Could Organ Transplantation Become a Thing of the Past?
Aug 11, 2017 Cedars-Sinai Staff
When doctors performed the first organ transplantation in 1954, transferring a man's kidney to his ailing twin, the miraculous procedure ushered in a new era of medicine. Millions of lives have since been saved.
What doctors really want: A world where we don't need transplantation.
Sometimes, the ideal solution is the one you don't need to use in the first place. Many experts hope for a day when the adage "an ounce of prevention is worth a pound of cure" will truly take hold. Also, even as underlying diseases develop, new treatments and cures could make the need for organ transplantation much less common than it is today.
Four Cedars-Sinai experts share their ideas for reducing the need for organ transplants.
Reversing Heart DamageDr. Eduardo Marbán wants to render organ transplantations unnecessary. That means intensifying research on diseases thought to be incurable so patients can be healed without resorting to donated organs. " My lab is investigating the possibility that 'irreversible' damage to hearts may, in some cases, be reversible," Dr. Marbán says. "Early-stage clinical trials of cell therapy in heart attack patients have yielded encouraging results. If we can heal the heart instead of removing it, transplants might be avoided."
To that end, science may have much to learn from the animal kingdom. For example, newts regrow limbs after amputation. "If we can figure out how they do that, we may be able to figure out how to regenerate damaged tissue in humans, too," Dr. Marbán says. "I see organ transplantation as nothing more than an interim technology, tiding us over until we know how to make sick organs healthy or prevent them from decaying in the first place."Dr. Eduardo Marbán is the director of the Cedars-Sinai Heart Institute and one of the world's leading cardiologists and heart researchers. His pioneering research, focusing on the molecular and cellular mechanisms involved in heart disease, has translated into key advances in stem cell treatments for heart attack and heart failure.
Become Your Own Organ Donor
"There is only one way to end the shortage problem while also ending organ rejection and the dangers of immunosuppression," Dr. Danny Ramzy says. "Make each and every person their own organ donor." Once the purview of science fiction, stem cell technology has brought Dr. Ramzy's dream within reach. Induced pluripotent stem cells (iPSCs) are created from an adult cell, then transformed to mimic embryonic stem cells that can be grown into specific tissues, including skin, lung, liver, or heart. Thanks to iPSCs, the day is nearing when scientists will be able to custom-build new organs to replace those that are failing. "The technology still has far to go," Dr. Ramzy explains, "but we're getting ever closer to creating organs that are a perfect genetic match for every patient. That's the holy grail, and I'm hopeful that I will see it during my lifetime."Dr. Danny Ramzy is director of Robotic and Minimally Invasive Cardiac Surgery and surgical director of Lung Transplantation. He specializes in cardiothoracic surgery.
Grow Part of a New Organ
It may take some time before a whole organ can be grown out of stem cells. In addition, some organ systems, such as the nervous system, are so complex that transplantation may be impossible. Still, an elegant solution may exist. "We could simply replace only the part of the organ that's sick," says Clive Svendsen, PhD. His team has successfully injected stem cells into brains and spinal cords and observed the damaged tissue rejuvenate. "The stem cells seem to migrate to the diseased areas," he explains. "As the technology evolves, we may be able to slow the progression of serious diseases of the nervous system like ALS (amyotrophic lateral sclerosis) and Parkinson's." He soon may see his research translate into a viable treatment of the future: The FDA just approved a Phase I clinical trial for ALS.Clive Svendsen, PhD, is professor of Medicine and Biomedical Sciences at Cedars-Sinai and director of the Board of Governors Regenerative Medicine Institute. He also heads the Svendsen Laboratory, which focuses on stem cell technology to battle neurodegenerative diseases such as ALS, Huntington's, Alzheimer's, and Parkinson's.
Confront the Obesity Epidemic"It is my dream that someday transplanting organs no longer will be necessary," says registered nurse Joyette Jagolino. "That may never happen, but awareness about disease prevention and a healthier lifestyle are steps in the right direction." According to The State of Obesity: Better Policies for a Healthier America, "if we fail to change the course of the nation's obesity epidemic, the current generation of young people may be the first in American history to live shorter, less healthy lives than their parents."
Obesity can lead to diabetes and hypertension, the two most common causes of kidney failure. Overweight patients experience increased risk for heart disease, stroke, and fatty liver disease. If the obesity rate were lower, the incidence of organ failure could be reduced as well.Joyette Jagolino, RN, is a transplant nurse and the service line manager at Cedars-Sinai's Comprehensive Transplant Center.