Restoration of pig organs after the heart has stopped raises hopes for transplants

Restoration of pig organs after the heart has stopped raises hopes for transplants

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<p><figcaption class=Photograph: Pierre-Philippe Marcou / AFP / Getty Images

Once the heart stops pumping blood, death quickly follows. Or does it?

Scientists have developed a way to restore function in pigs’ organs an hour after their heart stops beating, raising new questions about the nature of death and pointing to ways to improve organ transplant rates.

For decades, scientists have speculated that a flattened heart, and the oxygen and nutrient deficiency it brings, triggers a cascade of events that lead to irreparable cell death and damage to vital organs.

But in 2019, Yale University Professor Nenad Sestan and his colleagues announced a technique to restore some degree of function in pig brain cells up to six hours after death by pumping a form of synthetic blood called cryoprotective perfusate through the their blood vessels.

In addition to providing oxygen and nutrients, it contained drugs and other substances to protect cells from injury and prevent blood clots. Even though the pigs’ brains showed no signs of consciousness, the study provided the main evidence that irreparable cell damage caused by death may not be as irreparable.

Now, the same team has achieved a similar feat in other bodies. Their updated device, OrganEx, restored circulation and improved cell function in the heart, brain, liver, and kidneys of pigs who died of heart attacks an hour earlier. It has also activated programs involved in cell repair.

The research, published in Nature, highlights a previously unappreciated ability of the body to partially recover after blood flow is cut off, the researchers said.

“These cells work hours after they shouldn’t be. What [this] it tells us is that cell death can be stopped and their function restored in multiple vital organs, even an hour after death, ”Sestan said.

“These findings open the door to future transplant studies and possible treatments for ischemic injury [where blood flow to vital organs is disrupted]. “

Currently, the best way to restore oxygen and nutrient supply to private organs and tissues is extracorporeal membrane oxygenation (ECMO), in which blood is pumped through a machine that removes carbon dioxide and sends blood filled with oxygen in the body.

However, when Sestan’s team examined the organs of pigs that had undergone ECMO treatment an hour after their hearts stopped beating, they found that many of the smaller vessels that supply oxygen to these tissues had collapsed. The organs that had undergone the OrganEx treatment appeared to be less damaged and there were even signs of repair in the kidneys.

“This is a truly remarkable and incredibly significant study. It shows that after death, mammalian (including human) organ cells such as the brain do not die for many hours, even in the post mortem period, “said Dr. Sam Parnia, associate professor of intensive care medicine at the New York University Grossman School of Medicine, which was not involved in the research.

“By developing this organ preservation system, doctors will be able to provide new treatments to preserve post mortem organs in the near future. This will allow access to many more organs for transplantation, which will lead to thousands of lives saved every year. “

In the future, it may also be possible to support organ function in deceased people, such as from drowning, heart attack, or massive bleeding after a car accident, and bring them back to life hours later, once doctors have repaired the damage. , he added.

Sestan’s team warned that more animal experiments would be needed before human organ testing could be initiated. Even then, it would likely be many years before a deceased person was ever connected to the device.

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