumps into a whole bunch of ticks. And if you walk into a nest of those things... Oh my God, this sounds like a nightmare. Yeah, absolutely. I got 200 seed ticks. Oh, boy.

And then in November of that year, I was taking out to dinner, and the lamb chops were particularly delicious, and the French wine was delicious. And six hours later, I woke up covered in hives. He's got an allergy to really. an allergy to red meat. All just because of a tick bite? Tick bite.

That's right. We'll bite you right back after this. I'm Robert Crulwich. This is Radio Lab. Now we go back to Amy just when she's discovered that the allergy to meat that she's developed comes from a tick bite. A tick bite?

Hang on a second. Because, like, a few weeks before all this started happening, As I said, I was foraging for ramps in my mom's backyard, and I had a tick on my arm. Now, it turns out that not only was that tick bite a terrible thing for Amy, it was a kind of double tragedy. Hidden from view amongst the trees

and in the undergrowth. And I think it's only right at this point to back up is a fascinating world of wonders. And consider the story from a tick's point of view. Okay, so I'm Graham Hickling. I'm a wildlife disease ecologist at the University of Tennessee. So I was wondering if you could help us tell the story of, in this case, the Loon Star Tech that bit Amy. Oh yeah, sure.

So they start off in this little pile of eggs, perhaps a mass of 2,000 eggs, under the leaves. The proud mom just gave birth. At that point, she's just a kind of a withered husk. Meaning dead. But anyway... A few weeks later, those eggs will hatch and this mass of 2,000 baby ticks emerge from under the leaves.

Could I see them with my naked eye? If you ran into a mass of them all up together, you would feel like you've got a little smudge of dirt and then the dirt starts walking. So they'll just climb up and they'll potentially all be on the same leaf or the same twig looking for something to feed on. Now one teeny little tiny problem

for these teeny little tiny ticks is that they dry out. So when they come up from under the leaves, they come up briefly. And then they go back down. Get a little water, come back up, get thirsty, go back down. And rehydrate. So they, like, commute. Exactly.

And we refer to the behavior as questing. Oh, questing. So if you were one of these little baby ticks, up questing for food. While you're up there, you are essentially Velcro. Because on each one of your little legs, you have little kind of hook-like structures. And so you're flat against the leaf. Sort of sniffing in the air with your two little front legs. They can detect CO2 heat movement.

So let's say one day you're sitting there on your leaf, and you pick up the scent of a nearby mouse. My sort of the potato chips of the ecosystem, everything eats them. Which means you might be about to have your very first meal. So you basically stand up, stretch out all your little legs. And do a tick dance. And so it's kind of interpretive dance-like movements. While you're waiting for that mouse to come just close enough that you can grab on it,

So you're dancing and you're waiting and you're dancing and you're waiting and you're dancing and you're waiting and you're dancing and you're waiting and you're dancing and you're way. To be honest, you are probably going to wait your entire life and die unfulfilled. Because there are 2,000 of you starting off and a stable tick population. There's only going to be two of you that survive. Oh my gosh. So, 1,998 little baby ticks are born. And then that's it for them. But let's say that you're one of the lucky ones.

And one sunny day, there you are hanging out on your little leaf, when you detect two incoming mammals. One is a 40-year-old hominid. The other is her dog. So you perk up. You thrust your legs out. Wave, do the tick dance. And say that you're waving and you're dancing and you're hoping and you're waving and you're dancing

and you're hoping and you're waving and you're dancing and you're hoping. And slowly the dog's getting closer and closer and closer. And you reach out with one of your tiny little little so you get... Grab on and eat and survive. But the reason that tick ended up on me was I slept in bed with my dog naked. I mean, she's always naked, but I was also naked. I mean, that's not gross. I don't... I mean, does that sound weird?

No. But how do you know that's when? it happened. Because I know that like I did a good tick check on myself and I took a shower and everything and then in the middle of the night I woke up with a itching sensation and I went to the bathroom

and I couldn't really see what was on like something was on the back of my arm and it was a tick. So as the tick is biting into Amy, what is it giving Amy that's going to make her allergic to meat? Well actually I need to stop you there, Robert. Difficult one, Robert.

I don't know the answer to that. That's Peter Smith and Well, rejoining us is Cheryl Van Nguyen and the scientist. It's all up for speculation. We don't really know, but here's the theory. Normally, when you eat a piece of meat, you put alpha-gal in your stomach and your stomach digest it and it's in your body and there's no big deal. But the tick cunningly will drill into you, poke into you,

and injects its saliva. We'll call that tick spit. Tech spit into its victims. Straight into its victim's largest organ. The skin. And tick sput. But it has an anti-clotting factor, an anesthetic, anti-inflammatory compounds, and we think, the alpha-gal. Now, Peter says the thing about the skin is...

The skin is like this enormous, like, surveillance system. It's always on the lookout for invaders. So, when the alpha-gal comes through your skin, covered by all that bad, bad tick-spit stuff, that's going to really, like, set off your immune system. The immune system freaks out. Like, oh, uh-uh. And the alpha-gal, covered now in bad spit. Almost sort of...

By mistake, gets labeled bad. And now it's on the bad guy watch list. So... Therefore... The next time you eat meat... The meat comes in. And then... The body unleashes wave upon wave, upon wave, upon wave of chemical attacks...

To do battle against this alpha-go. And this reaction gets way out of hand. You've got so many antibodies multiply, multiply, multiplying, multiplying, multiplying, multiplying, multiplying, making you, rather in this case, Amy, feel just... Horrible. Right. I mean, it's very weird. It sounds like a science fiction movie.

It sounds like the beginning of a science fiction, at least kids' book. Let's not go to a movie. But, like, it's just strange. Which all goes to say that this really is a kind of double tragedy for Amy and her tick. Yeah, because ticks didn't evolve to bite humans. Right. We're a mistake. Like, we have opposable thumbs.

We're either going to pull them off. I actually woke my mom up and she helped get it off. Or if they drop off, they're going to drop off in an airport terminal or a Walmart car park or somewhere like that. Or a shag carpet. Or a shag carpet indoors and they're doomed. And for us, well, we lose something that historically anyway is a big part of who we are. Yeah. Because we have, we adapted in the grand evolutionary schema things to like eat flesh to eat meat.

Yeah. Yeah. I mean, I'm actually sitting here picturing a steak, but actually the thing, I mean, hot dogs like wrap ramps around a weenie and roast. Yum, that sounds so good, my mouth's watering. Weenies and ramps. Yeah. But I am going to my allergist tomorrow because I did, you know, I was reading about this allergy a lot when I first got it. And I read that for some people, the allergy can fade away.

so I'm going to get a blood test to see what my blood level of alpha-gal is. So what are you hoping for tomorrow? I want to be normal again. That was the end of the Dan and Amy conversation. She was going to go to the doctor, get herself tested, find out whatever. So we asked her back in to find out what happened. So I actually did get an appointment with my allergist, Dr. Korn. My name was Dr. Corn.

She's really nice. So I got the appointment. I got the blood draw, whatever. And a few days later, my doctor called me, and she said that my numbers were still really high. And I was like, well, how high are they? And she was like, three. And I was like, three? That's not high.

And she was like, they're supposed to be like one or something. So they had gone down, but they were still, you know, many times more than they. I should be so. But when you left and you were waiting for the call, were you waiting with the hope that you would soon be eating a bit of hot dog? I mean, honestly, I was hoping no. No? No.

I don't. Wait a say, you are the great, you. No, but I was afraid that she would be like, oh, my God, your numbers are so low. I think you could probably eat me. Let's do a food challenge. I would be like, ah, because like, that's such a scary memory. Yeah, I don't, you know, actually just the other. night I was eating at an Indian place and I was eating vegetarian but like I felt something and I pulled it out and in the dim light of an Indian restaurant like why are they all lit like that? I was like was this bacon and I suddenly you know like you just get this drop in your stomach and I'm like what time is it four hours from now if I you know because it's there's something about it being delayed that makes it so difficult it just as like like a suspense movie with you as a victim it's like it's like it's like it's like it's like it's like it's like it's like it's like it's like it's like it's like it's like it's like it.

It could happen in the next three hours or maybe not. I don't know. I mean, honestly, the only thing that the real reason I want to be able to eat meat is so that I will be prepared to eat it in case of emergency. I mean, I went on a canoe trip in the Adirondex, and I was like, well, what happens if I get stranded out here? And like, what if I have to hunt? But I can't even eat meat.

I would have to hunt fish. But then when the lake freezes over, what would I eat? I can't survive. Something's wrong with me. I feel evolutionarily challenged. This is what I think about before I go to bed every night. Would I be able to survive if I had just what's on me right now? A pen, underwear, my dog.

And so, yeah, I mean, that's a real issue. It's like, it's not a real issue. Obviously, it's never going to happen and live in Brooklyn. But I do, for some reason, I always think, like, I want to be prepared in case. But, yeah, you know, I don't think. I think I would go back to eating meat necessarily. Like you are still more, more frightened than game, so to speak. Well, also, like, I wish I could be a vegetarian for ethical reasons because it's not so much just the eating meat, but just like, you know, the factory farming and that kind of stuff.

So I feel like morally superior now, I can be like, well, I don't eat red meat. Of course, I'm forced to not eat it, but at the same time, I would if I had the, if I had the, if I had the, if I had the, willpower, I'd probably go that way anyway. And then also, I think it's great. It's like we're all evolving to be on this planet, which is getting harder to be on. And we know that meat takes a lot of resources. And like, now I don't, now I'm not doing that. So like, the tick is helping me evolve into a better human being. Like, so one could, instead of thinking of the tick as your teeny weenie, irritating enemy, you could think of it as a guiding life. You could think of it as a guiding light, making the world safer to share with your fellow earthlings.

Yeah. So you may have lost your relationship with meat, but at least you have your moral superiority. Yeah, I mean, I am superior. Yeah. So, huge thanks to Amy Pearl for telling a story which never stop being scary and wonderful. And to the fellow who brought her into the room, Dan Pashman, whose podcast, The Sporkful is it's all about food in every conceivable way. Like he talks about eating it, preparing it, worrying about it,

as you've heard, getting sick from it, getting fat from it, whatever. And you can find his show on iTunes or Stitcher or on the internet at sportful.com. And this story was produced by Annie McEwen and Matt Kilty with reporting help from Latif Nassar. See you next time. All right. So that was the original piece. We're going to take a quick break now. But when we come back, Sara and Soren are going to follow the thread from Amy's allergy to this brand new genetically modified pig that can help a human who needs a kidney and also maybe solve Amy's problem. Or maybe make it worse.

Stick with us. Walking into NYU. This building is huge. Hello. Hello. All right. How are you? I'm doing well.

I don't know. Do we shake hands? I don't know. I haven't done it. I haven't done this in a really long time. Okay. You ready for the radio lab? Yeah, sure.

Yep, everybody, come on in. Awesome. So our update today comes to us from producer Sarakari, who you just heard wandering the halls of NYU's Lingone Health Hospital back in 2021. That is when we made this update. Hello. Hi, guys. Hello. Hello.

This is really exciting. as well as our executive editor, Soren. Wheely, Wheeler. I can give us a start if you want me to. Actually, yeah. You should tell us how you even had the idea. Yeah, I mean, I had the idea by someone else having had an idea that I saw their idea in a newspaper.

It's called reading. But like, I don't know, what, a month ago maybe? I was reading the news. The news I was reading was the New York Times. Heard of it. Heard of it. It was like a science section news thing. and the article is basically announcing this big breakthrough.

News this evening about a major medical breakthrough. It's been called an astonishing step in medicine. Basically, a group of surgeons had managed to put a pig kidney into a human being. And it worked. Successfully transferring a pig kidney to a human patient. For the first time ever, the person's body didn't reject the kidney, which, when you think about all the people waiting on kidneys, you know. Game changer.

Yeah, totally. So I'm just, I'm reading through this article, but then in the middle of it, there's just a couple lines about a particular pig that they used for this kidney that drew this very weird line back to a story we had told here on Radio Lab. That's when I, so I brought in Sarah to, like, report this whole thing out. So I actually went to talk to the doctor who, who did this transplant. Hi, how's it going? Nice to meet you. How do you do? Good. How are you? His name is Robert Montgomery.

he's at NYU Langone Health, and he's the head of transplant surgery there. So when did it first occur to you that transplanting a pig kidney into a human would even be... I just started with, like, the most basic question, which is like, why would you do this? Because we don't have an adequate supply of organs for the people who need them, when they need them,

and so a lot of people die waiting. And so the idea of xenotransplant... And he just made the argument that using animal kidneys was the best way that he could think of to make a dent into that waiting list of 90,000 people. And do you know, is this person still walking around and is the pigs still walking around? Good question. So no. We did this transplant and someone who had been declared brain dead,

who had wanted to donate their organs but were unable to donate their organs. And so their family essentially donated their whole body so that we could test a xenotransmit. Like we're going to try this crazy thing that's never been done and see how it goes. And determine whether this was going to be safe to move into living humans. It's a proof of concept type thing. Yeah. So the family agreed and the doctors did the transplant and they could see, you know, like that it worked and the body wasn't rejecting the kidney. The kidney was doing its kidney stuff.

But the sort of amazing thing. is... Actually, as we sit here today, the same thing happened yesterday. While we were sitting there talking, he told me... You know, at two in the morning, we did our second xenotransplant. We actually just did the second one. You want to see? What? That's like happening right now. That's happening right now. And if you want to, you know, come down with me, I'll show you what we're doing.

And I was like, um, yes. And he took me downstairs. to this big room. It's like a conference room. It was totally silent. There was like a window looking into this operating room. Okay, can we walk up to the glass? And you could see just like the jumble of machines

and like medical equipment. What are we looking at? All right, so there's a ventilator over here. And in the middle of the room, you could see this person. That's the recipient. Lying there on the table covered by this blue surgical shroud. you can see the patient's body kind of like rising and falling as they breathe. Yeah, that's the ventilator.

And they actually attach the kidney at the person's thigh because they sort of want to be able to watch it. And they're not worried about the person getting up and walking around. So there's this incision at the thigh. And in that oval incision, you could see the pig kidney kind of like poking out. It was like covered by plastic. And Dr. Montgomery told me that, you know, when a body rejects a kidney. The kidney will literally turn black moments after the blood goes into it. But you could see, like with this one, it was bright pink.

And kind of amazingly, just like the first one. Within moments, it started to make urine, believe it or not. And so we knew right away that it was working. Wow. See right where it's dripping in? See how fast it's dripping? All that urine is coming out from that kidney. So, you know, this is just the second one that worked.

but eventually Dr. Montgomery and his team want to get to the point where they can do clinical trials on people who are walking around and doing things and living their lives and who would hold on to this kidney. Wow. Allow me to presume that you have two questions, which I think you do, even if you haven't said them yet, which is like, one, why did this never work before? And then two, why are we even telling you this? It's not our usual stick to just pick up a New York Times science news article and relay that to you. Fair. Which brings me back to that little part of the article that piqued my interest in the beginning because the pig that they got the kidney from to do this was a very special pig. Normally pigs and other mammals that aren't primates have a sugar in their body that our bodies don't have.

And so we don't like it or see it as foreign. and that's why usually an organ from another animal would get rejected. But this pig had been genetically modified. It had had the gene that makes that sugar removed, so it didn't have that sugar, which is part of the reason this worked. And that sugar just so happens to be called alpha-gal. Alpha-gal.

Hey, our old friend. There it is. There's the radio lab connection. Our old friend of me. It's really only the food that was kind of alluding us because we've known and have been also pursuing various medical device applications of the gal safe pig. You know, we've had conversations with... So I actually called up the company that makes this pig. They call it the gal safe pig.

The company itself is called Rivivikor. Started out as the U.S. division of the Scottish company that cloned Dolly the Sheep. Oh. The UK company that did Dolly the sheep. sheep, this is like they're sort of like American offshore. Got it. Okay. And from there, we actually cloned the world's first pigs.

So anyway, I talked to David Ayers. He's the company's chief scientific officer and also John Bianchi. Lead product development enterprises at Revivacore and I also am in charge of regulatory affairs. So

at what point, and either of you can take this, at what point did you guys realize, And I just wanted to ask them, like, okay, you made this pig for all of these medical transplant reasons. But did you know about the whole food side of things? I'll take this one, Dave, unless I'm the poor sap that I had to work with the FDA. I shouldn't say that. It was a very collaborative effort with the FDA.

And they told me that while they were in the middle of getting FDA approval for this pig to be used for medical reasons, they heard a certain radio show. After listening to the radio lab episode, the original episode, and listening to Amy Pearl, we thought, hmm, why not? Just expand the application to include food. We realized that the pigs that we had developed so that their organs wouldn't be rejected would also be a food source for these patients that have the Afigal allergy or the red meat allergy. Okay, wait, so hearing Amy Pearl on our show had something to do with,

thinking that, oh, we should make this a food product? It was absolutely a motivation of mine after listening to Amy. What? Yeah, totally. Yes. So, yeah, now because of Amy Pearl and her story, this pig is now FDA approved for medical devices and things like that and transplants, but also for food to use the meat of those pigs to make pork products

that, like, people with Alvigal syndrome can eat. Wow. So of course we immediately, like, called up Amy Pearl. And we're like, Amy Pearl, Amy Pearl, Amy Pearl, Pearl. Hi. Hello. We got something to tell you. Look at them.

Oh, no. Oh, my God. Have you always like tiny little bundles of cuteness in your life? When we talked to her, she had a couple of really small foster kittens, like, scrambling up and down her shoulders and mewing in the background. So we explained to her, you know, the whole deal, there's this pig that doesn't have alpha gal that's being used for, transplants from which you could make meat that would be safe to eat for people like you, Amy Pearl. Ugh, it's kind of, I mean, I just, I feel kind of disgusted because it's been a long time, long time since I've had pork or beef. I've found plenty of delicious things to eat that aren't

bacon. And she said that, you know, even if there is now, some pork that's totally safe, she still feels sort of the same way she did at the end of the original show, which is that she's kind of just over read me. I've kind of moved on from it, honestly. And happily, it sounds. Yeah, I feel like it's better for my peace of mind. It's better for my health. It's better for the plan itself.

And I feel lucky and happy. It's kind of like. But then, of course, you know, we had to tell her that, you know, we talked to the guys at Rivivacore. and that she and her story were sort of an inspiration for this meat becoming available to people. I'll just play you a clip of something they said to me. It was absolutely a motivation of mine after listening to Amy. When I heard the Radio Lab podcast, I'm thinking, well, we hold the hammer. Oh, gosh.

Great. I've had so funny. Oh, well. But it's fine. I mean, I, I guess he sounds like such a nice guy. Say more. Say more on what your feel. What's, what were you thinking as you heard it? You sort of like hung your head. I mean, I was thinking that never should have gone on a radio lab. I don't know. Just like always thinking misanthropic things. But I was thinking like, here's a person who's like, here's me.

just like talking about how delicious meat is and like juices and they're like yeah I love meat too and they're like she seems sad I'm gonna make meat for her and then it's like but I actually don't really I actually anyway I can make it for you I figured it out I have the hammer but I actually don't want it's okay I'm making it here it is I think she felt like because of her they'd gone and solves this problem that she didn't even really want solved. It's just kind of like you would like go to some kind of special FDA store to buy some special genetically modified pork just so you could have a bite of some kind of meat. I mean, it just was like, I don't know.

Do you guys ever get into philosophy? You ever? It just like immediately for me when you say, oh, they created this pig that you can, that alpha-gal people can eat. My next thought is like, what is the meaning of life? Why am I here? Why? Do you think you can close the gap between those two stores a little bit?

Like, are there some intermediate steps? Because it's like, well, is that good or bad? Well, I guess it's good for people who want to eat pork, but it's bad for the pig. It just immediately brings to mind, you. you know, how to live? Do you live to satisfy your desires and be happy? Or do you live to not harm others? Or why are we even here?

Are pigs below us? Are they above us? Is it okay to put a pig first? Like, what if someone's kid is dying of kidney cancer? Well, see that? Then now, like, that's now how, like, you know, this question has a, another whole layer because it's not just that they made a pig for people who got bit by a tick

but wish they could still have a hot dog. They also then, it turns out, made a pig that like could maybe have a kidney that could save a life where there's no other kidney available or maybe in the future more and more and more things like that. But it's just, it's kind of like when you start thinking about breeding animals just for organs for people, it's like re-deciding all over again, like, should we be eating another animal that might be intelligent? It's like you're just answering all those questions again, but for another purpose,

because, like, you can get organs, like kidneys out of other people, and it's, like, safe and there's... I mean... Yeah, that's a good point. And I asked this guy, this doctor about this and, and, you know, was sort of pushing him on, on like, why. Like, you've just opened the door to, like, a whole new way of exploiting animals. And I think his thing, which I'm convinced by, honestly, is like, look, there are 90,000 people right now, right now that need a kidney. and when it comes to like making the decision for yourself or like for a loved one,

if you're like they need a kidney and you're and you have the option to put a pig kidney in them, you're like, that's not even a question. You know, we eat millions of pigs anyway. I guess on balance I feel okay. I mean, I totally agree with you, but why don't they just, why don't they just make a fake kidney. Yeah. I mean, if somebody, like, imagine humans did not think, like, oh, it's okay to kill an animal

just to get its kidney for someone else. Yeah. It was, like, not even something that crossed their mind. We would have invented a plastic kidney by now, probably. So at this point in the interview, unfortunately, we actually still had one more thing that we had to tell Amy that we learned from the guys at Rivivacore. I don't have to tell you something that you might like even less. What they named the, they named the pig Amy before they hit it with the hammer.

Yeah, yeah, they did. What? Yeah. Are you kidding this? Are you kidding? No, I'm not. I'm not kidding. By the way, the first pig that meant went to market, we named Amy.

After Amy Pearl? Of course. Well, I did it in my mind. I'm not sure Dave approved that name, but it did. What did they name? The one who donated the kidneys? No, no. The first one that they slaughtered for me.

They named it Amy. And unofficially, but, you know, they did, yeah. I mean, I can see why they picked something that was, like, motivating for them, like, humanizing and motivating in their, their, like, quest to, solve this thing that they decided was a good problem to put their thoughts behind. I mean, it can't bother me. I can't let myself think about that. Poor, poor, poor, poor living creatures that suffer. Yeah. But I do think it's good. I am grateful that like you are holding the position of making all of us think twice, including me. Like, I think I've been part of the like, oh, this is a breakthrough. And look at the pig kidney and the human and the heart is beating and everything is working.

It's so cool. And I do think that it's really helpful for that you're reminding me. There is a cost to this that we shouldn't ignore and that, you know, that we should challenge our imaginations almost to imagine a world where we don't have to exploit these pigs and find another way. There could be some young budding scientist that'll listen to this version of the story and come up with an artificial kidney and name it, Amy. That would be great. That would be great. Yeah, I think that's the only way to make this right.

It's funny to think that there's like, I mean, how big was this pig at the end? Like usually pigs, I guess when they slaughter them for meat, maybe they're smaller. But like I met a pig in Vermont that was like 800 pounds and I gave her a whole watermelon. And to her it was like... Like a gum drop? Thanks. Yeah. I mean, she was just giant.

I took a hoe. I was like scratching her back with a hoe and it just like looked like a little toothbrush on her. And she was like, oh, that feels so good. I mean, I wonder if Amy got to be that big. 800 pound Amy Pretty formidable Watch out I'm just like now I'm wishing

I could change places with her And then I'll have done my time And like I would have now be like Left the Mortal Coil And she would be sitting here in this interview With her pig intelligence Which is plenty for this probably You think she could raise those kittens

And then she would end up on like one of those unlikely friendship calendars where it's like look at the pig raising the kittens. I wonder if there's a resemblance. What an incredible turn of events. What are you thinking? I'm just thinking about like Amy the pig going about her business, you know, with no thought to any of this. It's imagining like, oh, it's so warm here in the mud. I'm going to stay here for a little while.

Oh, I'm hungry. I'm going to go check out the trough for a while. Just like that kind of living. I don't know. When your brain hurts, you just have to like retreat to your body. Yeah. Thank you, Amy Pearl, for coming on the show again and making us think more deeply than we were again.

This update to the episode was reported and produced by Sarakari. and also thank you to Amy the Pig. Thank you, Amy the Pig. Okay, and finally an update to the update. It is now Lulu in 26. And back in March of 2024, surgeons transplanted a pig kidney into a living patient for the very first time. That patient was a 62-year-old man living with end-stage kidney disease.

His name was Rick Sleiman. And he lived with the kidney for about two more months before dying from heart issues, which as doctor said, were unrelated to the transplant. The pig for its part was genetically edited, of course, but we couldn't find out any more information about its life or name. Thank you to the pig for its service. Hi, I'm Gabby. I'm from the Bay Area, California, and here are the staff credits. Radio Lab is hosted by Lulu Miller and Lettif Nasser. Sorin Wheeler is our executive editor.

Sarah Sandbach is our executive director. Our managing editor is Pat Walters. Dylan Keefe is our director of sound design. Our staff includes Jeremy Bloom, W. Harry Fortuna, David Gable, Maria Paz Gutierrez, Sindu Nainasambandan, Matt Kielty, Mona Madgauker, Alex Nissen, Sara Kari, Natalia Ramirez, Joanna Strogatz, Anisa Vita, Aryan Wack, Molly Webster, and Jessica Young. with help from Gabby Santis and Maya Applebee Milamid. Our fact checkers are Diane Kelly, Emily Krieger, Natalie Middleton,

Angelie Mercado, and Sophie Semaii. Hi. I'm Monica, and I'm calling from Mexico City. Leadership support for radio lab science programming is provided by the Simon's Foundation and the John Templeton Foundation. Foundational support for Radio Lab was provided by the Alfred Pee. Floor Foundation. Thanks for listening to Return of the Alpha-Gal. If you just didn't get enough of that sweet tick allergy content,

you should check out what our neighbors and fellow science lovers, Science Friday, put together on the subject of their episode is appropriately titled. How Does a Tick Bite Cause a Red Meat Allergy? In it, you'll hear them talk with one of the first allergist to connect the allergy to tick bites almost 20 years ago, the latest research into the Alpha GAL syndrome, and how almost two decades later there are still so many mysteries. including why some people are more susceptible to developing the allergy than others and giving hints about which blood types make your risk higher or lower.

To learn more, check out the conversation on Science Friday's podcast by searching for How Does a Tick Bite Cause a Red Meat Allergy, wherever you cast your pods.