Have a heart? Don't let it break. Now they can recycle it!

Intriguing article in MIT Technology Review, “Transplant surgeons revive hearts after death.”

These days, we’re familiar with heart transplants from brain-dead patients into others needing a new, healthy heart.

But in a new experimental breakthrough, successes have been achieved in transplanting the hearts of those not brain dead. Yes, there are procedural and ethical issues involved.

Mind you, this involves actual human hearts, not 3-D printed replacements, or bits of heart tissue grown in labs from human stem cells.

But the possibility raises some issues of medical ethics to be explored: if the donor is not brain dead, when and by what criteria can the heart be removed?

Rather than dig in deeply here, I’ll refer you to the article itself. You’ll see a “reanimated” donated heart actually beating outside the bodies of both donor and recipient.  Here's the link.

Organ harvesting from aborted human fetuses, medical ethics, and the medical techno-thriller, A REMEDY FOR DEATH

The  method used in my medical techno-thriller, A REMEDY FOR DEATH, depends on human stem cells from adult donors (Induced Pluripotent Cells—IPS cells) rather than tissue from aborted fetuses--a topic very much in the news recently because of a series of videos.

(Want to know more  about Induced Pluripotent Cells? Here’s a link to a basic Wikipedia overview.) 

In case the link doesn't work, here it is in open form:   https://en.wikipedia.org/wiki/Induced_pluripotent_stem_cell

 That said, an alternate research strand is very much in the news these days—fetal tissue research using organs from aborted fetuses.

Reasonable people can—and most definitely do, strongly—disagree on the medical ethics not only of abortion but also of “organ harvesting” from the resulting fetus. The fields of bio-engineering, tissue engineering and regenerative medicine are moving very fast, and  medical ethicists are struggling to keep apace.

I expect you’ve heard about—and perhaps watched—the series of videos made by the Center for Medical Progress, an anti-abortion group recording interviews with Planned Parenthood staffers, as well as shots of the product of abortions induced in Planned Parenthood  facilities. 

In A REMEDY FOR DEATH,   I  raised different but related issues involving bio-engineering, organ harvesting and other issues--different because the plot-line does not involve aborted fetuses. But it does  touch upon some of the same issues of medical ethics and biological research ethics as are raised by these videos and resulting discussions.

For  an informative, balanced article on this issue of using aborted human fetal tissue in research, I suggest Sarah Kliff’s piece in VOX: "The Planned Parenthood controversy over aborted fetus body parts, explained"

That link repeated, in case it didn't come through:  http://www.vox.com/2015/7/14/8964513/planned-parenthood-aborted-fetuses

Medical ethics-- "Tampering with embryos is tampering with human souls" suggests article in London Daily Telegraph

If you're on this page, you likely know that my technothriller A REMEDY FOR DEATH deals with, among other issues, questions of medical ethics, including organ and tissue regeneration, cross-species "trading" of tissues and stem cells, and the ultimate question of, When does death in fact occur?

In this blog, I've included a lot of my earlier research used in working out A REMEDY FOR DEATH, and I'm still adding new articles and studies that I find with some or a lot of relevance to the book.

Hence you may be interested in the opinion piece in London's Daily Telegraph "Tampering with embryos is tampering with souls"  by Jacob Rees-Mogg, a member of the British parliament.  The piece picks up from a debate in the House of Parliament on the issue of  "three parent embryos – or rather mitochondrial transfer".  

Mr. Rees-Mogg points out three as-yet unsettled issues with the idea of blending "parenthood" from three people:

  1. Technical: do we yet know enough about how to do this?); 
  2. Ethical (involving both medical ethics and morality: "There may be unknown consequences of tampering with the genes of an embryo, and for the unreligious there will be mental issues to be faced by those who have three parents. The gravity of the change is such that it should not be made without the most careful thought and properly tested research.)
  3. Legal:  "This is a self-evidently dangerous road to start down as although the technique cannot at this stage affect eye colour, eventually there will be therapies that will. Once this line has been crossed the argument against going further is merely a matter of degree rather than absolute. Its current aim is small, that ten children each year that might have been born should be replaced by ten different babies. This is not a major problem yet the solution is a fundamental change in our understanding of our own humanity."

I'm  not going to go further, except to add that in his bio, Mr. Rees-Mogg demonstrates exceptional wisdom and prudence by stating clearly " He is not on Twitter."  Amen to that! I say.

By the way, if you object to the word "soul" in his article, you're welcome to adopt the terms "conscious essence" within the "Vehicle" -- terms that some of the characters use  as alternatives to "soul" and "body" in A REMEDY FOR DEATH.

"Science fiction comes alive as researchers grow organs in lab" -- Wall Street Journal and A Remedy for Death

"Science fiction" and "Wall Street Journal" are terms not often used in the same sentence, but just maybe science fiction is transforming into mainstream science.

The WSJ article this week, "Science fiction comes alive as researchers grow organs in lab" by Gautam Naik, is accompanied by a video, narrated by Mr. Naik, and a clear graphic, "Growing a new heart."

The first section focuses on work done in Madrid by Dr. Francisco Fernandez-Avila: a  human heart, taken from a cadaver has been "cleaned" to clear all the original cells so all that was left was the "scaffold". This builds on the work of American Dr. Doris Taylor at the Texas Heart Institute, in Houston,  who is working with the Spanish team. (For more on her work,  see my post "Reversing the aging process using pig hearts")

The "scaffold," once cleaned of the donor's cells, is seeded with stem cells from a human donor, who will--when the work is final -- be the recipient. (Though there's much more to it than that, needless to say.)  But it's one more instance of how science fiction in these areas is moving into fact.

At University College, London (and the allied Royal Free Hospital),  the WSJ's Mr.Naik describes how the team is working on a variety of kinds of "lab grown" organs to implant in humans, including a new nose for a man who lost his to cancer, new coronary arteries, windpipes, and others.  Dr. Alex Seifalian heads a team of 30 researchers there.

If you're interested in the how-to, they first developed the scaffold -- in this case by molding it with the help of an artist -- then poured the cartilage replacement material into a mold, then "added salt and sugar" to replicate the spongy feel of a normal nose.  (Hmm!)

Of course, using an artist's created mold is not the only way of shaping a lab-created organ. Last fall, another article in the Wall Street Journal (this by Robert Lee Hotz), reported on a method I've heard more and more about since. That article: "Need a new body part? No problem. Just use a bio-printer to produce it."

For still more, see the three-part series the New York Times ran, also last fall:  “Body Builders” by Henry Fountain., consisting of the three articles and the related graphics. 

This earlier blog post of mine will take you to the series:  "Bio-engineering human tissue on an animal scaffold"

Still more on brain cells implanted in mice.

My technothriller, A REMEDY FOR DEATH: Playing God with body, soul and bio-tech begins with a neuroscientist implanting human fetal brain cells in a chimp, Chimp Donnie.  (This is not really much of a plot spoiler, as it's only a springboard into the real --ethically scary! -- stuff in A Remedy for Death.)

Back then, when I first drafted it, the idea of implanting human fetal cells in an animal seemed very far out -- both technically and ethically. And I was advised by early readers -- including some in the New York publishing establishment -- that that idea was "impossible," "out-of-the range of believable, at least for decades."  And so on.

Well, it's happening here and now, as I posted last week in "Scientists enhance intelligence of mice with human brain cells" -- follow-up  and the week before in another post: "Mice given human brain cells become smarter"  (I was commenting on pieces in, respectively, Institute for Ethics and Emerging Technologies, and Discover Magazine.)

Now Slate has come out with its own take:  Researchers put human brain cells in mice. Why aren't conservatives freaking out?   The Slate article, by Jonathan Moreno, adds a couple of intriguing twists:

(1)  "Lost in the kerfuffle was the fact that many lab mice are already “chimerized” with a small number of brain cells from human sources, generally far less than 1 percent. These animals could provide important clues to the treatment of serious human diseases and to answer the basic question why human cognitive capacity is so much greater than that of other animals."

A "chimera" (like my fictional Chimp Donnie) is formed by implanting human cells in animals. (For a more detailed definition, and how chimeras are different from hybrids, you may want to check the short piece, "About hybrids and chimeras" ) (Blog of the  Center for Genetics and Society)

That piece also touches on some of the ethical concerns:  "Would a human-animal chimera have human rights? Could it be patented and owned? What if it were 99.9% human and 0.1% chimpanzee? What of the reverse situation?"

 (2)   Again from the Slate article:  "The purpose of the study was not to make  [the] mouse perform better in IQ tests but to learn something about the evolution of human cognition."  In other words, the aim wasn't to help mice outwit felines, but rather to help science understand how we 2-legged folk think, and learn to think.  

"Scientists enhance intelligence of mice with human brain cells" -- follow-up

 A post here last week --"Mice given human brain cells become smarter"  linked to a piece in Discover Magazine.

Here's a more extended account of what seems to be the same research.  (I say probably, as it is not clear from the Discover item where the work took place.)

In the work reported in the IEET (Institute for Ethtics and Emerging Technologies), written by George Dworsky    Dworsky IEET report, he writes,

"To conduct the experiment, the scientists created human chimeric mice — mice that were endowed with human glial cells.

("Chimera" --there's that word again, one we're going to be hearing much more of as science moves on.   A chimera, in this context, is a blend of  human with animals of some kind or another, to date mostly chimps and mice.)

"We did this by using a narrow glass micropipette to inject 100,000 human glial progenitor cells into each hemisphere of the developing mouse forebrain," said Goldman. This resulted in the widespread integration of human glia into their brain. Once the mice reached adulthood, a large proportion of their forebrain glia were essentially human.

May I intervene here to (modestly) point out that much the same was done by the fictional neurosurgeon/researcher in my technothriller A REMEDY FOR DEATH in his work with Chimp Donnie?

Back to IEET:

"To mitigate any ethical concerns, Goldman told io9 that the grafts were delivered into postnatal animals, they were of cells that could not be transmitted to offspring, and they did not involve neuronal replacement."

In other words, they made sure that (a) these "ensmartened" mice weren't going to pass on to their babies, and (b) the implanted human cells were not from an aborted fetus, but rather "from human skin cells reprogrammed into induced pluripotential cells." 

Which implies that human skin cells can be reprogrammed into brain cells.  Hmm, does that mean that when you, as the saying goes, "put your foot in your mouth" you are ultimately adding foot cells to augment the brain-power you just failed to demonstrate by what you said? I wonder.

"Mice given human brain cells become smarter" --Discover

A "chimera" as the term is used in the fields of regenerative medicine, bio-artificial organs, organ regeneration, and others, is a combination of humans and primates (or, now, humans and other animals).

So now we have a report via Discover Magazine that human brain cells from an aborted human fetus have now been implanted in mice . . . and it seems "the presence of human cells made the mice's brains function better". 

Just what that means is still being determined. No reports of whether these mice are smarter than cats.

Joking aside, I am very aware of the legal and ethical implications of taking human brain cells and implanting them in a creature of another species.

Quite some time back,I started what became my technothriller A REMEDY FOR DEATH with a scene of a neurosurgical researcher planting aborted human brain cells into a chimp to see if that would increase language abilities.

This was my fiction, and seemed  to be so extreme that it would set up the legal/ethical situation.  I wanted to shock, to get readers thinking, This should not be!

My agent at the time sent it to some New York publishers, and the most memorable reply came from a well-respected editor who said, in effect, "This is totally impossible." Times have changed.  

Interestingly, in that Discover piece you'll see some back-and-forth comments by readers on the two related issues of (a) taking cells from aborted / deceased human fetus for the sake of research; and (b) the ethics and implications of moving human brain cells to non-humans, thereby creating chimeras.

As one of the characters in A REMEDY FOR DEATH puts it, "You're opening very dangerous doorways! Once they're open, there's no stopping what may come through from the other side!"

"Reversing the aging process by using pig hearts"

"Reversing the aging process by using pig hearts" is a post I put up yesterday on my main blog, MichaelMcGaulley.com.  For some reason, I am unable to easily link it across, so I'll do it the hard way, because it's very relevant to  this blog, and the related technothriller, A REMEDY FOR DEATH.

Among the related topics are reversing the aging process, bio-tech, bio-artificial organs, chimeras-- human-animal hybrids, the use of human stem cells, medical ethics, organ harvesting, and organ regeneration-- among others.

To go to that other post, and the related article

Regenerative medicine: Nose stem cell transplant enables paralyzed dogs to walk

More on regenerative medicine and stem cells, though in this case a somewhat different source of cells.

The BBC reports on research at Cambridge University in England that appears to have enabled paralyzed dogs to overcome spinal injuries via work implanting "olfactory ensheathing cells" or "OEC" frm the dog's nose into its spinal cord. Result: 23 of the 34 dogs which had the transplanted cells were able to walk again, though admittedly not perfectly. Of the control group of other dogs, implanted with a placebo, none showed that ability.

The article raises the hope that in the future, similar work may enable paralyzed humans to show significant improvement, but cautions that may be quite some way off in the future.

What I found particularly intriguing is the use of olfactory ensheathing cells.  Seems we all-- humans and dogs-- have them growing within us. In fact, those are the only part of the human body where nerve fibers continue to grow in adults. That suggests that --perhaps-- OECs may offer an alternative to embryonic stem cells, or even to other stem cells.

If you go back to the BBC post, you will find a video showing one dog's progress over the six months after injection of these nerve cells. "Nerve cell transplant enables paralysed dogs to walk"

More on "when is death": now "organ donors who are 'pretty dead."

In the previous post, we looked at a couple of intriguing--maybe disturbing-- articles on the issue of harvesting organs from "recently dead" humans. (That post was "A REMEDY FOR DEATH. Ah, but what IS death? Two interesting articles.")

But that got into the emerging hot-button related issues of "what is death--how should it be gauged?" and "how dead does one really need to be an organ donor?"

In another take on the question, Dick Teresi in Discover Magazine, May 2012, wrote an article,   "The Beating Heart Donors"   Donors," --- that is, in some cases, those are "pretty dead." But how dead do you have to be to be an organ donor?  A couple of intriguing excerpts from that article:

  • "The only people who do not get a share of the transplant wealth are the most essential: the donors and their families. By law, they are the only ones who cannot be compensated. Joseph Murray, the surgeon who performed the first solid-organ transplant, maintains that donors must not be paid, in order to maintain the integrity of the field.
  • "The organ trade claims transplants are the neat extraction of body parts from totally dead, unfeeling corpses. But it's more complicated and messier than that."
  • "Organ transplants would be peripheral to the story of death if they were what the organ trade claimed them to be: the neat extraction of body parts from totally dead, unfeeling corpses. But it is more complicated and messier than that. The grisly facts compiled in this article are not an attempt to derail organ transplantation—an impossible task, given how entrenched the industry is—but knowledge that has been gained from the medical establishment’s obsession with recycling the bodies of people who are, in the words of Dr. Michael DeVita of the University of Pittsburgh’s Medical Center, only “pretty dead.”"

Just to be clear, these are Dick Teresi's words and thoughts.

In another of those little strokes of synchronicity that make my life so interesting, literally as I was writing this entry, I got a call from a friend, a retired Army Colonel, who told me he'd had a transplanted eye for 25 years now, still working well.

Transplants, good.  But still up in the air is the issue of donation.

Best yet, still to come, is the whole field of bio-artificial organs, organ fabrication, organ regeneration and the like .  It's happening, bio-artificial organs are being --what's the word? Created? Generated? Grown?  (On this, I recently did several posts noting current research in these fields. You'll find these mostly in the September 2012 archives of this blog.)

A couple of words more about Dick Teresi.  That Discover article is based on his newest book, THE UNDEAD: ORGAN HARVESTING, THE ICE-WATER TEST, BEATING HEART CADAVERS--HOW MEDICINE IS BLURRING THE LINE BETWEEN LIFE AND DEATH (available in both e-book and p-book version via Amazon  and other booksellers.)

And this: way back, when I was first beginning the research for my technothriller, A REMEDY FOR DEATH: Playing God with Body, Soul & Bio-tech, one of my earlist and most helpful resources with the book  THE THREE-POUND UNIVERSE  by Judith Harper and --you guessed!--Dick Teresi.  (Without giving away the plot of Remedy, suffice it to say that the three-pound universe is that thingee up inside your head, also known as "the brain."  And that one of the lead characters in Remedy just happens to be a experimental neurosurgeon with some ideas that are definitely outside the experimental mainstream.)