Tis the season for giving.

Australians aren’t very good at donating their organs. A comparison ORGAN DONATION RATE FOR SELECTED COUNTRIES with other countries puts us at the bottom of the list. Why this is so is uncertain. I don’t think that we shy away from giving our body parts on moral grounds, indeed whenever somebody does the right thing and approves that their loved ones are recycled, as was the case with David Hookes, they are roundly applauded and for a short time everyone seems to show interest in registering on tissue matching databases and completing donor cards. But it doesn’t last long and demand continues to outstrip supply.

Perhaps the thought of MOHT (mobile organ harvesting teams) lining up next to the tow truck drivers at car crashes, people on commission targeting the parents of teenagers who have overdosed, and any pressure being applied to other regular sources of young healthy organs doesn’t paint the right picture. I must admit, and I know some of you will think me weird, the thought flashed across my mind when I recently saw the lines of drowned bodies, what a waste of organs!

The other day I received a proposal from Adelaide-based Bresagen to ‘restructure’ the company. Actually what they really meant was that the company had gone broke and some canny Queenslanders were making them an offer they couldn’t refuse. Unfortunately, existing shareholders are faced with a ‘take it or leave it’ option, but that’s another issue. The reason I bought Bresagen shares in the first place was that I believed that they possessed unique IP relating to stem cell research and cloning technolgy. Their 2002 annual report made glowing references to cloning pigs and cell therapies based on proprietary stem cell lines but it seems that they bit off more than they could chew and had to cease the exciting, (b)leading-edge research.

For reasons that aren’t immediately apparent, they transferred all the ‘good stuff’ to the USA and are now committed to the commercial development of protein and peptide therapeutics. From the blurb they produced I got the impression that the best way to overcome the deficiency in available organs is to grow pigs as organ banks. I understand that pigs are physiologically similar to humans and it is only a simple molecule on the pig cell that causes human immune systems to reject pig organ transplants or xeno transplants as they are known.

So I was particulary interested to read an article on Bioethics that appeared in the Weekend AFR.

Let’s say you need a new liver. Zanjani would take some of your bone marrow stem cells and inject them into a fetal sheep. A few weeks later, the lamb would be born with a liver made up chiefly of your cells. It would be sacrificed and your new liver installed. Your immune system would eliminate the lamb’s liver cells, leaving behind a brand new organ perfectly matched to your body. Providing sick people with life-saving transplants is certainly a morally worthy activity.

J.Michael Bedford reported in 1977 that human sperm could penetrate the protective outer membranes of gibbon eggs. So far, from what we know, no one has attempted to create a human-chimpanzee hybrid. But would that be wrong?

I Googled for other writing that Ronald Baily has done and came across this site that lists many really interesting articles that reflect on various bioethical issues, including;
The case for selling human organs.

The normal way to handle shortages is to let prices rise to the market-clearing price. With organs, it might work this way: A cadaveric donor’s family might be able to sell their dear departed’s organs to patients who need them. Better yet, consenting living donors would be able to bargain with transplantees or their insurance companies for the sale of, say, a kidney or a piece of liver (both can be surgically removed without causing much permanent harm to the seller). But there is nothing resembling a market in human organs in the United States.

Why? At the very beginning of the organ transplant era some people feared that their doctors might hasten their deaths in order to obtain transplantable organs. Others worried that people living in rich countries might pay poor people living in developing countries for their organs. These fears have given rise to one of the most durable urban legends of all time: the one about the guy who goes to Spring Break in Florida and wakes up 3 days later in a hotel room with a hole in his side through which someone has extracted one of his kidneys.

The taboo topic in the organ transplant community is payment for organs. When it is discussed, euphemisms like “rewarded gifting” or “compensated donation” are used.

A Stem Cell Christmas Miracle?

For the sake of Ms. Hwang and millions (including about 250,000 Americans) who live with spinal cord injuries, let us hope that the South Korean research can be reliably replicated and improved upon. However, only more research will tell whether the promise of adult umbilical cord and embryonic stem cells will be fulfilled. Various lines of research should be pursued simultaneously to insure the best chance of discovering effective future treatments. It may well turn out that adult stem cells are good treatments for certain diseases, umbilical cord stem cells work best for others, and embryonic stem cells are better at curing still different maladies. Contrary to the claims of bioconservatives, it is not either adult and umbilical cord stem cells or embryonic ones; for the sake of millions of suffering patients, it’s necessary to forge ahead on all three fronts.

Transhumanism: The Most Dangerous Idea?

But what if enhanced posthumans took the Nietzschean superman option? What if they really did see unenhanced people “as inferior, even savages, and fit for slavery or slaughter”?
Let’s face it, plenty of unenhanced humans have been quite capable of believing that millions of their fellow unenhanced humans were inferiors who needed to be eradicated. However, as liberal political institutions have spread and strengthened, they have increasingly restrained technologically superior groups from automatically wiping out less advanced peoples (which was usual throughout most of history). I suspect that this dynamic will continue in the future as biotechnology, nanotechnology, and computational technologies progressively increase people’s capabilities and widen their choices.

The biggest problem I see when it comes to the ethics associated with biomedical engineering is that the ‘man in the street’ doesn’t understand either the subject or it’s ramifications. Too often the debate is hijacked by groups that have agenda that have little or nothing to do with bioethics. For example the religious conservatives almost stopped passage of legislation allowing the development of stem cell lines crucial for continued research and animal liberationists decry almost all research on animals, regardless of what benefits are likely to accrue.

In the new study, 19 paraplegic dogs between 2 and 8 years of age were treated with a PEG injection within 72 hours of injury in addition to getting standard veterinary therapy for spinal injury.
Standard treatment includes injection of steroids, surgical removal of any potentially damaging bone chips from the spinal area and physical rehabilitation, such as swimming. The group of 19 dogs was compared with a second group of dogs that had gotten only the standard treatment.

If subjects such as growing pigs specifically for human xeno transplant, the use of stem cells in sheep to create human body parts etc. etc. are not discussed and debated how are we to prepare to answer questions such as; would eating a liver composed chiefly of human liver cells grown in a sheep be cannibalism?

Bailey asks the question;

As humanity’s biotechnological prowess increases, we will confront again and again the question of what, if any, limits should be placed on research that mixes human and animal genes, cells and tissues.

Anybody got an answer?

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Mark Bahnisch
Mark Bahnisch
2021 years ago

Interesting questions, Wayne… This is not something I know anything much about but I do remember seeing some results of comparative international research which found that in the area of genetically modified food, Australians were particularly resistant to spicing together plant and animal genes. Which is one answer to Bailey’s question. Unfortunately I can’t recall where I read it or whether there was anything on why!

2021 years ago

“I must admit, and I know some of you will think me weird, the thought flashed across my mind when I recently saw the lines of drowned bodies, what a waste of organs!”

I happy to be corrected, but my understanding is that only the about-to-die brain-dead in hospitals are suitable for most organ donation.

The Hookes’ incident occured about midnight, and he died the following day at 7 pm.

Nic White
2021 years ago

People killed instantly in car accidents can have their organs dontated. People who have drowned probably can too.

In response to your question Wayne I have a very simple and fundamental answer – the ends justifies the means. If the result of an action, such as the mixing of human and animal genes, cells and tissues, is a profoundly beneficial method of saving and bettering the lives of people who have a need for new organs then ultimately it is a good one. Limits? As far as is necessary so long as the scales still tip in favour of the benefits. I think it would presumptious to draw a line now when so much technology is yet to be discovered and so many research angles are yet to be concieved.

On organ donations, can someone think of a convincing argument why we should not have compulsory organ donations in place for certain causes of death? It saves and betters lives, and the organs are no use to the body anymore – its dead. Better yet, countries with capital punishment could remove all useful organs from the criminal post mortem and distribute them to wherever it is extracted organs go before they are put in patients.

Ends justifies the means.

2021 years ago

Thankfully not all countries are restrained by these “ethics”. The research will go on, just not in the west.

2021 years ago

I’ve always wondered why people are so protective of their organs once they start to decay, and research into extension of life quality and quantity stirs so many to rant against it.

Homer Paxton
Homer Paxton
2021 years ago

If their organs aren’t any good then why not pianos?

2021 years ago

A timely post. The first organ transplant was 50 years ago last week – a kidney transplanted from one twin brother to the other thus prolonging his life for 8 years. I was stunned – I didn’t realise that 1954 micro surgery was so advanced.

I would have liked to see some data comparing “deaths that result in possible useful organs” compared with actually donation rate. I know that the US figures are artificially inflated because a very large number, compared to Australia, of young healthy people die on the operating table: they are gunshot victims. 3000 people per month are killed by guns in the States. A significant number of them result in people in comas and on life support. This means there are lots of potentially available organs.

The first link Wayne provided stated that most organ donation in Australia comes from road trauma. Young people are over represented in car accidents, hence it is unsurprising that they are the source of most of our organs.
Old people generally don’t make good organ donors.

The link did say that Spains high rate was cheifly due to hospital procedures and ours was low due to hospital staff not wanting to intrude on a family’s greif to get donation consent. Unfortunately they didn’t say why Germany’s was so large.
It was interesting that our rates were almost the same as the UK and NewZealand. These societies are the most similar to ours.

Should organ donation be an opt-out rather than an opt-in process? I think so. There aren’t that many good reasons to opt-out – we don’t have that many Hassidic Jews so their opting-out will have no impact.

As soon as you start involving money then the whole think goes to crap.

The irony remains that organ donation is dependant upon the untimely deaths of others.

2021 years ago

Interestingly enough, although many people opt for organ donation on their drivers licence, the hospitals cannot take this for consent. Therefore the hospital has to then get permission for the persons guardian, spouse, parents, or whatever, and this process takes too long. Hence a low rate of organ donation.

2021 years ago

as a single leg above knee amputee who sometimes uses a prosthesis, I’m very interested in this whole debate about the mixing of the human and non-human.

there’s an interesting take on this at a blog called “Dewey’s Girl” – librarians always have brilliant blogs btw…