Hacker News Reader

Comment by WirelessGigabit | Hacker News Reader

Given the amount of people needing organs, and dying because of no availability, this is great.

Doubt it will be used anytime soon. It is one of these breakthrough medical news that you hear about it now, and then you end up the next 10 years wondering whatever happened to it.

Based on the article, they've got a long way to go. Something closer though is pig kidneys with genetic modifications to keep the human immune system from attacking them. That has already worked for a while in a brain-dead patient.

The body attacking donor organs in general is a huge obstacle that still needs to be overcome, as it requires the users of the organ to be on immunosupressants, and in general greatly lessens the lifespan of the organ.

If they can make pig organs be accepted by the body without compromising the immune system that's a big breakthrough right there.

There is a different approach going on in the US right now to breed pigs with small genetic modifications to prevent hyperacute rejection and transplanting the pigs kidney with the pigs thymus embedded in the kidney. Its been tested on a brain dead patient who donated his body to science. There was no signs of rejection for 6 weeks and the kidney continued to remove waste and produce urine.

> The first hurdle to overcome in xenotransplants is preventing so-called hyperacute rejection, which typically occurs just minutes after an animal organ is connected to the human circulatory system. By “knocking out” the gene that encodes the biomolecule known as alpha-gal—which has been identified as responsible for a rapid antibody-mediated rejection of pig organs by humans—immediate rejection has been avoided in all five xenotransplants at NYU Langone. Additionally, the pig’s thymus gland, which is responsible for educating the immune system, was embedded underneath the outer layer of the kidney to stave off novel, delayed immune responses. The combination of modifications has been shown to prevent rejection of the organ while preserving kidney function.

https://nyulangone.org/news/pig-kidney-xenotransplantation-p...

There are enough kidneys, there are not enough donors. I suspect we could get closer to balance if we changed to opt-out or presumed consent.

UK is now opt out, and yet still at a shortage. According to a doctor friend, most people who die simply aren't suitable donors. Their old knackered organs, ravaged by whatever disease killed their owner, are no use.

People have no desire to donate organs only to have them go to people they might not like or wish were dead. Why give up a kidney to some baby boomer whose generation ravaged the Earth and left their children so poor? We must grow organs from scratch.

As cars get automated, there will be fewer kidneys (and other organs) available despite opt out.

Motorcyclists are still your core optimal donation demographic though.

There are many issues with organs from people killed in accidents. Availability, randomness of occurrence, suitability, immunity.

To be able to have a 'manufactured' supply seems much better, not least or especially if it is ultimately possible to remove all immunity problems.

The current system, whether opt-in or opt-out, is because we simply don't know how to do better. On demand grown organs using the recipient's own DNA seems to be the holy grail. I reckon we'll get there someday.

Or we could start allowing the remuneration of donors, and not just everyone else involved in the transplant process. Paying for kidneys is legal in Iran, and guess what? No shortage there.

Surely this just leads to people who are desperate being taken advantage of ...

How can you claim that? Certainly those who cannot pay are suffering from a shortage.

Another example is plasma donation to make plasma therapies. No country produces sufficient plasma for plasma therapies to meet the needs of their patient population unless they compensate for that donation. The few countries that do compensate are US, Germany, Austria, Hungary and Czech Republic.

> The U.S., with only five per cent of the world’s population, provides more than 70 per cent of all the plasma used to make plasma therapies for the whole world.

> If you add plasma obtained from Germany, Austria, Hungary and the Czech Republic — the other countries where compensation is offered — compensated plasma accounts for 89 per cent of all the world’s plasma for plasma therapies.

> This is worth emphasizing: There is no country in the world that manages to collect all the plasma needed for plasma therapies using non-compensated plasma collections. Every country in the world that uses plasma therapies depends on compensated plasma collections.

https://theconversation.com/not-compensating-canadian-blood-...

As long as there's a moral and ethical framework governing it to prevent abuse.

An ex-colleague of mine got a kidney transplant in China, most kidneys are from either volunteer donors or prisoners that have given their consent.

Although it is not impossible for this type of system to be gamed, having proper governance around it might be a good way forward.

There's also the option for living donation.

"Why I gave my kidney to a stranger — and why you should consider doing it too"

https://www.vox.com/science-and-health/2017/4/11/12716978/ki...

Reply on news.ycombinator.com