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Six Months Old, Eight New Organs
AEton writes "According to the BBC, Dr. Andreas Tzakis has just successfully replaced six-month-old Alessia Di Matteo's liver, stomach, pancreas, small and large intestine, spleen, left kidney, and right kidney in a record-setting operation. The child is so far doing fine with a one-year-old baby's organs. Tzakis is no stranger to multiple-organ transplants; in 1997 he set the previous record of seven organs by replacing seven of a two-and-a-half-year-old's organs. It must be a little odd to know that a growing plurality of your tissue used to be someone else's."
It might be early enough in the child's life that their immune system will accept the new tissue as its own, as all babies immune systems learn what their own body tissue types are, and only later start rejecting foreign tissues.
I believe that they do have to take antirejection drugs- regardless of their age. this site says (on the 7th page) "Again, as with the tiny premature babies and the dialysis patients, that up-front cost gives us an expanded capability to keep people with failed hearts alive a lot longer so they can receive even more care. Transplant patients can live for a very long time. The post-transplant follow-up care?including ongoing antirejection drugs . . ." So there you go. In addition, this site also claims that "Babies who now receive an incompatible blood-type heart still must take immunosuppressant drugs to ensure their bodies don't reject the donor heart. All transplant recipients, regardless of their age, blood type or the organ they receive, must do so."
"Has lived" normally indicates that the person lived for 10 years and continues to do so today. If the patient died, the quote has a bad (because it causes misunderstanding) grammar problem.
Mod down posts with a "Free Mac Mini/iPod" sig, they're spam!
Unfortunatly, yes they do. I am no doctor, but from knowledge I picked up due to personal experience with a kindey transplant patient, and a few references I found through a quick google (http://www.scienceblog.com/community/older/2003/B /20036915.html, http://surgery.uchicago.edu/patients/ped/p_ltc3.ht m, and so on) implies that.
Basically, because any transplanted organ is a 'foriegn' object (it _is_ from someone else's body), the body's immune system recognizes that it is not part of it's body and attacks it in much the same way it would attack an infection. Because of this, all transplant recipients (including small children) must take drugs to lower their immune system's response to such things so that the body dosen't kill the new organ.
is an identical twin transplant. i've read several references over that years that if one twin donates a kidney to the other that anti-rejection drugs are not needed.
eric
I thought that species with a DIVERSE genetic base had the best probability of survival.If, through technology, we are able to maintain an even MORE diverse code base, then is that not better?
.well, keeping in mind the progress of the last 100 years, can you call me crazy if I were to say that technology could cure all illness within the next thousand years? With that in mind, maybe your genetics gives you a disadvantage physically, but the mental advantages to your genetics is a far greater advantage to the human race. Or maybe just having your gene set to study will allow the human race to understand our code that much quicker. Technology is just so much faster than evolution that even if your contribution is very, very small (like teaching your kid to program OSS), it is enough to make up for any genetic deficiencies.
Good genes, bad genes . . . in the current environment it is easy for you to pass judgement, However, when the environment changes, so must your definitions of good and bad. Since change is uncertain, there is no way you can really know which genes are good or bad. Would it not be better to hold on to as many different genes as possible, just in case we need them later?
Besides, if your genes are really detrimental to your daily function, you will already have a disadvantage that will limit the spread of your genes compared to other "good" gened people. There's additional medical costs, social prejudice, and simply a higher risk of death for people with inferior genetic material. You may live a quite normal and happy life, but individuals with similar genetic material as you will automatically be limitted, relative to other "healthier" genes. Plus, you have to take in account how large and diverse our population is now. Evolution will continue whether you decide to help it or not. It is simply the way the world works, not a policy one should live their life by.
Finally, it really can be argued that evolution is no longer relevant to human survival. Evolution takes thousands and thousands of years to mold species. Technology, on the other hand . .
And maybe the environment will change and your son will be the only one left to impregnate an entire generation of women . . . nomatter how slight the possibilty, how could you rob such a possibility like THAT from ANYONE!
Sdelat' Ameriku velikoy Snova!
Are you joking or do you just have no idea what you're talking about? There are ENORMOUS waiting lists for organ transplants. It is VERY, VERY likely that there are other children waiting to get transplants.
But if a man with hemophilia were to pass on his genes to the next generation it will increase the prevalence of hemophilia in his grandchildrens generation. He can't pass it to his son, but any daughter he has will be a hemophilia carrier guaranteed. Also if his marries a women with the recessive hemophilia genes it will then be 50% probability that his children, both male and female could be affected, not just males. Should a daughter with hemophilia have children, then all her sons will have it, and all her daughters will be carriers.
1. The number of organs transplanted is NOT an indication of the pre-op condition/prognosis of the baby or an indicator of post-op "quality of life".
Her disorder is a single disease process that happens to affect most of her vital organs. All other things being equal, a baby born with several disorders, requiring fewer organs transplanted (even as little as 1 or 2), actually could be considered "sicker", have a much lesser chance of survival and be a greater "burden on society".
2. Of the eight organs transplanted, some might not have actually been "diseased" (more on this later).
3. The greater the number of organs transplanted is not proportional to the surgical difficulty.
Not to take away from Dr. Tzakis' great achievement, but technically the surgery might have been easier than transplanting a few non-contiguous organs. Here is why:
If you ask any transplant surgeon, the most difficult aspect of the surgery is doing the anastamoses (or "rejoinings"). Essentially taking the entire foregut and midgut en bloc significantly decreases the number of "rejoinings" one has to perform.
Tzakis likely only had to join this single unit of organs (the liver+stomach+pancreas+spleen+small bowel+large bowel) at two points (those being #1 the original esophagus-to-new stomach and #2 the new large bowel-to-original rectum) for complete continuity of the gastrointestinal tract and then probably about another 4 anastamoses for blood supply.
The entire blood supply for all the aforementioned organs (minus the kidneys) originate from only 2-3 arteries arising from the aorta. To leave the original pancreas and spleen (which are not significantly affected by her disorder) would have been several times more difficult than taking the "whole package" because the vascular supply for each organ would have to be dissected and reanastomed individually. This is more difficult because it's more vessels to join and the vessels are smaller i.e. more difficult to work with.
Transplanting even only 3 of these organs in non-continuity would have required 1-2 GI tract and 2+ vascular anastamoses for EACH organ. If you do the math you can quickly realize why it was probably easier to take all the organs, even if some were not diseased.
4. Transplanting both kidneys is NOT the transplant surgery standard of care. The baby would have done fine with one kidney and there has yet to be any studies proving that transplanting two kidneys vs. one improves a patient's post-op outcome. But if Tzakis did not take both kidneys he would be stuck at 7 and we wouldn't be talking about this whole topic right now (take it however you want).
So to make a long story short:
1. The baby was not as sick or doomed as one might think.
2. It's a great accomplishment but it wasn't "pushing the envelope".
3. The ethical issues raised are no different than those for any other medical procedure or treatment: should society help the inherently weak at the expense of the strong or should we fall into the Darwinian model of society were it's survival of the fittest? Or is there a middle-ground as to how much help we give the weak and who/what determines how much and what is too much help to give?
Nope. This is a logical fallacy called the Paradox of the heap.
I think you misunderstood the earlier post. Grains of sand are not identical; replacing every grain of sand in a heap, one at a time, gives you a different heap (though it may "look" the same. Actually, it would probably be impossible to replace each grain with a new one in the exact same position, because of packing issues.) However, elementary particles are identical, in a very fundamental and non-trivial sense. It doesn't mean anything to talk of "replacing every electron in your body by a different electron": in programming terms this really is a quantum mechanical NO-OP (or at most a change of sign in the overall wavefunction of the universe, if the number of electrons being replaced is odd, but this doesn't affect anything).
What your stating is based on a flawed (but common) misconception that the immune system 'learns what is dangerous' or attacks what is dangerous, which hasn't been shown by any real facts/supporting research.
In addition, a childs immune system is only 'immature' based upon the fact that it hasn't been exposed to as many antigens as an adult - which allow for a rapid secondary response when re-exposed to those antigens. An example is chicken pox - once you get it, your exposed to the antigens and your body can rapidly respond if exposed to it again so you only get the chicken pox once (most of the time.
Lastly, for the first few months alive, babies also have passive immunity that is gained from their mother. So, this would add an entire other level of complexity if the 'maternal' antibodies were to attack the new organs as well - though I have no idea if they would still be present at 6 months after birth. (As a side note, it also sometimes occurs that a mother's immune system will reject the baby and have to be treated with certain drugs to reduce/stop the killing of the fetus via the mothers immune reaction).
So, IMHO, yes, the child has to take the drugs for their entire life.
One last comment - very old people need more drugs because their bodies are failing because they are...OLD. Organs and cells do not have infinite lifespans. They simply can't deal with being sick at all - whereas a younger person can deal with the flu. Given the same level of immune response, the frail old person would die while a young healthy person would live.