Not Enough Organs — The Salamander Solution

Posted: March 16, 2012 in Ending the Organ Shortage -- Solutions

The organ shortage is real here at home and around the world.   People aren’t becoming organ and tissue donors in the numbers that are necessary to drastically cut or eliminate the deaths caused by the lack of organs.  Each year for the last several years there have been around 28,000 transplants in the U.S., that number has remained static, Unfortunately the number of people who need organs continues to grow and right now that number is approaching 114,000.

In the United States we obtain organs for transplantation via what is called the “altruistic” method or “opt in.”   That means we depend on the goodness of people to become organ donors.  The problem is that less than 50 percent of Americans ever get around to becoming donors and the result is that from 6000 to 7,000 people die every year because there aren’t enough organs to go around.  Obviously something has got to change, soon!

There are many alternatives to altruism including mandatory organ donation, compensation or incentives or a combination of many.  I have long been a supporter of “Presumed consent” (PC) which is the reverse of altruism.  Under PC you are automatically considered a donor unless you “opt out.”

The problem we face with any of these proposed changes is that it would take some kind of government action to force a change and my political instincts tell me that the country just isn’t in the mood to hear the government or a bureaucracy tell them they “must” do something even if it saves lives.  Furthermore there isn’t even a whiff of a scent of a move to change the system.  Once in a while a state makes some changes but we need a massive federal change.   If PC were introduced as a possible change and it is the most likely of all the alternatives, it would take a very long time if ever to make it the law of the land.  And…even if such a change had congressional and presidential approval and endorsement I am positive that there would be an almost immediate court challenge that would delay implementation indefinitely.

Presumed consent isn’t going to happen in this country.  We can keep pushing for it but I just don’t see it happening.  The National Organ Transplant Act (NOTA) has been on the books since 1984 and even though the gap between organ supply and demand continues to widen there is no widely popular movement in congress or at the United Network for Organ Sharing (UNOS) to change the system. There’s been talk, but no action and it is unlikely there will be any.  So where does that leave us.  Actually it leaves us with a lot of hope.

Some amazing things are happening in the area of regenerative medicine that could literally knock your socks off.  At the very heart of regenerative medicine are — the salamander and the newt.   They belong to the same amphibian family and they have the amazing ability to regrow organs.  I recently saw some time lapse photography of a salamander that had lost a leg and slowly over the period of several days it grew back (it’s in the link to the Atala video).  Researchers say, “If Salamanders can do it, why not humans?”  We’ll talk more about salamanders and newts later.

Anthony Atala is the director of the Wake Forest Institute for Regenerative Medicine.  He says, “Every thirty seconds a patient dies of diseases that could be prevented with tissue or stem cell replacement.”

That’s an amazing claim but then he is doing some pretty amazing things at Wake Forest. The first ever lab-grown organ, a bladder, to be implanted in a human was engineered by his team.  Additionally the team is developing fabrication technology that can “print” human tissue on demand.  Note I said “print” — the tissue will actually come out of a printer, similar to the one you have at home or in your office.  This link will take you to a video of Anthony Atala that is fascinating. http://tinyurl.com/7ctyr7v

But – as the commercial says, “Wait…there’s more.”  There is so much going on in regenerative medicine that I can only touch on a few things here but enough, I hope, to get you as excited as I am about the potential for saving lives.

Stem cells are said to be the very basis of life. Unlike cells of the skin or the brain, which have narrowly defined functions, the possibilities with stem cells are endless.   Given the proper setting, stem cells can develop into specialized cells so in theory they could replace those cells we lose when we age or get sick.  They are known as “pluripotent.”

Five years ago in 2007, some mice with sickle cell anemia were cured by infusing them with cells created from their own skin and modified by gene-splicing techniques so that they no longer contained the sickle-cell gene.  While it worked on mice it can’t be used on people because of the potential for the cells to trigger cancer but…it’s a beginning.

Last year a private U.S. company launched a cell therapy trial that could repair spinal injuries. It uses some special cells made from embryonic stem cells.  Four patients have been treated but no results as of yet.

In Scotland a trial to treat stroke was launched last year, using special nerve cells.  The company involved says it is evaluating the safety of the treatment which has been given to several patients in very low doses.

While all of the trials are in the earliest stages at least we are having trials in humans.  You can be sure that in the next few years more trials will start and we’ll find out the true potential of stem cell therapy.

Some of the advancements in the regenerative medicine are already being used.  Recently CBS News correspondent Wyatt Andrews reported on a man who re-grew a severed fingertip.  According to Andrews possibilities abound for creating an organ in the lab that can be transplanted into a patient without risk of rejection. It sounds like science fiction, he says, but it’s not. You can watch the full report here.  http://tinyurl.com/6wqmhay

And, finally, the story of cardiologist Mark Keating, a Harvard professor who is really into salamanders and newts and he’s spending all of his time studying them in hopes of uncovering their secret to regeneration.  Even if we could only partly regenerate an organ we’d be better off.  According to Dean Li, Keating’s business partner, “Patients with kidney failure need just 10 percent of their cells back and they can go off dialysis.”

But the small piece of kidney is less than the tip of the iceberg.  Hydra Biosciences, Keating’s Cambridge, Massachusetts Company, is also looking at the pancreas, skin, central nervous system, veins, joints, and eyes.

You can read more about Keating and his company here http://tinyurl.com/rnqm

While there is a considerable body of work taking place in regenerative medicine, there is also progress being made with artificial organs.  The exciting news here is the confluence of mechanical and biological research.  The result being organs that are a little of each.

Here are some headlines about technological medical advances:

  • A 10,000-rpm, no-pulse artificial heart  that doesn’t resemble an organic heart
  • A team of Japanese researchers who earlier this year engineered a mouse retina that is the most complex tissue ever engineered–have now derived a working pituitary gland from mouse stem cells.
  • Researchers in Cleveland have built an artificial lung that is so efficient it can breathe regular air rather than the pure oxygen required by current artificial lungs.
  • Impressive strides are being made toward developing an artificial pancreas, supplanting insulin injections and pinpricks for patients with diabetes

You can read the full stories and get information on other advancements as well at http://tinyurl.com/7t33pon

As you can see, there’s a lot going on.

So…back to my point.  I believe that we as Americans should take the following positions.

1). we should support and promote altruistic organ donation to the fullest extent of our abilities.  There is no nobler cause.

2)  We should encourage decision makers, policy leaders, elected officials, everyone in a position of power to support and fund the most promising scientific and technological possibilities as an investment in our future.

One certain way to control health the health care costs that threaten to bankrupt us is to have a healthier population.  Medical science and technology can lead us there if our political leaders will not only allow them to but also support their financial and other needs. .

I believe that by becoming a healthier nation, we’ll be able to put a lot of our economic problems away for good.  The ramifications of what these scientists are doing in regenerative medicine go well beyond providing transplants for people who need them.  What they are doing strikes at the soul of who we are as a nation and if we survive or succeed.  I prefer success.

You may comment in the space provided or email your thoughts to me at bob@baronson.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.

 Please view our video “Thank You From the Bottom of my Donor’s heart” on http://www.organti.org This video was produced to promote organ donation so it is free and no permission is needed for its use.

 Also…there is more information on this blog site about other donation/transplantation issues. Additionally we would love to have you join our Facebook group, Organ Transplant Initiative The more members we get the greater our clout with decision makers.

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Comments
  1. Jenny Porter says:

    USA is doing something right as although you have an opt in system, like we do in the UK, your country has the third highest cadaver donation rate in the world. Spain is top with opt out. We are a fair way down the list with opt in.

    Like

    • Bob Aronson says:

      Thanks Jenny…but none of us,no nation is doing well enough to stop the dying. We’ve got to do better and I believe donation alone will never even come close. Especially when you consider that so few of the people who are organ donors and die were physically healthy enough to donate. We need to offer much greater support to science and technology.

      Like

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