Fight Aging!

There are three principal problems with the current state of organ transplantation, from which all of the other well-known issues arise. Firstly the existing regulatory systems surrounding organ donation actively discourage donors by both restricting possible compensation and making the process far slower and more baroque than it has to be. This is often the case wherever bureaucrats and politicians become involved in medical matters: a donor really has to work hard as well as suffer surgery in order to give an organ, and there will be nothing but thanks for it. There is little fairness and little incentive to be found. For all that it gets most of the attention, this isn't really the important issue, however: it is a symptom. The medical community only makes an effort to reuse organs because of the second problem, the vital and central problem, which is that we do not yet have the biotechnologies needed to manufacture replacement organs to order, from scratch, reliably and safely, and at a mass-market price.

The third problem is that it requires major surgery with a significant risk of death and serious complications in order to transplant an organ. No-one really wants major surgery if they can possibly avoid it, and the risks escalate considerably in later life, at the time when you are most likely to actually need a replacement organ. Thus the ultimate goal of regenerative medicine and tissue engineering is most likely to regrow and repair existing organs in situ in the body. No surgery, just very sophisticated control over cellular behavior alongside equally sophisticated methods of repairing forms of accumulated cellular and molecular damage that cause degradation of organ function.

That grail of medicine lies a way in the future for most applications, however, so for now let us return to the second problem, the current inability to grow organs for transplantation on demand, ideally from the patient's own cells so as to eliminate the possibility of rejection. I think it uncontroversial to suggest that this challenge will be solved in the near future, this technology developed. Indeed comparatively simple and successful attempts have been taking place in limited trials for most of the past decade: tracheas, bladders, and so forth. A recent article on this topic, quoted below, pays attention to the New Organ initiative and its surrounding ecosystem of companies and non-profits involved in advancing the state of the art in regenerative medicine. More attention of this nature is always good to see. These and related efforts are spurring the research and development community to move more rapidly towards viable organ engineering, and the more support they gather the better:

How We'll Finally Put An End To Organ Donation Shortages

Looking at kidneys alone, about 25,000 people die each year waiting for a donation. And as New Organ founder Dave Gobel told io9, there are approximately two million estimated individuals in Europe, North America, and in the British Commonwealth who need replacement organs but don't show up anywhere on waiting lists because they're "deemed by the medical establishment to be 'not a transplant candidate' due to reasons such as having or having had cancer, being too old, and other triage-based disqualifiers."

At the same time, 95% of Americans support organ donation, but only 40% are registered organ donors. There's also the issue of how organs are procured today. "For someone needing a heart/lung transplant, someone must die for them," says Gobel "Imagine being in a situation where you must hope someone dies so you can live." Compounding the problem is that even for the fortunate few who do receive an organ donation (aside from those who receive a kidney), there are severe constraints on the quality of life after an operation. Many face a lifetime filled with the need to take auto-immune suppression drugs to stave off organ rejection, while the same drugs also lower their overall immune competence. "If all of that works out, they will still be facing the fact that transplant organs will often need to be replaced within 10 years of implant," says Gobel. "A ticking time bomb of life. Better than death for sure, but wow, what a life."

New Organ, a collective initiative hosted by Methuselah Foundation (a biomedical charity) and managed by the Institute of Competition Sciences, is currently raising awareness and facilitating research initiatives to help alleviate the shortages, including the New Organ Liver Prize - a $1,000,000 award to the first team "that creates a regenerative or bioengineered solution that keeps a large animal alive for 90 days without native liver function." The organization is currently working on a number of other related initiatives, including a shared roadmap, a prize portfolio to stimulate key breakthroughs, and a growing network of partners.

Indeed, as the biotechnology revolution takes shape, a number of solutions are emerging, including the ability to regenerate whole organs using stem cells, bioprinting tissue, and developing artificial and assistive organs. What's more, we'll soon be able to reliably preserve these bioengineered organs for when they're needed, such as in an emergency. (This prospect is being catalyzed by the Organ Preservation Alliance, a founding partner of New Organ.) Taken together, these advances will do much to meet the growing demand for replacement organs.