Tuesday, January 22, 2008

New Breakthrough May End Donor Shortage and Relieve Ethical Concerns

Another “proof of concept” success involving adult stem cells is showing once again that the proposals of many in the bioethics community to increase the pool of organ donors through an expansion of death criteria are both shortsighted and ethically wrongheaded. A recent press release reports, “US scientists have coaxed recycled hearts taken from animal cadavers into beating in the laboratory after reseeding them with live cells.” If this procedure is extended to humans, the potential “for almost limitless supply of hearts, and possibly other organs” could diminish the need for heart-beating cadaver organ donors. The theory behind the procedure involves developing “transplantable blood vessels or whole organs that are made from your own cells” thus eliminating the need for immunosuppressive drugs.

The well-publicized acute shortage of donor organs is highlighted by the fact that approximately 50,000 patients die every year waiting for a heart transplant. Many leading bioethicists have proposed expanding death criteria to include higher-brain death as a means for increasing organ supply. This would mean that patients in a permanent vegetative state (PVS) could be declared dead and their organs removed for transplantation, provided that either prior consent from the patient or consent by proxy is obtained. Given the tenuous nature of a PVS diagnosis, such proposals are certain to raise more controversy and greater suspicion regarding the means of procurement for the good of life-giving organ transplants.

Furthermore, these proposals fail to take into account that, under the current system, many recipients of donor hearts don’t survive any longer than those left on waiting lists. (See: Deng, Mario C., Effect of receiving a heart transplant: analysis of a national cohort entered on to a waiting list, stratified by heart failure severity BMJ 2000;321:540-545.) This is due primarily to the fact that the pre-existing weakened condition of heart patients is further compromised by the surgical procedure and the ensuing immune-suppressant diseases characteristic of organ recipients. The prospects of transplantable organs derived from recipients’ own cells are clearly preferable to the proposals of many in the bioethics community. Not only will it eliminate much of the controversy currently surrounding the procurement of organs for transplantation, but also promise greater survival rates for recipients.

Press Release: http://afp.google.com/article/ALeqM5jrDcLbJiEj8KXtPaMo_sPrzoUsKQ
Telegraph Report: http://www.telegraph.co.uk/earth/main.jhtml?view=DETAILS&grid=&xml=/earth/2008/01/13/sciheart113.xml

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