[Findings point to improvements in organ transplants and raise
questions over nature of death]
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RESTORATION OF PIG ORGANS AFTER HEART STOPPED RAISES HOPES FOR
TRANSPLANTS  
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Linda Geddes
August 3, 2022
The Guardian
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_ Findings point to improvements in organ transplants and raise
questions over nature of death _

An assistant preparing a kidney for a renal transplantation at La Paz
hospital in Madrid. The findings point to ways to improve organ
transplantation rates. , 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 pig organs an
hour after their hearts have stopped beating, raising fresh questions
about the nature of death and pointing to ways to improve organ
transplantation rates.

For decades, scientists had assumed that a flatlining heart, and the
deficit of oxygen and nutrients that it brings, triggers a cascade of
events leading to irreparable cell death and damage to vital organs.

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

As well as delivering oxygen and nutrients, it contained drugs and
other substances to protect cells against injury and prevent blood
clots. Even though the pigs’ brains showed no signs of
consciousness, the study provided proof of principal that the
irreparable cell damage caused by death, might not be so irreparable.

Now, the same team has achieved a similar feat in other organs. Their
updated device, OrganEx, restored circulation and improved the
function of cells in the hearts, brains, livers and kidneys of pigs
that had died from heart attacks an hour earlier. It also activated
programmes involved in cellular repair.

The research, published in Nature
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previously unappreciated capacity of the body to partially recover
after disrupted blood flow, the researchers said.

“These cells are functioning hours after they should not be. What
[this] tells us is that the demise of cells can be halted and their
functionality restored in multiple vital organs, even one hour after
death,” said Sestan.

“These results open the door for future transplantation studies and
possible treatments for ischemic damage [where blood flow to vital
organs is disrupted].”

Currently, the best way to restore oxygen and nutrient delivery to
deprived organs and tissues is extracorporeal membrane oxygenation
(ECMO), where blood is pumped through a machine that removes carbon
dioxide and sends oxygen-filled blood back into the body.

However, when Sestan’s team examined organs from pigs that had
undergone ECMO treatment an hour after their hearts stopped beating,
they discovered that many of the smaller vessels supplying oxygen to
these tissues had collapsed. Organs that had undergone 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
demonstrates that after death, cells in mammalian organs (including
humans) such as the brain do not die for many hours – well into the
postmortem period,” said Dr Sam Parnia, associate professor of
critical care medicine at New York University Grossman School of
Medicine, who was not involved in the research.

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

Further into the future, it might even be possible to support organ
function in people who have died, for example as a result of drowning,
heart attacks 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 cautioned that further animal experiments would be
necessary, before tests in human organs could be initiated. Even then,
it would likely be many years before a deceased person was ever hooked
up to the device.

_LINDA GEDDES is a Bristol-based freelance journalist writing about
biology, medicine and technology. Born in Cambridge, she graduated
from Liverpool University with a first-class degree in Cell Biology.
She spent nine years at New Scientist magazine working as a news
editor, features editor and reporter, and remains a consultant to the
magazine. Linda has received numerous awards for her journalism,
including the Association of British Science Writers’ awards for
Best Investigative Journalism. She is married with two young children,
Matilda and Max._

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* Science
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* Medicine
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* health
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* death
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* transplants
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