Speaker 1: Brought to you by Toyota. Let's go places. Welcome to
Speaker 1: Forward Thinking. Hey, they're in love in the Forward Thinking,
Speaker 1: the podcast that looks at the future and typically makes
Speaker 1: a reference to a song lyric, which I'm not doing today,
Speaker 1: and I'll explain why in a second. But I'm Jonathan
Speaker 1: Strickland and I'm Joe McCormick, and today we're gonna be
Speaker 1: looking into a very special listener request. Yeah. Camillo wrote
Speaker 1: in and said, hello, guys, I'm a long time listener
Speaker 1: since Tech Stuff in two thousand eight. That's going all
Speaker 1: the way back to the very beginning of Tech Stuff.
Speaker 1: That's when we were doing fifteen minute long episodes. I
Speaker 1: love all of how stuff works podcasts. And to keep
Speaker 1: this email short, I recently saw news of a head
Speaker 1: transplant that is expected to be performed in a couple
Speaker 1: of months. I can't recall a podcast specifically about head transplants,
Speaker 1: not off the top of my head. Wink wink. This
Speaker 1: sounds like a spooky subject, but very interesting. Keep up
Speaker 1: amazing tech at Futuristic Podcast. I wouldn't know what to
Speaker 1: do about you, guys at work. So Camillo's referring to
Speaker 1: a news item about a proposed head transplant that would
Speaker 1: not be taking place in a couple of months, unless
Speaker 1: you guys are listening to this in two thousand seventeen,
Speaker 1: because that is when it would the proposed surgery would
Speaker 1: actually take place, right, and the technology necessary for this
Speaker 1: feat is not quite so far along as the popular
Speaker 1: media has perhaps made it sound ye that the story
Speaker 1: okay is this? Back in July of one, doctor Sergio
Speaker 1: Carnavero of the Turn Advanced Neuromodulation Group or TANG in
Speaker 1: Italy announced his project to make head transplants possible. The
Speaker 1: project is called heaven Gemini, which is an acronym for
Speaker 1: something I do not know what. It sounds like, a
Speaker 1: like a robot in a video game. I know, right,
Speaker 1: we'll get there. Yeah. But so this February in he
Speaker 1: announced that the project's coming along well and that he
Speaker 1: thinks he'll be ready to conduct a head transplant surgery
Speaker 1: within the next two years. Yeah. Then it started making
Speaker 1: more headlines because in April he got a volunteer with
Speaker 1: a medical necessity, one Valerie spird Nov. Now Spritanov has
Speaker 1: Type one spinal muscular atrophy a k A worden ing
Speaker 1: Hoffman disease. Uh kinda vera has also being contacted by
Speaker 1: the way by transgender people. But the procedure is so
Speaker 1: risky that, you know, even he would not want to
Speaker 1: try it, you know, with a healthy body, even if
Speaker 1: that healthy body is is not the one that you want. Right. So,
Speaker 1: in other words, he would want only to perform the
Speaker 1: surgery for someone who is already at risk of dying
Speaker 1: or or whose quality of life is such that it
Speaker 1: would be considered a worthwhile risk. Right. And along those lines,
Speaker 1: let's take a second to talk about worden ing Hoffman. Sure,
Speaker 1: this is an inherited trait. The trait is an autosomal
Speaker 1: recessive trait, and it's a disease that's caused by disruptions
Speaker 1: or mutations in the s m IN one or survival
Speaker 1: motor neuron one gene, which is located on chromosome five.
Speaker 1: And it's also known as infantile spinal muscular atrophy and
Speaker 1: characterized by the degeneration of nerve cells within the lower
Speaker 1: brain stem and certain motor neurons in the spinal cord. Now,
Speaker 1: this leads to muscle weakness, generally beginning in the extremities
Speaker 1: and eventually leading to other areas including muscles involved in chewing, swallowing,
Speaker 1: and breathing. Uh. And tragically, a large percentage of infants
Speaker 1: who developed this pass away before reaching the age of two.
Speaker 1: So you can see why somebody suffering from this condition
Speaker 1: might be a candidate for something like a head transplant,
Speaker 1: if that were possible. Yeah, and Sprintanov himself has said,
Speaker 1: you know, he has lived beyond what most people had
Speaker 1: expected he would be able to to. You know, most
Speaker 1: people thought he would have passed away by now, most
Speaker 1: of the doctors he had been consulting through out his
Speaker 1: entire life. And so his his position on the matter
Speaker 1: is that he he is experiencing a difficult life. He's
Speaker 1: not expected to have a very long lifespan, and so
Speaker 1: for him, this is a risk that's worth taking. Sure. Sure.
Speaker 1: And you know, if if these headlines about the possibility
Speaker 1: of a head transplant have sounded kind of incredible to you,
Speaker 1: you're not the only one that the medical community has
Speaker 1: has kind of been an agreement about that, and that's
Speaker 1: been kind Yeah, and that's partially because a successful organ
Speaker 1: transplants have really only been happening for the past fifty
Speaker 1: years or so. So before we go into the specifics
Speaker 1: about this head transplant surgery and the controversy surrounding it.
Speaker 1: I want to take a look at the history of
Speaker 1: the medical technology surrounding transplantation. Sure, I actually didn't know
Speaker 1: that this was such a recent phenomenon. I imagined it
Speaker 1: would be one of those things that had been done
Speaker 1: in a dirt, an unpleasant way for hundreds of years. Well,
Speaker 1: there were certainly lots of early attempts that almost always
Speaker 1: resulted in the immediate death of the patient. If not that,
Speaker 1: then it resulted in the eventual death of the patient. Right,
Speaker 1: We've we've actually only had the technology, or rather than
Speaker 1: the methods to perform vascular anastomoses that that's joining up
Speaker 1: to blood vessels since the very beginning of the twentieth century.
Speaker 1: And it wasn't until then that people could really start
Speaker 1: to attempt real organ transplants. And I'm sure that there
Speaker 1: were a few unfortunate cases earlier than that where people
Speaker 1: kind of like stuck an organ in a thing and went, oh, nope,
Speaker 1: that's not working. But there well, I know there are
Speaker 1: a lot of cases in like mythology, and you don't
Speaker 1: know to what extent that might have been based on
Speaker 1: some horrific ancient experiment. Yeah, yeah, absolutely, um So. One
Speaker 1: of the researchers who was working on on the methodology
Speaker 1: of joining blood vessels together began attempting organ transplants in
Speaker 1: nineteen o six. Uh He He was trying to put
Speaker 1: a goat or pig kidneys into human patients who were
Speaker 1: experiencing renal failure, which, to be fair at that time
Speaker 1: was was a mortal organ failure. There was no coming
Speaker 1: back from that one. Um It obviously did not work out,
Speaker 1: but it did get the field started. In the meanwhile,
Speaker 1: another technology was in kind of co development in the
Speaker 1: medical community, and that's artificial respiration and circulation, and by
Speaker 1: nineteen fifty three, the heart lung machine or or the
Speaker 1: pump as we know it today had been created. That's
Speaker 1: something that can artificially circulate a patient's blood and an
Speaker 1: oxygen during a surgery. It was it was used for
Speaker 1: the first successful open heart surgery in and the next
Speaker 1: year in we get the very first successful human organ transplant,
Speaker 1: which was a kidney transplant. The doctor uh ended up
Speaker 1: transplanting a kidney from one identical twin to another identical twin.
Speaker 1: And the benefit of that is there was no risk
Speaker 1: of oregon rejection. In fact, that's the only case apart
Speaker 1: from using someone's own tissue, where you don't have to
Speaker 1: worry about the the rejection of tissue that you would
Speaker 1: in other transplant surgeries, right, Right, And I'm not sure
Speaker 1: whether people knew at that specific time that that was
Speaker 1: why it was successful. Yeah, I'm not entirely sure either,
Speaker 1: because there was a lot of unsuccessful transplants after that, right,
Speaker 1: There were quite a few. So Dr Joseph Murray was
Speaker 1: the one who performed the procedure and was eventually awarded
Speaker 1: the Nobel Prize for this work. Yeah, and the recipient
Speaker 1: of the kidney lived for eight years after the transplant surgery,
Speaker 1: so that was considered a success. It led to other
Speaker 1: surgeries that were not as successful. Yeah. If you look
Speaker 1: at the history of transplantation other than this, which the
Speaker 1: person lived for eight years afterwards, very often you see like,
Speaker 1: well they lived for seven days after d or twenty days,
Speaker 1: and that has a lot to do with the rejection
Speaker 1: of tissue that I was talking about. And then even
Speaker 1: after we started to develop drugs to help prevent that,
Speaker 1: the drugs themselves could lead to complications that could lead
Speaker 1: to fatalities. So it all depends upon the the technology
Speaker 1: and the drugs and the processes at the time. So
Speaker 1: nineteen fifty four is the first Oregon transplant. We moved
Speaker 1: to nineteen sixty three and we get the first lung
Speaker 1: transplant surgery, performed by Dr James Hardy. The recipient was
Speaker 1: actually a patient who was serving a life sentence in prison.
Speaker 1: The patient had lung cancer which had resulted in a collapsed,
Speaker 1: long and recurrent pneumonia. So Dr Hardy performs the lung transplant.
Speaker 1: It's considered to be a success. The patient begins breathing
Speaker 1: almost immediately, uh, without any problems. However, the patients subsequently
Speaker 1: suffered progressive kidney failure and died eighteen days after the transplant. Goodness, yeah,
Speaker 1: so the autopsy didn't show any signs of organ rejection.
Speaker 1: But other procedures that followed in the next few decades,
Speaker 1: and there weren't a whole lot. It wasn't like there
Speaker 1: were hundreds, but you know, the next several decades saw
Speaker 1: similar problems, with patients dying within a few months of
Speaker 1: the procedure, and the first truly successful lung transplant one
Speaker 1: where the patient would go on to live a normal
Speaker 1: lifestyle after the procedure was done. That didn't happen until
Speaker 1: nineteen eighty three, so two decades after the first one
Speaker 1: was when you had the first truly successful one um
Speaker 1: and that just kind of tells you that, you know,
Speaker 1: this is really complicated stuff. The first heart transplant took
Speaker 1: place in nineteen sixty seven, that was performed by Dr
Speaker 1: Christianne Barnard, and the patient passed away eighteen days after
Speaker 1: the procedure due to pneumonia. And this is where we
Speaker 1: see that the the anti rejection drugs, those are immunosuppressive drugs,
Speaker 1: because when you get somebody else's organ in planted in you,
Speaker 1: unless it's just the right one, like from your twin
Speaker 1: or something, typically your immune system regards that organ as
Speaker 1: something that shouldn't be in there and goes to work
Speaker 1: attacking it. Exactly, so, your own immune system is attacking
Speaker 1: your new oregon and that is obviously going to be
Speaker 1: a true complication. So that's why these immunosuppressive drugs have
Speaker 1: been administered in order to reduce that. But that also
Speaker 1: opens up the doorway to other potential uh, you know, pathogens,
Speaker 1: other potential illnesses, and you need your immune system. Yeah,
Speaker 1: it's it's pretty good to have around. Um. But advances
Speaker 1: started being made to those drugs in the nineteen seventies, right, Yes,
Speaker 1: that's when the chemists began to the chemists, that's when
Speaker 1: chemists in general began developing the anti rejection drug cyclosporing,
Speaker 1: which worked much better than earlier anti rejection drugs. Wouldn't
Speaker 1: be until nineteen eighty three that the FDA would give
Speaker 1: it clearance to be used in transplant surgeries. And like
Speaker 1: we were just saying a second ago, these immunosuppressant drugs, well,
Speaker 1: I mean in general, they interfere with either the creation
Speaker 1: or the activities of your your body's T cells, which
Speaker 1: are these specific types of white blood cells that that
Speaker 1: remember and attacks stuff that they identify as dangerous in
Speaker 1: your body. Um. And and this drug, cyclosporing is particularly
Speaker 1: useful because it, uh, it's the way in which it
Speaker 1: messes with your ear T cells is a little bit
Speaker 1: gentler that that some of the previous drugs, which were
Speaker 1: a little bit more of a nuke it from orbit
Speaker 1: kind of option, right. Uh. And yeah, So so being
Speaker 1: able to to mediate T cells response means that you
Speaker 1: can prevent them from attacking stuff that you want in
Speaker 1: your body, like a new heart or like your joints.
Speaker 1: The drug is also used in a rheumatoid arthritis care
Speaker 1: for example. Yeah, it's interesting. I mean we when we
Speaker 1: talk about our immune systems, they are incredibly important, but
Speaker 1: way they can cause some big problems right when you
Speaker 1: you least need those big problems, and things like allergies.
Speaker 1: See yeah, cats, dumb body. Yeah, I want to hug
Speaker 1: the cats. Yeah, we can have a whole discussion about
Speaker 1: my allergies and how I'm not very pleased with them,
Speaker 1: but at any rate, UH immune systems. Clearly we'd be
Speaker 1: much worse off without them, but we do have to
Speaker 1: take them into account with something as traumatic as a
Speaker 1: transplant surgery. UH. Now, when we move on with some
Speaker 1: more kind of cool updates to transplant technology, we start
Speaker 1: looking at UH synthetic and regenerative medicine approaches, which are
Speaker 1: really awesome. This is the idea where we don't necessarily
Speaker 1: have to rely upon a donor to get the organ
Speaker 1: that we need in order to perform the transplant, and
Speaker 1: the earliest examples of this are actually UH in skin
Speaker 1: grafting products. So like a not like an internal organ
Speaker 1: but rather an external Yeah. So the first one would
Speaker 1: be an apple graph, which was a skin grafting product
Speaker 1: that the FDA approved, and in two thousand one the
Speaker 1: FDA approved Dermographed, another kind of skin graph product. So
Speaker 1: this would allow doctors to grow the skin externally, you know,
Speaker 1: not attached to the patient, and then grafted onto the
Speaker 1: patient without having to remove a patch of skin from
Speaker 1: one part of the body and transplant to another part
Speaker 1: of the body. Right, it's really useful for stuff like
Speaker 1: like ulcers that are not healing under their own power.
Speaker 1: And these things are all basically fake skin that contain
Speaker 1: real human cells. And and by fake skin, it might
Speaker 1: be a collagen that's been composed of of of cow
Speaker 1: cells or something like that. But but at any rate,
Speaker 1: it's it's a bio structure that that you can put
Speaker 1: on a patient and it will grow into the patient
Speaker 1: and his body and attached to the patient's own skin.
Speaker 1: So that is so gross and amazing. At the same time,
Speaker 1: I started thinking about the dark Man series, one of
Speaker 1: those and you don't go out in the sun because
Speaker 1: otherwise it all just end up bubbling off of you.
Speaker 1: It's only in dark Man, though not this stuff. Dark Man,
Speaker 1: the one that had a certain set of skills. Well
Speaker 1: he he later proved to a certain set of skills. Yes, yes, yes,
Speaker 1: many things were taken from dark Man. In two thousand
Speaker 1: and eight, a patient received an airway transplant that was
Speaker 1: regenerated airway, so the airways scaffold came from a donor.
Speaker 1: That part was remained like a traditional transplant, but the
Speaker 1: doctors had removed the donor's cells from the scaffold, the
Speaker 1: various cells that were attached to the scaffolding, so it's
Speaker 1: just kind of a raw structure at that point. They Yeah,
Speaker 1: they added bone marrow cells from the patient, and the
Speaker 1: bone cells are essentially kind of like stem cells subset
Speaker 1: of stem cells, if you think of it that way.
Speaker 1: They used the bone marrow which would ended up creating
Speaker 1: the the tissue for the airway, and then they transplant
Speaker 1: that into the patient and this helped reduce the possibility
Speaker 1: of an oregon rejection because it was the patient's own tissue,
Speaker 1: right right. The thing about bone marrow is that all
Speaker 1: of your T cells are grown there. So if you
Speaker 1: have some some bone marrow cells creating T cells, then yeah, yeah,
Speaker 1: it's already saying hey, Uh, we're all on the same
Speaker 1: team essentially. Then we saw the first full face transplant. Uh,
Speaker 1: you know, bone bones and all like like cheekbones, jaw, nose, teeth,
Speaker 1: all the muscles and eyelids and all of that stuff. Uh.
Speaker 1: And it's so hard to not make a face off
Speaker 1: reference here, but man, that movie is really terrible and
Speaker 1: this surgery is really incredible. Uh. And this was basically
Speaker 1: made possible, I mean because we had all of the
Speaker 1: all of the elements of that, all of the bone
Speaker 1: afting and and uh and muscle connection and all of
Speaker 1: that stuff. But but anti rejection medication was really what
Speaker 1: allowed the surgery to be a success. Um. The the
Speaker 1: patient went through two phases of rejection and was saved
Speaker 1: successfully both times. Wow. Uh. In two thousand eleven, that's
Speaker 1: when a patient received the first regenerated airway transplant that
Speaker 1: used a synthetic scaffold rather than one from a donor,
Speaker 1: so in this case, there was no need for any
Speaker 1: kind of donation. They were able to build it from
Speaker 1: the ground up essentially, and in the first successful regenerated
Speaker 1: trachea transplant takes place, as well as a successful regenerated
Speaker 1: trachea with synthetic scaffold transplant in a child man. So
Speaker 1: now we're getting to that point where we'll talk more
Speaker 1: about this in a little bit. But the idea of
Speaker 1: being able to build these synthetic structures and then incorporate
Speaker 1: the patient's tissue into those synthetic structures to create new
Speaker 1: versions of the patient's own organs, that's where we're headed.
Speaker 1: But we'll talk more about that in a little bit.
Speaker 1: Um As for head transplants, to get back to the
Speaker 1: topic at hand, Uh, well, we've seen some experiments, some
Speaker 1: pretty crazy mad science style experiments involved. Well we can
Speaker 1: certainly recall those Russian experiments with like dogs taking the
Speaker 1: head off of a dog and putting it on another
Speaker 1: dog or well I think they were also just experimenting
Speaker 1: with if they could keep a dog's head living not
Speaker 1: attached to the dog body, so they attached it to
Speaker 1: like a circulatory Uh yeah, and you can see videos
Speaker 1: of this if you believe that no special effects were
Speaker 1: involved in creating them. At the time. They would like
Speaker 1: do incredibly disturbing things like pound a hammer on the
Speaker 1: table where the severed dog's head was, and the dog's
Speaker 1: head would seem to sort of react react to it. Yeah. Um, yeah,
Speaker 1: we talked about that in our episode about Frankenstein. Yes
Speaker 1: we did. I cannot, I cannot ever watch those again.
Speaker 1: Once was enough. It was truly disturbing. Yeah. But in
Speaker 1: the nineteen fifties and sixties and even into the seventies,
Speaker 1: there were some experiments, largely in Russia but in other
Speaker 1: places as well, with head transplants with dogs and monkeys. Um.
Speaker 1: There was one monkey head transplant that was successful for
Speaker 1: eight days. The monkey was able to continue eating and breathing,
Speaker 1: but had was essentially paralyzed from the neck down and
Speaker 1: died eight days after tissue rejection. But it did kind
Speaker 1: of work that the spinal cord never fused back. That
Speaker 1: was one of the things we'll talk about too. Well.
Speaker 1: That seems like a pretty major issue, a huge issue obviously.
Speaker 1: But anyway, these these were these were um experiments, but
Speaker 1: none of them were like, uh, you know, a ground
Speaker 1: the foundation for further work, right. No one looked at
Speaker 1: them and said, you know, this is a great plan. Yeah, Okay,
Speaker 1: Well I think we should look at where the science
Speaker 1: of transplantation rests today, like what are we good at
Speaker 1: doing and what are the things that that are still
Speaker 1: presenting problems for us. Well, guys, we are so good
Speaker 1: at cutting. We are terrific at cutting stuff like seriously.
Speaker 1: And this is important because, uh you know, as you
Speaker 1: have perhaps seen in your own kitchen, if your knives
Speaker 1: are getting a little bit dull, a less than sharp edge,
Speaker 1: what will damage the tissue that you're cutting and and
Speaker 1: invite an immune response, which is what you do not want.
Speaker 1: Right Cutting with a dull knife tends to sort of
Speaker 1: do some ripping and crushing exactly. Um. So with it,
Speaker 1: with advances in material science necessary to create very sharp blades,
Speaker 1: and with the advent of laser systems that can be
Speaker 1: used in surgery, we are able to keep both the
Speaker 1: organs and the patients much healthier. Uh. We've also developed
Speaker 1: ways of keeping organs viable while waiting for to perform
Speaker 1: transplant surgery. Typically this involves bathing the organs in a
Speaker 1: cold salt water solution or saline uh. And it well
Speaker 1: usually let the organs last several hours, depending upon the organ.
Speaker 1: So for kidneys it could be forty eight hours, for
Speaker 1: livers it's about twenty four hours. For all heart only
Speaker 1: five to ten hours, So it's very dependent upon the
Speaker 1: type of organ. Obviously, with something like a person's head,
Speaker 1: you've got a lot more to consider, you know, keeping
Speaker 1: the brain oxygenated and everything. So, but the the whole
Speaker 1: idea here is that by lowering the temperature, you lower
Speaker 1: the amount of energy the cells need to exert in
Speaker 1: order to survive, and that prolongs their viability so that
Speaker 1: you can get them to where they need to be
Speaker 1: in the surgery can be performed, but it is a
Speaker 1: matter of hours, right. This isn't something where you can
Speaker 1: just you know, you've got a freezer full of organs
Speaker 1: and you can just go and pull one out whenever
Speaker 1: you need it. It's it's one of the things that
Speaker 1: makes this such a delicate and difficult um field of medicine.
Speaker 1: Here's another thing that I think is fascinating, which is
Speaker 1: the ability to keep a patient alive while you're sort
Speaker 1: of like moving around or removing or inserting organs that
Speaker 1: we normally think of as absolutely critical to survival. How
Speaker 1: do you actually do a heart transplant? Uh, you hook
Speaker 1: someone up to one of those artificial heart lung machines
Speaker 1: and kind of let it go and you you also
Speaker 1: one of the advances that we've seen since the nineteen fifties,
Speaker 1: was the capacity to do that with artificially cooled blood,
Speaker 1: which helps the rest of the patient's body. Oh, I'm sorry,
Speaker 1: literally chill out. It just kind of it preserves the
Speaker 1: rest of the organs while the transplant is going on. Yeah,
Speaker 1: we talked a little bit about that when we were
Speaker 1: talking about the possibility of suspended animation in a previous episode.
Speaker 1: How this is something that's apt hypothermia. I don't know
Speaker 1: if this would technically qualifies that, but at least it's
Speaker 1: a similar principle. Keeping temperature is low to prevent tissue degeneration. Yeah. So,
Speaker 1: and even in that episode, if you recall, it was
Speaker 1: really all about keeping a patient alive in order to
Speaker 1: address a medical issue immediately, as opposed to perpetually keeping
Speaker 1: that patient alive until you can thaw them out, like
Speaker 1: a hundred years from now. That's not what That's not
Speaker 1: where the technology is right now. Um. Then, of course
Speaker 1: we've got the immunosuppressive drugs, the anti rejection drugs we're
Speaker 1: talking right, So the early ones were pretty pretty damaging
Speaker 1: to a person. Even if they were working as they
Speaker 1: were intended, they could cause other consequences. For example, because
Speaker 1: in general killing stuff in your body, like like we
Speaker 1: all know from an example for for chemotherapy, Yeah, kill
Speaker 1: stuff in your body. Yeah stuff, the good and the bad. Right,
Speaker 1: So the newer drugs have lower toxicity with fewer side
Speaker 1: effects like side effects like raising your blood pressure or
Speaker 1: your coless role or even uh, giving you diabetes that
Speaker 1: could be one of the side effects of these older
Speaker 1: immuno suppressive drugs and still a risk with the current ones. Um,
Speaker 1: even with those advances, there are a lot of things
Speaker 1: you have to take into consideration. They can be toxic,
Speaker 1: toxic to kidneys, they can cause they may cause cancer
Speaker 1: and uh. And the thing about them is that most
Speaker 1: patients who have to start taking them due to a
Speaker 1: transplant have to take them for the rest of their lives. Yeah.
Speaker 1: So one of the things that people are really looking
Speaker 1: into our ways of performing surgeries that would not require
Speaker 1: immunosuppressive drugs. So in other words, these were generative medical
Speaker 1: approaches where you're using the tissue from the patient him
Speaker 1: or herself, then you don't need to worry about using
Speaker 1: the immunist suppressive drugs for the rest of their lives.
Speaker 1: That because they're getting a transplant of their own tissue um.
Speaker 1: Obviously that would be a huge benefit. All right, well,
Speaker 1: let's bring it back to the discussion of the head transplant,
Speaker 1: because that's what everybody's got to know. Can I get
Speaker 1: my head put on a more attractive body or maybe
Speaker 1: like a dinosaur body? Right? Well, I'm sorry to sound
Speaker 1: like a tale from the crypto. I'm sorry, No, that
Speaker 1: that was in bad taste. I shouldn't make light of it. Actually,
Speaker 1: you know, can you if you have a dise he
Speaker 1: is affecting your body? Yeah? Can you? Can you actually
Speaker 1: get a head transplant? So let's let's look at Canavero's proposal.
Speaker 1: It's pretty it's pretty intense. Yeah, he's estimating that it
Speaker 1: will require the coordinated efforts of a hundred surgeons working
Speaker 1: for a grand total of thirty six hours, although the
Speaker 1: surgery itself would be very short. Yeah, we'll talk about
Speaker 1: that in a second. So your head disconnected for thirty
Speaker 1: six hours. No, that would be bad, um because for
Speaker 1: one thing, a head can't remain viable on its own.
Speaker 1: It would have to be kept alive throughout the procedure,
Speaker 1: which would be pretty tricky. Yeah, you can't. You can't
Speaker 1: put it in a a saline solution like you could
Speaker 1: with a liver or a heart, you would have to have,
Speaker 1: you know, some form of circulation going with that head
Speaker 1: the entire time. Plus the head is home to lots
Speaker 1: of stuff like it's not an oregan like a heart,
Speaker 1: right you're talking about. You have your eyes, you have
Speaker 1: your nose, your um, your ears, you've got skin, you've
Speaker 1: got glands that are very important um all located in
Speaker 1: that area, and of course you have the brain. So
Speaker 1: if you decapitate ahead, which obviously would be one of
Speaker 1: the steps of this surgery, you immediately have a decrease
Speaker 1: in blood pressure in the head. No big surprise there,
Speaker 1: there's no way of pumping blood continuously there. But that
Speaker 1: also means that you have a you start to deprive
Speaker 1: the brain of oxygen, so then the patient would go
Speaker 1: into a coma, which would be shortly followed by death. Right,
Speaker 1: You'd start to have that cell death throughout the brain,
Speaker 1: which is exactly what you don't want to happen because
Speaker 1: we generally consider that your river postables is damage to
Speaker 1: the brain that's going to kill you. So Canavero has
Speaker 1: based the the idea that it needs to the procedure
Speaker 1: of actually hooking up the head from the patient to
Speaker 1: the donor body would need to happen in less than
Speaker 1: one hour based upon previous surgeries, including the one I
Speaker 1: was referring to earlier about the the monkey head that
Speaker 1: had been transplanted and lived for eight days. Uh, that
Speaker 1: was all based on those earlier experiments. And so the
Speaker 1: actual point where you separate the patient's head from the
Speaker 1: patient's body and then attach it to the donor body
Speaker 1: would have to take less than an hour out of
Speaker 1: that full thirty six hours we were talking about previously. Um,
Speaker 1: you would have to have that connection there so that
Speaker 1: the the brain could remain viable. However, when you're actually
Speaker 1: doing the the transplant, both bodies, the patient and the
Speaker 1: donor body would have to be in cardiac arrest. And
Speaker 1: then you could start the heart of the donor body
Speaker 1: afterward once the the head has been attached, but until
Speaker 1: then they would both be in cardiac arrest. And then,
Speaker 1: assuming that the surgery is in fact a success, any
Speaker 1: signs of rejection would have to be handled immediately. And
Speaker 1: the head is home to so many systems like the
Speaker 1: eyes and the brain and all of this that the
Speaker 1: risks of rejection would be much greater than if it
Speaker 1: were a single oregan. You have a lot of potential
Speaker 1: points of failure. In other words, and uh, during this
Speaker 1: time after the surgery, that the patient would have to
Speaker 1: be kept unconscious. Uh, you know, not just immediately, but
Speaker 1: for like three to four weeks in order to allow
Speaker 1: the spinal cord to grow new connections, and and medically
Speaker 1: induced coma has come with other risks on top of
Speaker 1: the ones we've already talked about, including things like blood clots, infection,
Speaker 1: and reduced brain activities. So that would be another thing
Speaker 1: to keep your ion, assuming that the surgery itself had
Speaker 1: gone well. Oh sure, Although as we were mentioning earlier
Speaker 1: that that spinal cord severance might be the real problem
Speaker 1: in getting the surgery to be effective, because you know,
Speaker 1: muscles and blood vessels can be cut and then sutured
Speaker 1: back together, or or not sutured but reattached in the
Speaker 1: zany medical ways that they do. I do not actually
Speaker 1: understand the process, so I'm not going to talk about it.
Speaker 1: But spinal cord severing and and fusion would have to
Speaker 1: be so sharp and clean and uh kind of Ourrow
Speaker 1: says that the chemicals he mentioned polyethylene glycol and cheetahs
Speaker 1: on um. It's kind of essentially like a biologically uh
Speaker 1: created glue, is what these tend to be sure, he
Speaker 1: claims that those could encourage fusion. Um electrodes would be implanted,
Speaker 1: and while the patient was kept unconscious after the surgery,
Speaker 1: that the team would be a dyeing electrical stimulation via
Speaker 1: the electrodes in order to help boost new nerve connections. So,
Speaker 1: in other words, it's it's not enough to have everything
Speaker 1: plugged in properly. You also have to have these signals
Speaker 1: passing through in order for the body to recognize that
Speaker 1: their actual impulses passing along the spine, right, in order
Speaker 1: to recognize, hey, we're brain tissue, your brain tissue. Let's
Speaker 1: make brain happen. Yeah. Well, and it's not just in
Speaker 1: our sort of non expert point of view that this
Speaker 1: sounds like a very very ambitious proposal. Well, especially when
Speaker 1: you take into account what Cannaverro has said that assuming
Speaker 1: that everything goes well, what the patient will be capable
Speaker 1: of doing after the surgery, Ah yeah, I mean, so
Speaker 1: they'd be down for about a month while their spinal
Speaker 1: cord is reconnected. But then he claims that a patient
Speaker 1: would be able to walk within a year after the surgery. Yeah,
Speaker 1: that's I mean, so if you think that we are
Speaker 1: a little skeptical, you're right, because they're just so many
Speaker 1: different hurdles to overcome in order for this to even
Speaker 1: remotely work. But yeah, we're not the only ones to
Speaker 1: express skepticism. The medical community at large has expressed everything
Speaker 1: from cautious skepticism to outright disbelief. Like there aren't a
Speaker 1: whole lot of people coming out and saying, yeah, I
Speaker 1: think this is gonna work. In fact, most of the
Speaker 1: reports I've read have said, uh that they were they
Speaker 1: were very skeptical. Some of them even went further to
Speaker 1: suggest that kind of Vera's idea is crazy, like that's
Speaker 1: I've seen that word being yeah, uh, and it could
Speaker 1: in fact be crazy for a reason. Yeah. So this
Speaker 1: was something I came across while I was researching the story.
Speaker 1: And let's just prevace it by saying that this is
Speaker 1: a kind of like sort of con spiratorial allegation. But yeah,
Speaker 1: it this this falls. This can fall under the category
Speaker 1: of conspiracy theory. There's a lot of circumstantial evidence that
Speaker 1: that seems to support it, but it's circumstantial evidence, right,
Speaker 1: And why we're dancing around this is because there are
Speaker 1: now allegations that perhaps the timing of these announcements has
Speaker 1: coincided with the promotion of a certain video game, that
Speaker 1: video game being Metal Gear Solid five, the Phantom Pain.
Speaker 1: In other words, that this entire thing about head transplantation
Speaker 1: is a marketing stunt. Yeah. Now that now there's some
Speaker 1: who say that Canavero seems actually sincere about head transplants,
Speaker 1: but perhaps the timing of this particular discussion is in
Speaker 1: fact more of a collaboration, and that right right right,
Speaker 1: in other words, saying like, this is something I want
Speaker 1: to do sometime in the future, but I'm gonna say
Speaker 1: I'm gonna do it now because oh it's being it's
Speaker 1: part of this other grander stunt of promoting a video game.
Speaker 1: So so what's the deal with the promotion? Alright? So
Speaker 1: here here's the circumstantial evidence that has come about, Um,
Speaker 1: the game Metal Gear Solid five has there's been images
Speaker 1: leaked of are not even leaked, I mean promoted of.
Speaker 1: There's a character in the game. There's a doctor who
Speaker 1: looks I wrote eerily similar to Cannavero. But if you
Speaker 1: look at the pictures, they look like it's looks like
Speaker 1: it's the same guy, right, Like on casual glance, you
Speaker 1: wouldn't even be able to tell. We're looking at a
Speaker 1: pair of photos in our notes right now. The top
Speaker 1: photo in our notes is a picture of Canavero. The
Speaker 1: bottom photo is a picture of the character in the game,
Speaker 1: and the bottom photo looks like it's just another picture
Speaker 1: of Canavero. It's a little uncanny. Yeah, yeah, so so
Speaker 1: there's that. Then there are a couple of other pieces
Speaker 1: of against circumstantial evidence. Not so not this, No, this
Speaker 1: is oaking gun. The patient of Valerie Spirridanov is also
Speaker 1: a CG artist in game development supervisor, So some have
Speaker 1: said that maybe that Spiritanov is in on this as well,
Speaker 1: and it's not a sincere attempt at this surgery. Again
Speaker 1: it this is just an allegation. Cannavero has published work
Speaker 1: about Phantom Pain in the past, and the subtitle of
Speaker 1: the game is The Phantom Pain. There are several acronyms
Speaker 1: used by Cannavero, you know, things like heaven that are
Speaker 1: also used in the Metal Gear Solid game. So there's
Speaker 1: some terminology that is seems to be shared between the
Speaker 1: publications written by Canavero and the stuff within the game
Speaker 1: which came first, don't know. Uh. Hideo Kojima, who was
Speaker 1: one of the creators of the game, tweeted back in
Speaker 1: two thousand ten that he had found an quote ally
Speaker 1: to help address a huge taboo. He planned the game
Speaker 1: to have this enormous taboo incorporated in it, and did
Speaker 1: not give any more details. So people looking at this
Speaker 1: now are retroactively looking back at all the tweets and
Speaker 1: stuff and saying, maybe Kennevero is this ally someone who
Speaker 1: would support an idea like a head transplant, which supposedly
Speaker 1: happens within the course of Metal Gear Solid five. So,
Speaker 1: in fact, there are some promotional images of Metal Gear
Speaker 1: Solid five which show this this scientist character uh holding
Speaker 1: some form of device to a decapitated head on a platter. Um,
Speaker 1: it doesn't like a scene of violence. It looks like
Speaker 1: a scene of mad science in that case at any rate,
Speaker 1: So that more circumstantial evidence. Uh. And Kajima is um
Speaker 1: kind of a well certainly a well known figure in
Speaker 1: the video games circles about Yeah, and he recently made
Speaker 1: headlines when he when he left Konami, who he had
Speaker 1: been collaborating with for for a very long time. Um.
Speaker 1: His most recent project economy was Silent Hills, which is
Speaker 1: that Greadmo del Toro Norman ritas Silent Hill new Silent
Speaker 1: Hill game that it was making so many waves a
Speaker 1: few months ago, I just got canceled, and that has
Speaker 1: been very upsetting. I mean, you the big news from
Speaker 1: like a year ago was when uh Konami released PT
Speaker 1: and didn't say what PT was for, and PT ended
Speaker 1: up being a playable trailer for Silent Hills. You didn't
Speaker 1: know that while you're playing it. It was only after
Speaker 1: you had completed the trailer, which by the way, was
Speaker 1: incredibly creepy. Oh yeah, yeah, it's very effective. I watched
Speaker 1: a playthrough of it and it's very yeah, very unsettling.
Speaker 1: So this was one of those things where, you know,
Speaker 1: Kojima has been known for going through elaborate setups to
Speaker 1: promote video games in non traditional and and very media
Speaker 1: savvy ways. Well, I have to say, if this is
Speaker 1: a promotional stunt for a video game, it is a
Speaker 1: bizarre one in very bad taste. Yeah, I mean there's
Speaker 1: certainly there have been plenty of of ways of marketing
Speaker 1: games that were not directly tied back to the games,
Speaker 1: at least not initially. Like like alternate reality games, there
Speaker 1: are quite a few that started off that no one
Speaker 1: was even sure what it was trying to promote at
Speaker 1: the beginning, so it's possible that this was promotion. However, Canavero,
Speaker 1: for his part, denies involvement, and Coginia also denied that
Speaker 1: Cannavera's likeness was used. So Cannivera had come out and said,
Speaker 1: I didn't give permission for my likeness to be used.
Speaker 1: They shouldn't be using my my image without my permission,
Speaker 1: and Cogima said, oh, we weren't actually using him. It's
Speaker 1: just a coincidence. It's a coincidence. If it's a coincidence,
Speaker 1: it's a phenomenal coincidence, because this whole thing is a
Speaker 1: phenomenal coincidence. If it's all a coincidence, I mean, and
Speaker 1: strange things happen in the universe. Chaos theory, I get it.
Speaker 1: Law law of truly large numbers says that even things
Speaker 1: that would seem impossible sometimes happen. But yeah, it's it's
Speaker 1: one of those where the circumstantial evidence is such that
Speaker 1: if there's nothing there, it's really, it almost seems more
Speaker 1: weird that there'll be nothing there then that this is
Speaker 1: all about a promotion for a video game. So we
Speaker 1: will see, I suppose, eventually how all of this shakes out,
Speaker 1: and whether whether it's a clever ruse or not. But
Speaker 1: at any rate, I'm glad that the headlines popped up
Speaker 1: for it because we got to do this research into
Speaker 1: transplantation and and all of the amazing research it's going
Speaker 1: into it. Yeah. Well, whether or not we can transplant ahead,
Speaker 1: we are going to be forging some new territory and
Speaker 1: transplantation soon, and I think we should talk about future
Speaker 1: of medical transplantation. Sure, uh yeah, yeah. One thing that
Speaker 1: researchers are looking at doing is keeping organs alive longer, because,
Speaker 1: as as we said earlier, you know, the the expiry
Speaker 1: date on organs from a donor is really short, a
Speaker 1: matter of hours or two days at most for kidneys.
Speaker 1: In August, though, the FDA approved a device that uh
Speaker 1: preserves one particular organ, the lungs, for long enough to
Speaker 1: determine whether they're a really good match for a transplant,
Speaker 1: about four extra hours on top of the normal time. Lungs,
Speaker 1: by the way, are really particularly tricky. About eighty percent
Speaker 1: of donated lungs are deemed unfit for transplant. Yeah, and
Speaker 1: the creators of the machine, which is called the x
Speaker 1: vivo Profusion system, um, they're they're hoping that eventually their
Speaker 1: their system will allow for the storage of lungs for
Speaker 1: up to two or three days. That's pretty cool. Yeah.
Speaker 1: I gotta say though, x vivo profusion system sounds like
Speaker 1: something I would see in a spay. Just step into
Speaker 1: our x vivo perfusion system and you will come out
Speaker 1: a new person. Another thing that we're seeing advances in
Speaker 1: our going back to the the regenerative medicine approach and
Speaker 1: the synthetic scaffolding for things like airways, it's three D
Speaker 1: printing and transplants. Um. So this is something that we've
Speaker 1: been talking about for a while and our three D
Speaker 1: printing episodes. I think we've referred to it once or twice.
Speaker 1: But the idea of using tissue as essentially ink and
Speaker 1: being able to print upon first designing the scaffolding the
Speaker 1: structure of whatever organ you're making, and then printing the
Speaker 1: tissue directly onto that scaffolding. So yeah, so that you
Speaker 1: have a a healthy organ to transplant, and it's made
Speaker 1: from the patient's own tissue. So the yeah, you've got
Speaker 1: you've got a nice uh a nice heads up. You're
Speaker 1: able to get to a point where you can make
Speaker 1: this transplant surgery without the worry of the organ being
Speaker 1: rejected the body reacting in negative way. However, you know
Speaker 1: that being said, it sounds like I'm making it sound
Speaker 1: way easier than it really is, because depending upon the organ,
Speaker 1: some of these organs are incredibly complex. You know you're
Speaker 1: talking about you know, it's not just a massive tissue. Obviously,
Speaker 1: it's important and has lots of different parts to it.
Speaker 1: So to be able to synthetically create a working version
Speaker 1: of that ourselves from the ground up is depending on
Speaker 1: the organ, easier said than done. Actually, for all of
Speaker 1: the organs, it's easier said than done. We are not
Speaker 1: lumpy space people. Not just if we could just like
Speaker 1: have a massive tissue that's generally liver shaped and you're fine,
Speaker 1: it would be so much easier. But no, that's not
Speaker 1: the way it works. However, it is very promising and
Speaker 1: we're seeing more and more, um uh, you know, advances
Speaker 1: in that. In March of this year, of a Russian
Speaker 1: company called three D bio Printing Solutions announced it had
Speaker 1: successfully printed a mouse by roid using these bioprinting techniques
Speaker 1: and they're planning on transplanting this printed organ into a
Speaker 1: mouse that suffers from hypothyroidism. And uh, the results have
Speaker 1: not yet been published. They said that they will be
Speaker 1: presenting their results at a conference called the Second International
Speaker 1: Congress on Bioprinting, which will take place in Singapore in July.
Speaker 1: So in July they will announce how this experiment went,
Speaker 1: whether it was a success or not. Uh. And you know,
Speaker 1: a thyroid is relatively simple, so it was a good
Speaker 1: thing to target for this kind of procedure. And also
Speaker 1: it's important because thyroid cancer is a real thing. It
Speaker 1: can it affects around three thousand people, or rather three
Speaker 1: hundred thousand people are diagnosed with it every year. So
Speaker 1: being able to print a thyroid on an as needed
Speaker 1: basis could potentially save thousands of lives every year. So
Speaker 1: if this ends up being a success, it could be
Speaker 1: it could be the getting of something truly transformational in medicine. Yeah. Yeah,
Speaker 1: other researchers are looking into entirely artificial organs and of
Speaker 1: course we do have some systems right now, that that
Speaker 1: will keep a patient alive until a real biological organ
Speaker 1: can be transplanted. But as our technology and also our
Speaker 1: our understanding of human biology improve, we might end up
Speaker 1: with some some medical cyborgs. There are research labs working
Speaker 1: on artificial kidneys. Those are still in development, but with
Speaker 1: artificial hearts, which you know, replace a whole a whole
Speaker 1: heart like ventricles and valves and all. Uh. Some artificial
Speaker 1: hearts have supported patients for up to four years before
Speaker 1: a transplant organ became available, right Yeah, And and I
Speaker 1: mean we could do an entire episode about about artificial
Speaker 1: organs and the development of those, because that's also a
Speaker 1: fascinating story, uh and and an amazing achievement in technology
Speaker 1: to have been able to create something that is medically
Speaker 1: safe to implant in a person and can keep them
Speaker 1: alive until an actual organic uh replacement is available. And
Speaker 1: that Yeah, I'm excited to see that continue with other
Speaker 1: organs besides the heart and kidneys. Oh. Absolutely. Also on
Speaker 1: the immuno suppression front, there is a team out of
Speaker 1: Massachusetts General Hospital that's been conducting a clinical trial for
Speaker 1: bone marrow transplants in addition to organ transplants. Kidney transplants specifically,
Speaker 1: so uh so, So the idea here is like, like
Speaker 1: we were saying, with the scaffolding, the throat scaffolding issue
Speaker 1: in some other patients. If you, uh, if you give
Speaker 1: someone a kidney transplant and also destroy some of the
Speaker 1: patient's native bone marrow and give them a transplant of
Speaker 1: some of the donor's bone marrow. Oh, I see. So
Speaker 1: the so in other words, the patients getting bone marrow
Speaker 1: and an organ from the same donor. So that means
Speaker 1: that the bone marrow which is generating these T cells
Speaker 1: is already familiar with the tissue of up donated organ.
Speaker 1: So you wind up with these two bone marrow T
Speaker 1: cell creating systems working together to support the patient's original
Speaker 1: tissue and the new organ. I see. So that would uh,
Speaker 1: that would at least hopefully cut down the incidence of
Speaker 1: organ rejection, because the patient's own systems would be generating
Speaker 1: the same native T cells as the tissue that was donated.
Speaker 1: Right right. We're still waiting for the results of these trials,
Speaker 1: but as of two thousand eight, four of the original
Speaker 1: five patients had gone for five years without having to
Speaker 1: take immuno suppressive dress. That's pretty incredible. That's amazing. So
Speaker 1: obviously I think the ultimate future that we want to
Speaker 1: get to with organ transplantation is the ability to have
Speaker 1: these regenerative techniques where you sort of regrow organs with
Speaker 1: your own stem cells. They're based on your own biology.
Speaker 1: That seems like the ideal solution all around, but as
Speaker 1: you pointed out, that is a ways off, and there
Speaker 1: are people who need organs to day. Right in the meantime,
Speaker 1: we have a need that is not going to just
Speaker 1: sit on hold for the decade or so it'll take
Speaker 1: for us to get that that technology to maturity. Right,
Speaker 1: So in the meantime, I wanted to talk about something
Speaker 1: else I read about, which is a more controversial sort
Speaker 1: of temporary solution in the meantime, and that would be
Speaker 1: open markets for organ donation. And by market I mean
Speaker 1: the exchange of money. You would a physical market, It
Speaker 1: looks like a farmer's market. That would be a little No,
Speaker 1: that would be very that would be very unsafe. Would however,
Speaker 1: fit right into silent hills. Yes, but so so of
Speaker 1: course today you cannot purchase an organ for transplant. No, well,
Speaker 1: in most countries you can't. And so like you could
Speaker 1: maybe go to Iran and purchase a an organ for transplant.
Speaker 1: But in the United States and many other countries, you
Speaker 1: can choose to donate your organs at fath or if
Speaker 1: you're a very nice person or you care about somebody
Speaker 1: very much, you can donate something like a kidney while
Speaker 1: you're still alive, Like you can continue living with just
Speaker 1: one kidney. Somebody else might have renal failure and they
Speaker 1: need a kidney, and you can give them one of yours, UM,
Speaker 1: but you can't sell it to them. Regally, you're not
Speaker 1: supposed to sell your organs, but some people have argued
Speaker 1: that it would be a good idea to move to
Speaker 1: a general, open market for organ donation, where you could
Speaker 1: be paid a market determined price, for example, a kidney.
Speaker 1: And of course their arguments for and against UM. The
Speaker 1: most obvious and pressing argument for is that thousands of
Speaker 1: people die every year on the waiting list for kidneys.
Speaker 1: Oh yeah, there's a crazy shortage of organs of all
Speaker 1: kinds in the market. Yeah. So in the United States,
Speaker 1: according to the National Kidney Foundation, in four thousand, four
Speaker 1: hundred and fifty three patients died while waiting on a
Speaker 1: kidney transplant. There on the waiting list. There, I assume
Speaker 1: they're probably on dialysis waiting to get a kidney, and
Speaker 1: they did not get one in time and they died
Speaker 1: from Yeah. On average, they say twelve people die every
Speaker 1: day waiting for a kidney. On top of that, there's
Speaker 1: simply the problem of waiting. So let's say you're waiting
Speaker 1: four years to get a kidney and you eventually get one,
Speaker 1: and that allows you to extend your you know, your
Speaker 1: lifespan and to go on living. But that time while
Speaker 1: you're waiting, you're having to undergo dialysis. It's just going
Speaker 1: to be a major blow to your quality of life
Speaker 1: and your ability to do things. And you don't recapture
Speaker 1: those four years. Yeah, and so in economic terms, this
Speaker 1: is a situation where demand has greatly outpaced supply. There
Speaker 1: is way more demand for kidneys than there are kidneys
Speaker 1: to go around. So some economists have proposed a very
Speaker 1: economic sounding solution. Uh. One example of people making this
Speaker 1: argument is in January, economist Gary Becker and Julio Elias
Speaker 1: authored a peace in the Wall Street Journal where they
Speaker 1: recommended this path. It was called cash for Kidneys, the
Speaker 1: Case for a Market for Organs, and they support compensation
Speaker 1: for live kidney donation in a model where family members
Speaker 1: can be compensated when when they choose to give up
Speaker 1: the healthy organs of a dead relative, right, because that
Speaker 1: can be one of the blocks placed in organ donation
Speaker 1: is when even if a person has selected to be
Speaker 1: an organ donor, you need the acquiescence of their surviving
Speaker 1: relatives in order to go ahead with the organ donation. Right.
Speaker 1: So somebody might if you have a relative who's just
Speaker 1: passed away, they might have a healthy heart and somebody
Speaker 1: else needs that heart. But you could say no, no, no,
Speaker 1: but the yeah, yeah, the the understandably upset family members
Speaker 1: might not want that. Right. So, even if it is
Speaker 1: your wish as an organ donor to have of your
Speaker 1: organs donated, it's possible for your next of kin to
Speaker 1: say no, I don't want that to happen, and the
Speaker 1: medical professional the medical professionals will back away. They won't
Speaker 1: they won't continue. Yeah, And so this is understandably a
Speaker 1: very controversial proposal. Um, And I'm not sure where I
Speaker 1: stand on it. I can see the arguments on both sides.
Speaker 1: On one hand, I I would probably if I were
Speaker 1: myself someone who needed a kidney I would think like, well, yeah,
Speaker 1: if there's some way I could, you know, can motivate
Speaker 1: people to do more donations, then yes, please do it
Speaker 1: any anyway you can, of course. Yeah. But then of
Speaker 1: course there are arguments against it. Uh. The the economists
Speaker 1: in this piece who were who were for it, that
Speaker 1: they did try to offer some of the objections and
Speaker 1: encounter them. Oh and one they proposed made sense to me.
Speaker 1: They said, well, people who are going to be offering
Speaker 1: to sell their kidneys, or people who very often are
Speaker 1: people who are in a desperate situation. Somebody's like I
Speaker 1: need money, now what you know, what can I do
Speaker 1: while I can sell a kidney? And then that you
Speaker 1: you might sort of be in a way forced to
Speaker 1: make that decision by financial circumstances, and then later in
Speaker 1: life come to really regret that decision. It'll end up
Speaker 1: disproportionately affecting a specific democrats. Yes, specifically people who are
Speaker 1: in who are in bad economic circumstances. Um and I
Speaker 1: can totally see that being true. That yeah, it would
Speaker 1: be sort of like a thing that you won't imagine
Speaker 1: that many wealthy, well off people saying I could really
Speaker 1: use the ten thousand or fifteen thousand bucks from a kidney.
Speaker 1: Of course, then again they proposed sort of countermeasures to that. Well,
Speaker 1: one thing you could do is you could put a
Speaker 1: waiting period in place, so you like you'd be forced
Speaker 1: to undergo counseling. You can't just say like, no, take
Speaker 1: my kidney today. You know, there would be like a
Speaker 1: three month period, and that seems like that could come
Speaker 1: into play. They also pointed out that in their opinion,
Speaker 1: I don't know to what extent this is true, but
Speaker 1: they claimed that it also would be mainly to the
Speaker 1: benefit of people who are more economically disadvantaged, because if
Speaker 1: you're rich, you can typically more easily find a way
Speaker 1: to get an organ if you need one, you can
Speaker 1: you can travel to another country, or you can pay
Speaker 1: for workarounds. Yeah. So in general, I think this is
Speaker 1: a really interesting and difficult question. I don't know what
Speaker 1: the right answer to that is. Yeah, I mean it
Speaker 1: sounds like kind of like a like an ethical problem
Speaker 1: of putting a price tag upon human bodies. Yeah, I mean,
Speaker 1: they're there's certainly, and obviously this would also lead people
Speaker 1: to say, now you're going to make that urban legend
Speaker 1: come to life, the one about you know called the doctor,
Speaker 1: you wake up in a bathtub full of ice, one
Speaker 1: would hope there would be measures put in place to
Speaker 1: avoid you being able to sell someone else's kid. Yeah,
Speaker 1: it's like like when I went to donate blood and
Speaker 1: then was disappointed to find out it had to be mine.
Speaker 1: I don't know where I stand on this either. It's
Speaker 1: one of those things that's really difficult to kind of
Speaker 1: put my finger on. On the one hand, I definitely
Speaker 1: don't want there to be thousands of people who are
Speaker 1: are waiting and hoping and dying because they don't have
Speaker 1: the access to organs that they need. On the other hand,
Speaker 1: I don't like the I don't necessarily love the idea
Speaker 1: of people electing to get a surgery that they otherwise
Speaker 1: never would because they need the cash. I mean, they're
Speaker 1: the now. On the on the the brightest side of
Speaker 1: things that we can point out is that if everything
Speaker 1: works well, this will hopefully be a transitional period where
Speaker 1: we will end with the ability to create the organs
Speaker 1: that are based off the patient themselves, and the need
Speaker 1: for donors will be eliminated entirely. But that's the future
Speaker 1: we may not ever arrive at. We can hope, but
Speaker 1: we don't necessarily know that's going to happen. Yeah, this
Speaker 1: is one of those situations. I feel like it comes
Speaker 1: up fairly often on this show where there's a there's
Speaker 1: a solution inside that would be the correct, the right solution,
Speaker 1: but we're not quite there yet, and there is something
Speaker 1: vision Yeah, and there on the way there there's a
Speaker 1: there's a really unpleasant kind of transitional period. Yeah. Yeah, no,
Speaker 1: that's that's entirely accurate, I would say. So, I'm curious
Speaker 1: what our listeners think about this? What are your opinions?
Speaker 1: You know, Camillo wrote in I wonder what what opinions
Speaker 1: Camilo has about this? Because this is this is tricky stuff,
Speaker 1: and uh, you know, we want to be we want
Speaker 1: to see the greatest benefit for the most number of
Speaker 1: people without it becoming like this weird question of ethics
Speaker 1: that no one's comfortable with. But you know, this is
Speaker 1: real life, and in real life they are there are
Speaker 1: often a lack of easy answers. Another thing that I
Speaker 1: think would be worth considering. And I'm not even sure
Speaker 1: what their position would be, but what doctors think about this? Yeah,
Speaker 1: because I bet that they have they might have our
Speaker 1: mints for against this that we haven't even thought of
Speaker 1: just like a procedural or medical yeah sure, or even
Speaker 1: just of their personal experience of of working with patients
Speaker 1: and with families, and you know that the kind of
Speaker 1: stuff that we can read about and and sympathize with,
Speaker 1: but not truly empathize with. Oh yeah, I mean there,
Speaker 1: we haven't even touched any of the psychological effects that
Speaker 1: that patients can experience when undergoing transplant surgery. And I
Speaker 1: mean that's an entirely different field that is complex, fascinating
Speaker 1: and and a little bit terrifying. Yeah, and certainly I
Speaker 1: am not qualified to address it. It's but it is
Speaker 1: something that I'm fascinated by. Uh Well, at any rate,
Speaker 1: I am very curious to hear from other listeners like Camilla.
Speaker 1: Thank you so much writing in Yes, Yes always. This
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