This company is about to grow new organs in a person for the first time

Jessica Hamzelou

MIT Technology Review

Originally posted 25 AUG 22

Here is an excerpt:

Livers have a unique ability to regenerate. Cut away half an animal’s liver, and it will grow back. Human livers damaged by toxins or alcohol can usually regrow too. But some diseases can cause extensive damage from which the liver can’t recover. For these diseases, the treatment of choice is usually a liver transplant.

Transplants aren’t always an option for people who are very unwell, however. That’s why Eric Lagasse and his colleagues at LyGenesis have taken this different approach. Lagasse, a stem-cell biologist at the University of Pittsburgh, has spent years researching cell-based treatments for liver disease. Around 10 years ago, he was experimenting with the idea of injecting cells from healthy livers into diseased ones in mice.

It is difficult to access the livers of small, 25-gram mice, which Lagasse was studying, so instead he and his colleagues injected the cells into the spleens of mice with liver disease. They found that the cells were able to migrate from the spleen to the liver. To find out if they could migrate from other organs, Lagasse’s team injected liver cells at various sites in the mice’s bodies.

Only a small number of mice survived. When Lagasse and his colleagues later performed autopsies on those survivors, “I was very surprised,” he recalls. “We had a mini liver present … where the lymph node would be.”

Little incubators

Lymph nodes are small, bean-shaped structures found throughout the body. They play a crucial role in our immune health, making cells that help fight infections. And while Lagasse was initially surprised that liver cells could multiply and grow in lymph nodes, it makes sense, he says. 

Lymph nodes are natural homes for rapidly dividing cells, even if those are usually immune cells. Lymph nodes also have a good blood supply, which can aid the growth of new tissue.

The info is here.

Proposal for Revising the Uniform Determination of Death Act

Hastings Bioethics Center

Originally posted 18 FEB 22

Organ transplantation has saved many lives in the past half-century, and the majority of postmortem organ donations have occurred after a declaration of death by neurological criteria, or brain death. However, inconsistencies between the biological concept of death and the diagnostic protocols used to determine brain death–as well as questions about the underlying assumptions of brain death–have led to a justified reassessment of the legal standard of death. We believe that the concept of brain death, though flawed in its present application, can be preserved and promoted as a pathway to organ donation, but only after particular changes are made in the medical criteria for its diagnosis. These changes should precede changes in the Uniform Determination of Death Act (UDDA).

The UDDA, approved in 1981, provides a legal definition of death, which has been adopted in some form by all 50 states. It says that death can be defined as the irreversible cessation of circulatory and respiratory functions or of brain functions. The act defines brain death as “irreversible cessation of all functions of the entire brain, including the brainstem.” This description is based on a widely held assumption at the time that the brain is the master integrator of the body, such that when it ceases to function, the body would no longer be able to maintain integrated functions. It was presumed that this would result in both cardiac and pulmonary arrest and the death of the body as a whole. Now that assumption has been called into question by exceptional cases of individuals on ventilators who were declared brain dead but who continued to have function in the hypothalamus. 

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Revision of the UDDA should first defer to a revision of the guidelines. Clinical criteria for the diagnosis of “cessation of all functions of the entire brain” must include all pertinent functions, including hypothalamic functions such as hormone release and regulation of temperature and blood pressure, to avoid the specter of neurologic recovery in those who fulfill the current clinical criteria for the diagnosis of brain death.

It is likely that the failure to account for a full set of pertinent brain functions has led to inconsistent diagnoses and conflicting results. Such inconsistencies, although well-documented in a number of cases, may have been even more frequent but unrecognized because declaration of brain death is often a self-fulfilling prophecy: rarely do any life-sustaining interventions continue after the diagnosis is made.

To be consistent, transparent, and accurate, the cessation of function in both the cardiopulmonary and the neurological standard of the UDDA should be described as permanent (i.e., no reversal will be attempted) rather than irreversible (i.e., no reversal is possible). We recognize additional challenges in complying with the UDDA requirements that these cessation criteria for brain death include “all functions” of the “entire brain.” In the absence of universally accepted and easily implemented testing criteria, there may be real problems with being in perfect compliance with these legal criteria in spite of being in perfect compliance with the currently published medical guidelines. If the concept of brain death is philosophically valid, as we think is defensible, then the diagnostic guidelines should be corrected before any attempt is made to correct the UDDA. They must then “say what they mean and mean what they say” to eliminate any possibility of patients with persistent evidence of brain function, including hypothalamic function, being erroneously declared brain dead.

The info is here.

Call for retraction of 400 scientific papers amid fears organs came from Chinese prisoners

Melissa Davey
The Guardian
Originally published February 5, 2019

A world-first study has called for the mass retraction of more than 400 scientific papers on organ transplantation, amid fears the organs were obtained unethically from Chinese prisoners.

The Australian-led study exposes a mass failure of English language medical journals to comply with international ethical standards in place to ensure organ donors provide consent for transplantation.

The study was published on Wednesday in the medical journal BMJ Open. Its author, the professor of clinical ethics Wendy Rogers, said journals, researchers and clinicians who used the research were complicit in “barbaric” methods of organ procurement.

“There’s no real pressure from research leaders on China to be more transparent,” Rogers, from Macquarie University in Sydney, said. “Everyone seems to say, ‘It’s not our job’. The world’s silence on this barbaric issue must stop.”

A report published in 2016 found a large discrepancy between official transplant figures from the Chinese government and the number of transplants reported by hospitals. While the government says 10,000 transplants occur each year, hospital data shows between 60,000 to 100,000 organs are transplanted each year. The report provides evidence that this gap is being made up by executed prisoners of conscience.

The info is here.