It has been said that the only certain thing in life is death, and as we head into the final week of the spookiest month of all, I’d like to introduce a peculiar study that has raised significant ethical questions about mortality.
During the initial phase of death, the lack of oxygen, blood flow, and nutrients triggers a cascade of biochemical processes that shut down the body’s cells and organs. However, Nenad Sestan, MD, PhD, of the Yale School of Medicine, New Haven, Connecticut, and colleagues discovered a way to cease this permanent cell failure.
“All cells do not die immediately, there is a more protracted series of events,” said David Andrijevic, MD, also of the Yale School of Medicine and co-lead author of the study. “It is a process in which you can intervene, stop, and restore some cellular function.” (Yale News)
The researchers restored blood circulation and other cellular functions in pigs a full hour after their deaths, as they reported in the journal Nature on August 3rd, 2022. Furthermore, these findings may actually help to extend the health and life of human organs, as well as expand the availability of donor organs for transplant.
Their new system, dubbed OrganEx, was based on an earlier Yale-led project published in 2019 that restored circulation and certain cellular functions in the brain of a dead pig with technology dubbed BrainEx. This surgical procedure utilizes a perfusion device similar to that of heart-lung machines—which do the work of the heart and lungs during surgery—and an experimental fluid designed to promote cell viability and suppress inflammation in the brain under normal body temperature (37°C). Cardiac arrest was induced in anesthetized pigs, which were treated with OrganEx an hour after death.
“If we were able to restore certain cellular functions in the dead brain, an organ known to be most susceptible to ischemia [inadequate blood supply], we hypothesized that something similar could also be achieved in other vital transplantable organs,” stated the investigators during a Yale News press release.
Just 6 hours after OrganEx treatment, key cellular functions in the liver, heart, and kidneys were active, with some organ function having been restored. Interestingly, they were also able to restore circulation throughout the body, which was previously thought to be impossible. Even under the microscope, it was challenging to distinguish between healthy organs and those treated with OrganEx after death.
Not only this, but involuntary and spontaneous muscular movements in the head and neck were also observed, even though the animals remained anesthetized during the entire 6-hour experiment. Notably, the study authors state that this indicates the preservation of some motor functions.
Although the experimental protocols were approved by Yale’s Institutional Animal Care and Use Committee as well as an external ethics and advisory committee, the researchers put the utmost importance on conducting additional studies that undergo rigorous ethical review from other scientists and bioethicists. Despite the obvious ethical implications, OrganEx technology has the potential to be applied in several situations. Especially in cases of tissue and organ damage due to ischemia.
“There are numerous potential applications of this exciting new technology,” said Stephen Latham, JD, PhD, director of the Yale Interdisciplinary Center for Bioethics. “However, we need to maintain careful oversight of all future studies, particularly any that include perfusion of the brain.” (Yale News)
References
- Nenad Sestan, MD, Phd. Yale School of Medicine. (n.d.). Retrieved October 25, 2022, from https://medicine.yale.edu/profile/nenad_sestan/
- David Andrijevic, MD. Office of Academic & Professional Development (OAPD). (n.d.). Retrieved October 25, 2022, from https://medicine.yale.edu/oapd/profile/david_andrijevic/
- Andrijevic, D., Vrselja, Z., Lysyy, T. et al. Cellular recovery after prolonged warm ischaemia of the whole body. Nature 608, 405–412 (2022). https://doi.org/10.1038/s41586-022-05016-1
- Vrselja, Z., Daniele, S.G., Silbereis, J. et al. Restoration of brain circulation and cellular functions hours post-mortem. Nature 568, 336–343 (2019). https://doi.org/10.1038/s41586-019-1099-1
- Hathaway, B. (2022, August 5). Yale-developed technology restores cell, organ function in pigs after death. YaleNews. Retrieved October 25, 2022, from https://news.yale.edu/2022/08/03/yale-developed-technology-restores-cell-organ-function-pigs-after-death
- Stephen Latham, JD, Phd. Yale School of Medicine. (n.d.). Retrieved October 25, 2022, from https://medicine.yale.edu/profile/stephen_latham/
- Yale University. (2022, August 3). Technology restores cell, organ function in pigs after death. ScienceDaily. Retrieved October 25, 2022 from www.sciencedaily.com/releases/2022/08/220803112550.htm