This work could enable more patients to benefit from much-needed organ transplants.
At the prestigious Yale University, researchers have conducted an experiment that could revolutionize organ transplantation. Using a new technique called OrganEx, they were able to partially revive the cellular activity of certain organs in a pig dead for an hour.
The term ” cellular is very important here. It serves to rule out a problematic interpretation from the outset: it is not in no way a form of resurrection. The life of a cell and that of an entire organism are two very different concepts. Et in this case, it is indeed small fundamental sub-units of the living being in question. The pigs weren’t conscious in any way, and they weren’t animals.” zombie “.
Organs that leave despite brain death
Indeed, all the organs in question have absolutely not started to function normally again, as if nothing had happened. The stoppage of blood circulation caused considerable damage to the majority of tissues, starting with the nervous system; all the guinea pigs were in a state of complete and irreversible brain death.
On the other hand, the researchers still found encouraging signs. The heart, for example, has started producing a little electrical activity again. Some other organs, such as the kidneys, liver and lungs, also showed signs of activity.
” We have restored certain cellular functions across multiple organs that would have been dead without our intervention says neurobiologist Nenad Sestan. “ These cells are working when they should have stopped hours ago! »
To achieve this, the researchers relied on a cocktail of electrolytes, vitamins, amino acids and nutrients. They also added anti-inflammatories and other substances supposed to limit cellular stress. They then mixed this serum with real pig blood before warming it to body temperature and then returning it to the circulatory system.
The ECMO of the future?
The system is vaguely reminiscent of ECMO, or extracorporeal membrane oxygenation. It is a technique used in hospitals that allows the body of a patient to be oxygenated in an absolute emergency situation, for example when the heart and the lungs have both stopped working.
According to the Yale researchers, however, their technique was shown to be much more effective in getting the fluids moving again in the organs. By testing ECMO on a control group, they concluded that this approach caused more swelling and bleeding compared to OrganEx. But above all, ECMO which only postpones the inevitable; OrganEx, on the other hand, seems to stimulate certain cell regeneration mechanisms of the organ!
” This system shows that it is possible not only to slow cell damage, but also to activate processes at the genetic level to promote cell repair. says Brendan Parent, a bioethics professor at New York University not associated with the study.
For the researchers, this is a very encouraging result; it lays the foundation for an approach that could significantly lengthen the window during which an organ remains viable after the donor dies. On paper, this could allow patients in life-threatening emergencies to benefit from an organ that could not have been used otherwise. This therefore avoids a deadweight loss that is difficult to accept in this context.
The researchers also suggest that this technique could help regenerate damaged organs in living patients, for example after a heart attack.
Towards a redefinition of clinical death?
Note, however, that this is far from the first time that work of this kind has shown enormous potential; and as often, for the moment, this work is still very far from having the slightest clinical application. Many additional analyzes will still have to be carried out to verify even the relevance of the concept.
The next step will be, for example, to test whether these reactivated organs can actually transform into viable grafts. Otherwise, these works would immediately lose much of their interest. It will also be necessary to validate the replicability of the protocol.
The idea is still worth exploring, though, as it could help save the lives of some patients. We can even see a link with the recent xenografts of pig hearts to humans that have been tested recently.
But even if this step is validated, there will still be a whole host of outstanding ethical, regulatory and medical questions. Brendan Parent, for example, believes that this study could even “ force us to reconsider what is “dead” and what is not ! It will therefore be interesting to follow the results of this work.