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Organ transplants aren’t new, but scientists are still making breakthroughs in transplant success rates and the sources of the organs.

Hosted by: Hank Green

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Sources:
Deceased Donor Uterus Transplant:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31766-5/fulltext
https://www.nytimes.com/2015/11/13/health/uterus-transplants-may-soon-help-some-infertile-women-in-the-us-become-pregnant.html
https://www.scientificamerican.com/article/first-successful-uterus-transplant-from-deceased-donor-leads-to-healthy-baby/
https://www.bswhealth.med/Pages/departments/transplant/uterus-transplantation.aspx
https://scrubbing.in/mother-consider-profoundly-blessed-part-study/
https://www.ncbi.nlm.nih.gov/pubmed/27125227
Pig Hearts in Baboons:
https://www.nature.com/articles/s41586-018-0765-z
https://www.nature.com/articles/ncomms11138
https://www.scientificamerican.com/article/baboons-survive-for-half-a-year-after-heart-transplants-from-pigs/
https://www.sciencemag.org/news/2016/04/researchers-keep-pig-hearts-alive-baboons-more-2-years
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1475508/
https://www.researchgate.net/publication/320929300_Porcine_to_Human_Heart_Transplantation_Is_Clinical_Application_Now_Appropriate
Thanks to Skillshare for sponsoring this episode. [INTRO ♪].

Tomorrow, one baby will celebrate a very special first birthday. That’s because of the several hundred thousand babies born last year on December 15, she was the first person in the world to be gestated in a transplanted uterus which came from a deceased donor.

And her successful birth could offer renewed hope for prospective parents with absolute uterine infertility who either were born without a uterus or have had it surgically removed for medical reasons. The child’s mother has Mayer Rokitansky Küster Hauser syndrome, which means her uterus never fully developed, and she was born without one, though she has functional ovaries. Although she gave birth about a year ago, her case was just published in The Lancet this December.

She got the uterus she carried her child in from a donor who had passed away from a stroke. Before the transplant, she went through one round of in-vitro fertilization, where she had her eggs collected, fertilized, and then frozen, so they could be implanted later. Then she received an entire uterus, including the cervix and fallopian tubes, from the donor.

She had to go on drugs that suppressed her immune system to make sure her body didn’t reject the new organ. And seven months after getting her new uterus, she underwent the final step of IVF, and one of her embryos successfully implanted in the donated tissue. The whole process from organ transplant to giving birth took a little more than a year and the baby was delivered about 4 weeks prematurely by cesarean section to avoid any complications.

And the doctors took out the uterus at the same time so she could stop taking those immune-suppressing drugs. This isn’t the first successful birth from a transplanted uterus, but previous ones were from living donors—usually a very generous family member or friend. Transplants from deceased donors have been performed, but none of the recipients carried a fetus to full term.

That made doctors wonder if uteruses were too fragile to be extracted and transplanted after a person’s death. Now we know that they aren’t, necessarily. There are some other benefits to having a donor that’s alive when the procedure is done—the surgeries can be done at a convenient time for the surgeons, donor, and recipient, for example.

With deceased donors, the procedure is more rushed, but the biggest advantages are that the pool of donors is much larger, and there’s no concern that the donor will be harmed by the surgery. Doctors are still debating whether a living or deceased donor is ultimately best, but one thing's for sure: having deceased donors as a possibility will increase the total number of uteruses available. And that means more people can get the life-giving surgeries they need if they want to carry a child.

Now, if you think transplanting organs between people is tricky, transplanting between species is a whole other level. But earlier this month, scientists reported in Nature that four baboons lived several months with hearts transferred from pigs. This latest accomplishment puts us one step closer to whole organ xenotransplantation: putting organs from other species in people.

Though that might sound like the start of a horror movie, right now there just aren’t enough hearts to go around from people, but there are plenty of pig hearts out there. If we could use organs from other species, then more people could receive the hearts they need. And we already use valves from pig hearts.

The tricky thing with using a whole heart, though, is that it has to be kept alive:. When doctors use pig valves, the tissue is killed first, and that reduces the risk of rejection. Because animals differ genetically and produce different proteins and hormones, an animal’s immune system is more likely to attack living organs from another species.

Scientists have successfully kept pig hearts alive for a while in baboons before, but they were just kind of tacked on to blood vessels in the abdomen to show that the organ could survive without being rejected. They tried hooking them up properly, but at most, the monkeys only survived for 57 days. So it’s really remarkable that the four baboons in this new study lived over three times longer than that—up to 195 days before they were euthanized to meet the experiment’s ethics requirements.

To succeed, the researchers started by breeding genetically engineered pigs whose hearts lacked certain proteins, making them look more like baboon—and human—hearts. They then concocted a mix of drugs that dampened the baboon’s immune system and slowed the growth of the pigs’ hearts so they didn’t get too big for the baboon’s body. Then, during the transplant procedure, the team dunked the organs in a special nutrient solution.

That’s because, when a heart is taken out of a donor, it essentially has a heart attack and the tissue can get damaged. Human hearts can recover from this kind of trauma, but pig hearts are more sensitive and usually don’t, which is part of why a lot of transplants fail. So figuring out how to reduce that damage was a big piece of the puzzle.

Although the researchers dubbed this latest experiment a success, there is still a lot of work to be done before we can even consider transplanting a whole pig organ into a person. And there are a lot of ethical questions that need to be addressed along the way. Still, it’s a big step forward for transplant science.

And it makes it a little more likely that one day, people’s lives could be saved by organs from livestock. Packing up organs and moving them to a new place is a complex science. But packing a bag and transporting yourself somewhere new and exciting shouldn’t be.

And you can find all the best travel tips on Skillshare. Once you’ve made your way to an exciting place, though, you’ll want to make sure that you can show everyone back home all the great sights. So to learn more about capturing the world around you, you might want to try Dan Rubin’s class on travel photography.

What I like most about this class is that it covers all the basics in a fun way: by taking you on a scavenger hunt in New York City and challenging you to take five iconic travel photos. Whether you’re shooting with a fancy DSLR or just your phone, he shows you how to get the best shots, plus gives tips for editing. And it’s just one of the many classes that can take your travel to the next level.

Skillshare has more than 20,000 other classes about everything from cooking to music, so there’s plenty to explore. Right now, Skillshare is offering SciShow viewers 2 months of unlimited access to all of their classes for free! So you can indulge your wanderlust or pick up a new skill, all while supporting SciShow.

You can follow the link in the description to check it out for yourself! [OUTRO ♪].