WEBVTT - Transplants of the Future 0:00:00.160 --> 0:00:07.120 Brought to you by Toyota. Let's go places. Welcome to 0:00:07.280 --> 0:00:13.280 Forward Thinking. Hey, they're in love in the Forward Thinking, 0:00:13.320 --> 0:00:15.560 the podcast that looks at the future and typically makes 0:00:15.560 --> 0:00:18.040 a reference to a song lyric, which I'm not doing today, 0:00:18.120 --> 0:00:20.000 and I'll explain why in a second. But I'm Jonathan 0:00:20.040 --> 0:00:24.239 Strickland and I'm Joe McCormick, and today we're gonna be 0:00:24.280 --> 0:00:28.760 looking into a very special listener request. Yeah. Camillo wrote 0:00:28.760 --> 0:00:30.840 in and said, hello, guys, I'm a long time listener 0:00:30.880 --> 0:00:34.040 since Tech Stuff in two thousand eight. That's going all 0:00:34.080 --> 0:00:35.840 the way back to the very beginning of Tech Stuff. 0:00:35.840 --> 0:00:38.360 That's when we were doing fifteen minute long episodes. I 0:00:38.400 --> 0:00:41.120 love all of how stuff works podcasts. And to keep 0:00:41.159 --> 0:00:43.680 this email short, I recently saw news of a head 0:00:43.920 --> 0:00:46.600 transplant that is expected to be performed in a couple 0:00:46.600 --> 0:00:51.040 of months. I can't recall a podcast specifically about head transplants, 0:00:51.240 --> 0:00:53.440 not off the top of my head. Wink wink. This 0:00:53.479 --> 0:00:56.360 sounds like a spooky subject, but very interesting. Keep up 0:00:56.440 --> 0:00:59.640 amazing tech at Futuristic Podcast. I wouldn't know what to 0:00:59.680 --> 0:01:05.400 do about you, guys at work. So Camillo's referring to 0:01:05.640 --> 0:01:09.240 a news item about a proposed head transplant that would 0:01:09.280 --> 0:01:11.000 not be taking place in a couple of months, unless 0:01:11.000 --> 0:01:13.480 you guys are listening to this in two thousand seventeen, 0:01:13.560 --> 0:01:16.160 because that is when it would the proposed surgery would 0:01:16.160 --> 0:01:19.160 actually take place, right, and the technology necessary for this 0:01:19.200 --> 0:01:21.840 feat is not quite so far along as the popular 0:01:22.200 --> 0:01:25.880 media has perhaps made it sound ye that the story 0:01:25.959 --> 0:01:30.040 okay is this? Back in July of one, doctor Sergio 0:01:30.080 --> 0:01:35.640 Carnavero of the Turn Advanced Neuromodulation Group or TANG in 0:01:35.720 --> 0:01:39.960 Italy announced his project to make head transplants possible. The 0:01:40.000 --> 0:01:43.440 project is called heaven Gemini, which is an acronym for 0:01:43.560 --> 0:01:45.800 something I do not know what. It sounds like, a 0:01:45.880 --> 0:01:48.160 like a robot in a video game. I know, right, 0:01:48.320 --> 0:01:54.160 we'll get there. Yeah. But so this February in he 0:01:54.200 --> 0:01:57.080 announced that the project's coming along well and that he 0:01:57.120 --> 0:02:00.000 thinks he'll be ready to conduct a head transplant surgery 0:02:00.160 --> 0:02:04.000 within the next two years. Yeah. Then it started making 0:02:04.000 --> 0:02:07.400 more headlines because in April he got a volunteer with 0:02:07.440 --> 0:02:12.600 a medical necessity, one Valerie spird Nov. Now Spritanov has 0:02:12.800 --> 0:02:17.040 Type one spinal muscular atrophy a k A worden ing 0:02:17.240 --> 0:02:21.440 Hoffman disease. Uh kinda vera has also being contacted by 0:02:21.440 --> 0:02:24.720 the way by transgender people. But the procedure is so 0:02:24.840 --> 0:02:27.600 risky that, you know, even he would not want to 0:02:27.639 --> 0:02:30.600 try it, you know, with a healthy body, even if 0:02:30.639 --> 0:02:34.200 that healthy body is is not the one that you want. Right. So, 0:02:34.240 --> 0:02:37.280 in other words, he would want only to perform the 0:02:37.360 --> 0:02:41.440 surgery for someone who is already at risk of dying 0:02:41.600 --> 0:02:45.080 or or whose quality of life is such that it 0:02:45.120 --> 0:02:49.320 would be considered a worthwhile risk. Right. And along those lines, 0:02:49.440 --> 0:02:52.640 let's take a second to talk about worden ing Hoffman. Sure, 0:02:53.000 --> 0:02:56.560 this is an inherited trait. The trait is an autosomal 0:02:56.680 --> 0:03:00.760 recessive trait, and it's a disease that's caused by disruptions 0:03:00.800 --> 0:03:04.520 or mutations in the s m IN one or survival 0:03:04.560 --> 0:03:08.400 motor neuron one gene, which is located on chromosome five. 0:03:09.040 --> 0:03:12.720 And it's also known as infantile spinal muscular atrophy and 0:03:12.800 --> 0:03:16.200 characterized by the degeneration of nerve cells within the lower 0:03:16.280 --> 0:03:20.720 brain stem and certain motor neurons in the spinal cord. Now, 0:03:20.760 --> 0:03:24.760 this leads to muscle weakness, generally beginning in the extremities 0:03:24.880 --> 0:03:29.120 and eventually leading to other areas including muscles involved in chewing, swallowing, 0:03:29.160 --> 0:03:32.560 and breathing. Uh. And tragically, a large percentage of infants 0:03:32.600 --> 0:03:36.360 who developed this pass away before reaching the age of two. 0:03:36.800 --> 0:03:39.680 So you can see why somebody suffering from this condition 0:03:39.760 --> 0:03:43.640 might be a candidate for something like a head transplant, 0:03:43.680 --> 0:03:46.640 if that were possible. Yeah, and Sprintanov himself has said, 0:03:46.880 --> 0:03:50.600 you know, he has lived beyond what most people had 0:03:50.600 --> 0:03:54.760 expected he would be able to to. You know, most 0:03:54.800 --> 0:03:57.120 people thought he would have passed away by now, most 0:03:57.120 --> 0:04:00.280 of the doctors he had been consulting through out his 0:04:00.400 --> 0:04:04.760 entire life. And so his his position on the matter 0:04:04.840 --> 0:04:10.120 is that he he is experiencing a difficult life. He's 0:04:10.160 --> 0:04:13.040 not expected to have a very long lifespan, and so 0:04:13.120 --> 0:04:16.400 for him, this is a risk that's worth taking. Sure. Sure. 0:04:17.040 --> 0:04:22.160 And you know, if if these headlines about the possibility 0:04:22.200 --> 0:04:26.440 of a head transplant have sounded kind of incredible to you, 0:04:26.440 --> 0:04:29.000 you're not the only one that the medical community has 0:04:29.360 --> 0:04:32.320 has kind of been an agreement about that, and that's 0:04:32.360 --> 0:04:35.760 been kind Yeah, and that's partially because a successful organ 0:04:35.800 --> 0:04:38.599 transplants have really only been happening for the past fifty 0:04:38.720 --> 0:04:41.880 years or so. So before we go into the specifics 0:04:42.000 --> 0:04:47.040 about this head transplant surgery and the controversy surrounding it. 0:04:47.240 --> 0:04:49.240 I want to take a look at the history of 0:04:49.240 --> 0:04:53.600 the medical technology surrounding transplantation. Sure, I actually didn't know 0:04:53.920 --> 0:04:56.920 that this was such a recent phenomenon. I imagined it 0:04:56.920 --> 0:04:59.160 would be one of those things that had been done 0:04:59.279 --> 0:05:02.520 in a dirt, an unpleasant way for hundreds of years. Well, 0:05:02.520 --> 0:05:07.920 there were certainly lots of early attempts that almost always 0:05:07.960 --> 0:05:12.160 resulted in the immediate death of the patient. If not that, 0:05:12.240 --> 0:05:16.080 then it resulted in the eventual death of the patient. Right, 0:05:16.120 --> 0:05:19.840 We've we've actually only had the technology, or rather than 0:05:19.839 --> 0:05:24.000 the methods to perform vascular anastomoses that that's joining up 0:05:24.040 --> 0:05:27.640 to blood vessels since the very beginning of the twentieth century. 0:05:27.880 --> 0:05:30.200 And it wasn't until then that people could really start 0:05:30.240 --> 0:05:33.640 to attempt real organ transplants. And I'm sure that there 0:05:33.640 --> 0:05:36.120 were a few unfortunate cases earlier than that where people 0:05:36.200 --> 0:05:39.159 kind of like stuck an organ in a thing and went, oh, nope, 0:05:39.200 --> 0:05:42.320 that's not working. But there well, I know there are 0:05:42.320 --> 0:05:44.520 a lot of cases in like mythology, and you don't 0:05:44.560 --> 0:05:46.680 know to what extent that might have been based on 0:05:46.760 --> 0:05:51.440 some horrific ancient experiment. Yeah, yeah, absolutely, um So. One 0:05:51.440 --> 0:05:55.120 of the researchers who was working on on the methodology 0:05:55.200 --> 0:05:58.880 of joining blood vessels together began attempting organ transplants in 0:05:58.960 --> 0:06:02.039 nineteen o six. Uh He He was trying to put 0:06:02.080 --> 0:06:05.600 a goat or pig kidneys into human patients who were 0:06:05.600 --> 0:06:08.920 experiencing renal failure, which, to be fair at that time 0:06:09.040 --> 0:06:12.400 was was a mortal organ failure. There was no coming 0:06:12.440 --> 0:06:16.120 back from that one. Um It obviously did not work out, 0:06:16.720 --> 0:06:20.160 but it did get the field started. In the meanwhile, 0:06:20.560 --> 0:06:24.760 another technology was in kind of co development in the 0:06:24.800 --> 0:06:30.839 medical community, and that's artificial respiration and circulation, and by 0:06:31.160 --> 0:06:34.920 nineteen fifty three, the heart lung machine or or the 0:06:34.960 --> 0:06:37.960 pump as we know it today had been created. That's 0:06:38.000 --> 0:06:42.200 something that can artificially circulate a patient's blood and an 0:06:42.200 --> 0:06:45.720 oxygen during a surgery. It was it was used for 0:06:45.800 --> 0:06:50.160 the first successful open heart surgery in and the next 0:06:50.279 --> 0:06:54.560 year in we get the very first successful human organ transplant, 0:06:55.040 --> 0:06:59.000 which was a kidney transplant. The doctor uh ended up 0:06:59.160 --> 0:07:03.560 transplanting a kidney from one identical twin to another identical twin. 0:07:03.600 --> 0:07:06.640 And the benefit of that is there was no risk 0:07:06.839 --> 0:07:11.560 of oregon rejection. In fact, that's the only case apart 0:07:11.600 --> 0:07:14.520 from using someone's own tissue, where you don't have to 0:07:14.520 --> 0:07:18.640 worry about the the rejection of tissue that you would 0:07:18.640 --> 0:07:21.960 in other transplant surgeries, right, Right, And I'm not sure 0:07:22.040 --> 0:07:25.480 whether people knew at that specific time that that was 0:07:25.560 --> 0:07:28.600 why it was successful. Yeah, I'm not entirely sure either, 0:07:28.720 --> 0:07:32.320 because there was a lot of unsuccessful transplants after that, right, 0:07:32.520 --> 0:07:35.120 There were quite a few. So Dr Joseph Murray was 0:07:35.160 --> 0:07:37.840 the one who performed the procedure and was eventually awarded 0:07:37.880 --> 0:07:42.000 the Nobel Prize for this work. Yeah, and the recipient 0:07:42.080 --> 0:07:45.440 of the kidney lived for eight years after the transplant surgery, 0:07:45.560 --> 0:07:49.120 so that was considered a success. It led to other 0:07:49.160 --> 0:07:53.240 surgeries that were not as successful. Yeah. If you look 0:07:53.240 --> 0:07:57.200 at the history of transplantation other than this, which the 0:07:57.240 --> 0:08:00.200 person lived for eight years afterwards, very often you see like, 0:08:00.280 --> 0:08:04.320 well they lived for seven days after d or twenty days, 0:08:04.360 --> 0:08:06.800 and that has a lot to do with the rejection 0:08:06.880 --> 0:08:09.119 of tissue that I was talking about. And then even 0:08:09.160 --> 0:08:12.520 after we started to develop drugs to help prevent that, 0:08:12.840 --> 0:08:16.040 the drugs themselves could lead to complications that could lead 0:08:16.080 --> 0:08:22.040 to fatalities. So it all depends upon the the technology 0:08:22.080 --> 0:08:24.360 and the drugs and the processes at the time. So 0:08:24.800 --> 0:08:28.920 nineteen fifty four is the first Oregon transplant. We moved 0:08:28.960 --> 0:08:31.840 to nineteen sixty three and we get the first lung 0:08:31.920 --> 0:08:36.040 transplant surgery, performed by Dr James Hardy. The recipient was 0:08:36.080 --> 0:08:38.679 actually a patient who was serving a life sentence in prison. 0:08:39.400 --> 0:08:42.000 The patient had lung cancer which had resulted in a collapsed, 0:08:42.040 --> 0:08:46.360 long and recurrent pneumonia. So Dr Hardy performs the lung transplant. 0:08:46.440 --> 0:08:49.440 It's considered to be a success. The patient begins breathing 0:08:49.480 --> 0:08:55.000 almost immediately, uh, without any problems. However, the patients subsequently 0:08:55.000 --> 0:09:00.360 suffered progressive kidney failure and died eighteen days after the transplant. Goodness, yeah, 0:09:00.360 --> 0:09:03.959 so the autopsy didn't show any signs of organ rejection. 0:09:04.320 --> 0:09:08.360 But other procedures that followed in the next few decades, 0:09:08.400 --> 0:09:10.480 and there weren't a whole lot. It wasn't like there 0:09:10.480 --> 0:09:14.400 were hundreds, but you know, the next several decades saw 0:09:14.480 --> 0:09:17.240 similar problems, with patients dying within a few months of 0:09:17.280 --> 0:09:21.280 the procedure, and the first truly successful lung transplant one 0:09:21.320 --> 0:09:24.040 where the patient would go on to live a normal 0:09:24.120 --> 0:09:27.320 lifestyle after the procedure was done. That didn't happen until 0:09:27.440 --> 0:09:30.920 nineteen eighty three, so two decades after the first one 0:09:30.960 --> 0:09:34.319 was when you had the first truly successful one um 0:09:34.360 --> 0:09:36.200 and that just kind of tells you that, you know, 0:09:36.240 --> 0:09:40.440 this is really complicated stuff. The first heart transplant took 0:09:40.440 --> 0:09:44.040 place in nineteen sixty seven, that was performed by Dr 0:09:44.080 --> 0:09:47.800 Christianne Barnard, and the patient passed away eighteen days after 0:09:47.840 --> 0:09:50.880 the procedure due to pneumonia. And this is where we 0:09:50.920 --> 0:09:55.920 see that the the anti rejection drugs, those are immunosuppressive drugs, 0:09:56.480 --> 0:10:00.640 because when you get somebody else's organ in planted in you, 0:10:00.720 --> 0:10:03.320 unless it's just the right one, like from your twin 0:10:03.480 --> 0:10:07.920 or something, typically your immune system regards that organ as 0:10:08.120 --> 0:10:10.880 something that shouldn't be in there and goes to work 0:10:10.920 --> 0:10:14.920 attacking it. Exactly, so, your own immune system is attacking 0:10:15.000 --> 0:10:18.960 your new oregon and that is obviously going to be 0:10:19.480 --> 0:10:23.600 a true complication. So that's why these immunosuppressive drugs have 0:10:23.640 --> 0:10:26.520 been administered in order to reduce that. But that also 0:10:26.640 --> 0:10:30.800 opens up the doorway to other potential uh, you know, pathogens, 0:10:30.800 --> 0:10:33.880 other potential illnesses, and you need your immune system. Yeah, 0:10:33.880 --> 0:10:36.600 it's it's pretty good to have around. Um. But advances 0:10:36.640 --> 0:10:40.000 started being made to those drugs in the nineteen seventies, right, Yes, 0:10:40.040 --> 0:10:43.920 that's when the chemists began to the chemists, that's when 0:10:44.160 --> 0:10:50.080 chemists in general began developing the anti rejection drug cyclosporing, 0:10:50.640 --> 0:10:54.480 which worked much better than earlier anti rejection drugs. Wouldn't 0:10:54.480 --> 0:10:56.839 be until nineteen eighty three that the FDA would give 0:10:56.840 --> 0:11:00.280 it clearance to be used in transplant surgeries. And like 0:11:00.280 --> 0:11:05.120 we were just saying a second ago, these immunosuppressant drugs, well, 0:11:05.160 --> 0:11:08.400 I mean in general, they interfere with either the creation 0:11:08.600 --> 0:11:11.600 or the activities of your your body's T cells, which 0:11:11.640 --> 0:11:14.560 are these specific types of white blood cells that that 0:11:14.640 --> 0:11:18.080 remember and attacks stuff that they identify as dangerous in 0:11:18.120 --> 0:11:23.520 your body. Um. And and this drug, cyclosporing is particularly 0:11:23.600 --> 0:11:29.640 useful because it, uh, it's the way in which it 0:11:29.720 --> 0:11:31.800 messes with your ear T cells is a little bit 0:11:32.080 --> 0:11:35.960 gentler that that some of the previous drugs, which were 0:11:36.000 --> 0:11:37.680 a little bit more of a nuke it from orbit 0:11:37.760 --> 0:11:43.120 kind of option, right. Uh. And yeah, So so being 0:11:43.120 --> 0:11:46.480 able to to mediate T cells response means that you 0:11:46.520 --> 0:11:48.839 can prevent them from attacking stuff that you want in 0:11:48.840 --> 0:11:51.200 your body, like a new heart or like your joints. 0:11:51.200 --> 0:11:53.760 The drug is also used in a rheumatoid arthritis care 0:11:53.800 --> 0:11:56.880 for example. Yeah, it's interesting. I mean we when we 0:11:56.880 --> 0:11:59.760 talk about our immune systems, they are incredibly important, but 0:12:00.040 --> 0:12:03.240 way they can cause some big problems right when you 0:12:03.240 --> 0:12:06.760 you least need those big problems, and things like allergies. 0:12:06.760 --> 0:12:13.280 See yeah, cats, dumb body. Yeah, I want to hug 0:12:13.320 --> 0:12:17.280 the cats. Yeah, we can have a whole discussion about 0:12:17.280 --> 0:12:19.439 my allergies and how I'm not very pleased with them, 0:12:19.440 --> 0:12:23.240 but at any rate, UH immune systems. Clearly we'd be 0:12:23.320 --> 0:12:25.520 much worse off without them, but we do have to 0:12:25.559 --> 0:12:29.760 take them into account with something as traumatic as a 0:12:29.840 --> 0:12:34.520 transplant surgery. UH. Now, when we move on with some 0:12:34.559 --> 0:12:38.560 more kind of cool updates to transplant technology, we start 0:12:38.640 --> 0:12:43.600 looking at UH synthetic and regenerative medicine approaches, which are 0:12:43.640 --> 0:12:47.359 really awesome. This is the idea where we don't necessarily 0:12:47.360 --> 0:12:51.280 have to rely upon a donor to get the organ 0:12:51.400 --> 0:12:54.400 that we need in order to perform the transplant, and 0:12:54.480 --> 0:12:58.120 the earliest examples of this are actually UH in skin 0:12:58.240 --> 0:13:02.720 grafting products. So like a not like an internal organ 0:13:02.800 --> 0:13:06.880 but rather an external Yeah. So the first one would 0:13:06.880 --> 0:13:10.000 be an apple graph, which was a skin grafting product 0:13:10.000 --> 0:13:13.720 that the FDA approved, and in two thousand one the 0:13:13.760 --> 0:13:18.719 FDA approved Dermographed, another kind of skin graph product. So 0:13:19.760 --> 0:13:23.840 this would allow doctors to grow the skin externally, you know, 0:13:23.880 --> 0:13:26.160 not attached to the patient, and then grafted onto the 0:13:26.160 --> 0:13:29.520 patient without having to remove a patch of skin from 0:13:29.559 --> 0:13:31.719 one part of the body and transplant to another part 0:13:31.720 --> 0:13:35.120 of the body. Right, it's really useful for stuff like 0:13:35.120 --> 0:13:38.960 like ulcers that are not healing under their own power. 0:13:39.400 --> 0:13:42.440 And these things are all basically fake skin that contain 0:13:43.200 --> 0:13:46.040 real human cells. And and by fake skin, it might 0:13:46.080 --> 0:13:50.480 be a collagen that's been composed of of of cow 0:13:50.559 --> 0:13:52.400 cells or something like that. But but at any rate, 0:13:52.400 --> 0:13:57.200 it's it's a bio structure that that you can put 0:13:57.240 --> 0:14:00.000 on a patient and it will grow into the patient 0:14:00.000 --> 0:14:02.120 and his body and attached to the patient's own skin. 0:14:02.760 --> 0:14:07.360 So that is so gross and amazing. At the same time, 0:14:07.559 --> 0:14:11.640 I started thinking about the dark Man series, one of 0:14:11.640 --> 0:14:13.280 those and you don't go out in the sun because 0:14:13.280 --> 0:14:15.840 otherwise it all just end up bubbling off of you. 0:14:16.440 --> 0:14:19.680 It's only in dark Man, though not this stuff. Dark Man, 0:14:19.760 --> 0:14:22.760 the one that had a certain set of skills. Well 0:14:22.840 --> 0:14:26.680 he he later proved to a certain set of skills. Yes, yes, yes, 0:14:27.000 --> 0:14:29.920 many things were taken from dark Man. In two thousand 0:14:29.960 --> 0:14:33.560 and eight, a patient received an airway transplant that was 0:14:33.760 --> 0:14:38.280 regenerated airway, so the airways scaffold came from a donor. 0:14:38.880 --> 0:14:43.240 That part was remained like a traditional transplant, but the 0:14:43.720 --> 0:14:47.200 doctors had removed the donor's cells from the scaffold, the 0:14:47.760 --> 0:14:49.960 various cells that were attached to the scaffolding, so it's 0:14:50.000 --> 0:14:55.840 just kind of a raw structure at that point. They Yeah, 0:14:56.160 --> 0:14:59.560 they added bone marrow cells from the patient, and the 0:14:59.600 --> 0:15:03.400 bone cells are essentially kind of like stem cells subset 0:15:03.440 --> 0:15:04.920 of stem cells, if you think of it that way. 0:15:05.120 --> 0:15:07.440 They used the bone marrow which would ended up creating 0:15:07.480 --> 0:15:11.480 the the tissue for the airway, and then they transplant 0:15:11.560 --> 0:15:15.520 that into the patient and this helped reduce the possibility 0:15:15.720 --> 0:15:18.960 of an oregon rejection because it was the patient's own tissue, 0:15:20.240 --> 0:15:22.520 right right. The thing about bone marrow is that all 0:15:22.560 --> 0:15:25.480 of your T cells are grown there. So if you 0:15:25.600 --> 0:15:30.440 have some some bone marrow cells creating T cells, then yeah, yeah, 0:15:30.440 --> 0:15:32.920 it's already saying hey, Uh, we're all on the same 0:15:32.960 --> 0:15:39.000 team essentially. Then we saw the first full face transplant. Uh, 0:15:39.040 --> 0:15:42.480 you know, bone bones and all like like cheekbones, jaw, nose, teeth, 0:15:42.720 --> 0:15:45.720 all the muscles and eyelids and all of that stuff. Uh. 0:15:45.760 --> 0:15:47.440 And it's so hard to not make a face off 0:15:47.480 --> 0:15:50.480 reference here, but man, that movie is really terrible and 0:15:50.520 --> 0:15:54.280 this surgery is really incredible. Uh. And this was basically 0:15:54.320 --> 0:15:56.880 made possible, I mean because we had all of the 0:15:56.920 --> 0:15:59.520 all of the elements of that, all of the bone 0:16:00.000 --> 0:16:02.760 afting and and uh and muscle connection and all of 0:16:02.800 --> 0:16:06.160 that stuff. But but anti rejection medication was really what 0:16:06.280 --> 0:16:09.720 allowed the surgery to be a success. Um. The the 0:16:09.760 --> 0:16:13.240 patient went through two phases of rejection and was saved 0:16:13.280 --> 0:16:16.800 successfully both times. Wow. Uh. In two thousand eleven, that's 0:16:16.800 --> 0:16:19.880 when a patient received the first regenerated airway transplant that 0:16:20.000 --> 0:16:22.600 used a synthetic scaffold rather than one from a donor, 0:16:22.720 --> 0:16:24.960 so in this case, there was no need for any 0:16:25.000 --> 0:16:27.480 kind of donation. They were able to build it from 0:16:27.520 --> 0:16:32.920 the ground up essentially, and in the first successful regenerated 0:16:33.000 --> 0:16:36.960 trachea transplant takes place, as well as a successful regenerated 0:16:36.960 --> 0:16:41.760 trachea with synthetic scaffold transplant in a child man. So 0:16:42.000 --> 0:16:44.800 now we're getting to that point where we'll talk more 0:16:44.840 --> 0:16:46.960 about this in a little bit. But the idea of 0:16:47.280 --> 0:16:50.840 being able to build these synthetic structures and then incorporate 0:16:51.200 --> 0:16:55.120 the patient's tissue into those synthetic structures to create new 0:16:55.200 --> 0:16:59.160 versions of the patient's own organs, that's where we're headed. 0:16:59.200 --> 0:17:00.960 But we'll talk more about that in a little bit. 0:17:01.560 --> 0:17:05.040 Um As for head transplants, to get back to the 0:17:05.080 --> 0:17:10.000 topic at hand, Uh, well, we've seen some experiments, some 0:17:10.119 --> 0:17:14.360 pretty crazy mad science style experiments involved. Well we can 0:17:14.359 --> 0:17:18.840 certainly recall those Russian experiments with like dogs taking the 0:17:18.840 --> 0:17:21.000 head off of a dog and putting it on another 0:17:21.040 --> 0:17:24.520 dog or well I think they were also just experimenting 0:17:24.560 --> 0:17:28.280 with if they could keep a dog's head living not 0:17:28.440 --> 0:17:31.000 attached to the dog body, so they attached it to 0:17:31.160 --> 0:17:36.920 like a circulatory Uh yeah, and you can see videos 0:17:36.960 --> 0:17:39.480 of this if you believe that no special effects were 0:17:39.480 --> 0:17:41.879 involved in creating them. At the time. They would like 0:17:42.480 --> 0:17:45.639 do incredibly disturbing things like pound a hammer on the 0:17:45.640 --> 0:17:48.879 table where the severed dog's head was, and the dog's 0:17:48.880 --> 0:17:52.960 head would seem to sort of react react to it. Yeah. Um, yeah, 0:17:53.000 --> 0:17:55.640 we talked about that in our episode about Frankenstein. Yes 0:17:55.680 --> 0:18:00.280 we did. I cannot, I cannot ever watch those again. 0:18:00.480 --> 0:18:04.240 Once was enough. It was truly disturbing. Yeah. But in 0:18:04.280 --> 0:18:06.920 the nineteen fifties and sixties and even into the seventies, 0:18:06.960 --> 0:18:09.560 there were some experiments, largely in Russia but in other 0:18:09.600 --> 0:18:15.240 places as well, with head transplants with dogs and monkeys. Um. 0:18:15.280 --> 0:18:20.400 There was one monkey head transplant that was successful for 0:18:20.520 --> 0:18:25.080 eight days. The monkey was able to continue eating and breathing, 0:18:25.160 --> 0:18:28.040 but had was essentially paralyzed from the neck down and 0:18:28.240 --> 0:18:33.000 died eight days after tissue rejection. But it did kind 0:18:33.000 --> 0:18:35.960 of work that the spinal cord never fused back. That 0:18:36.000 --> 0:18:37.640 was one of the things we'll talk about too. Well. 0:18:37.760 --> 0:18:40.840 That seems like a pretty major issue, a huge issue obviously. 0:18:41.600 --> 0:18:45.800 But anyway, these these were these were um experiments, but 0:18:45.880 --> 0:18:49.159 none of them were like, uh, you know, a ground 0:18:49.240 --> 0:18:53.199 the foundation for further work, right. No one looked at 0:18:53.240 --> 0:18:57.000 them and said, you know, this is a great plan. Yeah, Okay, 0:18:57.000 --> 0:18:59.200 Well I think we should look at where the science 0:18:59.240 --> 0:19:03.360 of transplantation rests today, like what are we good at 0:19:03.400 --> 0:19:05.960 doing and what are the things that that are still 0:19:06.000 --> 0:19:09.960 presenting problems for us. Well, guys, we are so good 0:19:10.000 --> 0:19:14.679 at cutting. We are terrific at cutting stuff like seriously. 0:19:14.840 --> 0:19:19.639 And this is important because, uh you know, as you 0:19:19.720 --> 0:19:22.600 have perhaps seen in your own kitchen, if your knives 0:19:22.600 --> 0:19:27.800 are getting a little bit dull, a less than sharp edge, 0:19:27.880 --> 0:19:31.080 what will damage the tissue that you're cutting and and 0:19:31.200 --> 0:19:34.600 invite an immune response, which is what you do not want. 0:19:34.840 --> 0:19:37.199 Right Cutting with a dull knife tends to sort of 0:19:37.240 --> 0:19:41.639 do some ripping and crushing exactly. Um. So with it, 0:19:41.800 --> 0:19:46.120 with advances in material science necessary to create very sharp blades, 0:19:46.200 --> 0:19:48.600 and with the advent of laser systems that can be 0:19:48.680 --> 0:19:50.960 used in surgery, we are able to keep both the 0:19:51.359 --> 0:19:56.440 organs and the patients much healthier. Uh. We've also developed 0:19:56.480 --> 0:20:02.040 ways of keeping organs viable while waiting for to perform 0:20:02.119 --> 0:20:06.720 transplant surgery. Typically this involves bathing the organs in a 0:20:06.760 --> 0:20:12.440 cold salt water solution or saline uh. And it well 0:20:12.600 --> 0:20:15.600 usually let the organs last several hours, depending upon the organ. 0:20:15.680 --> 0:20:18.439 So for kidneys it could be forty eight hours, for 0:20:18.600 --> 0:20:21.840 livers it's about twenty four hours. For all heart only 0:20:21.960 --> 0:20:24.439 five to ten hours, So it's very dependent upon the 0:20:24.480 --> 0:20:28.160 type of organ. Obviously, with something like a person's head, 0:20:28.280 --> 0:20:30.800 you've got a lot more to consider, you know, keeping 0:20:30.800 --> 0:20:35.200 the brain oxygenated and everything. So, but the the whole 0:20:35.359 --> 0:20:38.639 idea here is that by lowering the temperature, you lower 0:20:38.720 --> 0:20:41.639 the amount of energy the cells need to exert in 0:20:41.720 --> 0:20:45.000 order to survive, and that prolongs their viability so that 0:20:45.080 --> 0:20:46.480 you can get them to where they need to be 0:20:46.560 --> 0:20:49.960 in the surgery can be performed, but it is a 0:20:50.040 --> 0:20:52.959 matter of hours, right. This isn't something where you can 0:20:53.000 --> 0:20:54.919 just you know, you've got a freezer full of organs 0:20:54.920 --> 0:20:56.840 and you can just go and pull one out whenever 0:20:56.880 --> 0:20:58.480 you need it. It's it's one of the things that 0:20:58.560 --> 0:21:04.200 makes this such a delicate and difficult um field of medicine. 0:21:05.000 --> 0:21:08.159 Here's another thing that I think is fascinating, which is 0:21:08.480 --> 0:21:13.440 the ability to keep a patient alive while you're sort 0:21:13.440 --> 0:21:16.960 of like moving around or removing or inserting organs that 0:21:17.040 --> 0:21:21.400 we normally think of as absolutely critical to survival. How 0:21:21.440 --> 0:21:26.640 do you actually do a heart transplant? Uh, you hook 0:21:26.720 --> 0:21:29.760 someone up to one of those artificial heart lung machines 0:21:30.280 --> 0:21:32.280 and kind of let it go and you you also 0:21:32.560 --> 0:21:35.160 one of the advances that we've seen since the nineteen fifties, 0:21:35.320 --> 0:21:39.280 was the capacity to do that with artificially cooled blood, 0:21:39.720 --> 0:21:43.840 which helps the rest of the patient's body. Oh, I'm sorry, 0:21:44.119 --> 0:21:48.040 literally chill out. It just kind of it preserves the 0:21:48.040 --> 0:21:51.200 rest of the organs while the transplant is going on. Yeah, 0:21:51.200 --> 0:21:53.160 we talked a little bit about that when we were 0:21:53.160 --> 0:21:57.000 talking about the possibility of suspended animation in a previous episode. 0:21:57.000 --> 0:22:00.440 How this is something that's apt hypothermia. I don't know 0:22:00.480 --> 0:22:03.200 if this would technically qualifies that, but at least it's 0:22:03.200 --> 0:22:08.639 a similar principle. Keeping temperature is low to prevent tissue degeneration. Yeah. So, 0:22:08.880 --> 0:22:10.919 and even in that episode, if you recall, it was 0:22:10.960 --> 0:22:16.159 really all about keeping a patient alive in order to 0:22:16.280 --> 0:22:20.560 address a medical issue immediately, as opposed to perpetually keeping 0:22:20.560 --> 0:22:22.359 that patient alive until you can thaw them out, like 0:22:22.400 --> 0:22:24.919 a hundred years from now. That's not what That's not 0:22:24.960 --> 0:22:27.680 where the technology is right now. Um. Then, of course 0:22:27.680 --> 0:22:31.399 we've got the immunosuppressive drugs, the anti rejection drugs we're 0:22:31.440 --> 0:22:35.840 talking right, So the early ones were pretty pretty damaging 0:22:35.920 --> 0:22:38.959 to a person. Even if they were working as they 0:22:38.960 --> 0:22:42.720 were intended, they could cause other consequences. For example, because 0:22:42.880 --> 0:22:45.159 in general killing stuff in your body, like like we 0:22:45.200 --> 0:22:48.640 all know from an example for for chemotherapy, Yeah, kill 0:22:48.720 --> 0:22:52.200 stuff in your body. Yeah stuff, the good and the bad. Right, 0:22:52.280 --> 0:22:56.040 So the newer drugs have lower toxicity with fewer side 0:22:56.080 --> 0:22:59.480 effects like side effects like raising your blood pressure or 0:22:59.520 --> 0:23:04.280 your coless role or even uh, giving you diabetes that 0:23:04.320 --> 0:23:07.040 could be one of the side effects of these older 0:23:07.240 --> 0:23:11.320 immuno suppressive drugs and still a risk with the current ones. Um, 0:23:11.359 --> 0:23:14.840 even with those advances, there are a lot of things 0:23:14.880 --> 0:23:17.560 you have to take into consideration. They can be toxic, 0:23:17.800 --> 0:23:21.800 toxic to kidneys, they can cause they may cause cancer 0:23:22.200 --> 0:23:24.359 and uh. And the thing about them is that most 0:23:24.480 --> 0:23:26.679 patients who have to start taking them due to a 0:23:26.680 --> 0:23:29.879 transplant have to take them for the rest of their lives. Yeah. 0:23:29.960 --> 0:23:32.960 So one of the things that people are really looking 0:23:32.960 --> 0:23:37.360 into our ways of performing surgeries that would not require 0:23:37.480 --> 0:23:42.160 immunosuppressive drugs. So in other words, these were generative medical 0:23:42.240 --> 0:23:46.120 approaches where you're using the tissue from the patient him 0:23:46.240 --> 0:23:49.440 or herself, then you don't need to worry about using 0:23:49.440 --> 0:23:52.600 the immunist suppressive drugs for the rest of their lives. 0:23:52.640 --> 0:23:57.120 That because they're getting a transplant of their own tissue um. 0:23:57.160 --> 0:23:59.639 Obviously that would be a huge benefit. All right, well, 0:23:59.720 --> 0:24:03.560 let's bring it back to the discussion of the head transplant, 0:24:03.640 --> 0:24:06.360 because that's what everybody's got to know. Can I get 0:24:06.359 --> 0:24:09.600