After inserting a solution called OrganEx into the veins of pigs that had been dead for an hour, scientists were able to revive cells in the pigs’ organs, according to a study published in Nature. This offers a potential tool to increase the number of organs available for transplants and raises questions about the definition of death.
Study details
The study builds on a previous study conducted by Yale University researchers in which a device called BrainEx pumped synthetic blood into 32 brains that came from pigs that had been dead for hours. The researchers observed several signs of recovery in brain function after being connected to BrainEx and receiving the solution.
For the new study, Yale researchers injected the OrganEx solution — which contains nutrients, anti-inflammatory drugs, anti-cell death drugs, nerve blockers and artificial hemoglobin mixed with each animal’s blood — into the veins of pigs that had been anesthetized and killed an hour earlier. .
The researchers found that the hearts of the pigs that received OrganEx began to beat and cells in a number of organs – including their hearts, livers, kidneys and brains – began to function again. They also found that the pigs did not set up like a normal dead pig would.
By comparison, other pigs that had also been dead for an hour and were treated with extracorporeal membrane oxygenation (ECMO) – a machine used to pump blood out of the body, oxygenate it and then return it to the body – became stiffened, their organs swelled and damaged, and their blood vessels collapsed.
Potential for organ transplantation, treatment
The study authors said they were shocked by OrganEx’s ability to revive cells in dead pig organs.
“We didn’t know what to expect,” said David Andrijevic, a Yale neuroscientist and author of the study. “Everything we’ve recovered has been amazing to us.”
The authors said one of OrganEx’s goals is to eventually use it to increase the supply of human organs available for transplant.
According to Robert Porte, a transplant surgeon at the University of Groningen in the Netherlands, most countries have a five-minute “no-touch” policy after a patient’s respirator is turned off before transplant surgeons come to remove organs. However, “before you rush to the operating room, it’s going to be extra minutes” and sometimes organs can be damaged to the point where they’re unusable, he said.
Because of this, between 50% and 60% of patients who die after the end of life support and whose families want their organs donated are unable to be donors, the New York Times reports.
If OrganEx can revive these organs, the effect “will be huge,” Porte said, greatly increasing the number of organs available for transplant.
“You can take the organ from a deceased donor and connect it to the perfusion technology and maybe then be able to transport it long distances over a long period of time to get it to the recipient who needs it,” said Steven Latham, director of Yale’s Interdisciplinary Center for Bioethics and co-author of the study.
Alexandra Glaser, president of New England Donor Services, said the OrganEx system could change the rules for dealing with organ shortages.
However, Latham cautioned that this research is in its very early stages.
“We wouldn’t be able to say that this study shows that any of the organs in this pig are … ready for transplantation into other animals, we don’t know if they all function, what we’re looking at is the cellular and metabolic levels,” he said. “And we’re not close to being able to say, ‘Oh my God, we restored life not only to this pig, but to any of the individual organs.’ We can’t say that yet. It’s still very early.” “
Port added that OrganEx could also be used to treat heart attack and stroke patients. “One can imagine that the OrganEx system (or its components) could be used to treat such people in an emergency,” he said. “However, it should be noted that more research will first be needed to confirm the safety of the system’s components in specific clinical situations.”
However, Latham cautioned that implementation of OrganEx is also “quite a ways off”.
“This idea of a relationship [a] someone who’s had an ischemic injury, you know, someone who’s drowned or had a heart attack, I think it’s pretty far out,” he said. “The much more promising short-term potential use here is with preserving organs for transplant.”
Ethical questions
Some experts also said the study raised ethical questions about the definition of death.
Nita Farahani, a law professor at Duke University who studies the ethical, legal and social implications of emerging technologies, said the study was “incredible, mind-blowing.”
“We assume that death is a thing, it’s a state of being,” she said. “Are there forms of death that are reversible? Or not?”
Brendan Parent, an attorney, ethicist and director of transplant ethics and policy research at New York University’s Grossman School of Medicine, said the study raises “difficult questions around life and death.”
“By the accepted medical and legal definition of death, these pigs were dead,” he said. But, he added, “a critical question is: What feature and what kind of feature will make a difference?”
Parent also said that OrganEx creates an ethical dilemma between assessing how useful the technology can be in increasing the supply of transplantable organs and how it can be used by doctors on patients near death.
“We have an ethical obligation to prioritize its development to save lives before looking at how it might benefit organ transplantation,” he said. (Kolata, New York Times, 8/3; Marcus, Wall Street Journal, 8/3; Hunt, CNN, 8/3)
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