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Here’s a taste of what we’re serving today:

  • Patchwork People: Transplantation and the Problem of Rejection

  • PLUS: Can AI Suffer?, Benzene, and Rain and Conflict 💧

MEDICINE

Patchwork People: Transplantation and the Problem of Rejection

Transplantation is the artificial introduction of biological material to an organism and can be super useful when a patient’s tissue/organ has failed beyond pharmaceutical intervention or surgical repair. However, without effectively preparing both the recipient’s body and the transplanted material, the transplant can be rejected, eliciting a potentially extremely dangerous immune response. One of the ways to avoid this is by immunosuppression to reduce the extent of any immune response. However, it follows that they are highly susceptible to other infections during this period. There are several other methods to avoid rejection, such as by analysing genetics (DNA typing) to check how similar a recipient is to the donor: greater similarity often reduces rejection, but the opportunity to refine this in the future is huge…

💡 Things to consider

  • Could antigen removal reduce rejection?: Antigens are tiny protein markers that are recognised by our immune cells to distinguish between our own body cells and foreign material. It is these antigens presented on MHC molecules (surface glycoproteins that help present pathogens to immune T cells) of host cells that trigger the cascade that leads to an immune response in rejection. It would therefore make sense that if we removed these from the transplanted material, our body could not reject it. Unfortunately, however, viruses beat us to it, by adapting to evade the process of antigen presentation on MHC molecules of infected host cells. Our body countered this by immune cells (namely NK cells) recognising when a cell has this MHC missing, which would indicate that it is infected with a virus and should be destroyed by the immune system. Therefore, a transplant stripped of MHC molecules and antigen would be seen as “missing-self” and potentially virus-infected and so rejection would prevail.

  • Patchwork people: Is there a limit to how much of a body could be made of transplants? Some transplants are more straightforward than others. For example, the influence of genetically matching liver tissue has no effect on allograft survival, compared to bone marrow, for which it is extremely important. Most organs in the abdomen and thorax can be transplanted, as well as the cornea, bones, heart valves, and stem cells. A single individual could receive all of these transplants, but the intensity of the surgery and associated immunosuppression could be detrimental. Overall, a brain transplant is unachievable at the moment mainly due to the inability of nerve tissue to heal properly: scarred nerves cannot transmit signals well. Besides, how effectively could the brain adapt to control its new body?

Maybe keep your own one …

  • Supply and demand: Until we can artificially grow human organs, there is likely to always be a waiting list for organ transplants, dependent upon human donors. Might we be able to use animal organs to meet this demand? Mechanically, animal organs may function very similarly to human counterparts, such as pig hearts. However, could this open the door for increased transmission of animal diseases? What ethical dilemmas might arise from using animal organs for human survival?

🔎 Find out more

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That’s it for this week! We’d like to thank this week’s writer: Rob Folkard.

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