Organ Transplantation
Medical, Technological and Ethical Challenges

Summary

The Dr. Lawrence H. and Roberta Cohn Forums
ORGAN TRANSPLANTATION: Medical, Technological and Ethical Challenges
Presented in Collaboration with The Huffington Post and in Association with Harvard Health Publications
People die each day waiting on lists for lifesaving organs, and the rise of chronic diseases such as diabetes only increases the demand. With the need for scientific innovation and donor support becoming ever more critical, this Forum explored biomedical advances that promise to address the scarcity, as well as the efforts of medical leaders, advocates and policymakers to reduce the numbers waiting for transplants. Through 3-D printing, scaffolding, chips and other innovations, scientists made extraordinary strides in tissue engineering and developing artificial organs. This program looked at the potential of advances like these, along with the ongoing role of current donation programs; ethics of matching and allocation policies; controversies around buying and selling organs; and approaches such as “presumed consent”, used in some countries to increase supply, where patients are presumed to have given permission to donate their organs, unless they have explicitly opted out.

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Presented in Collaboration with The Huffington Post and in Association with Harvard Health Publications

Background Articles

Image Credit: iStockphoto.com/aydinmutlu

  • The Forum Moderator

    Welcome everyone. Our speakers will begin in a few minutes.

  • The Forum Moderator

    Thank you for joining us today. Our event has begun.

  • The Forum Moderator

    This event is part of the Dr. Lawrence H. and Roberta Cohn Forums. Dr. Cohn sadly passed away this January. He was a cardiac surgeon and a member of the team that conducted the first heart transplant in New England in 1984.

  • Joining the stream from Philadelphia. We are HelpHOPELive, a 501(c) nonprofit that helps families across the country fundraise for transplants, catastrophic injuries and catastrophic illnesses. http://www.helphopelive.org

  • The Forum Moderator

    The event also is is presented in collaboration with The Huffington Post and in association with Harvard Health Publications.

  • The Forum Moderator

    We will have a Q&A during this event. Do you have a question for the panelists? Post them here or email them to theforum@hsph.harvard.edu.

  • The Forum Moderator

    Welcome

    • This is fantastic. Looking forward to future livestreams from The Forum.

  • Question: what can the average person do to effectively promote organ donation and dispel common organ donor myths?

    • The Forum Moderator

      Thanks! Great question.

  • The Forum Moderator

    Dr. Delmonico is a transplant surgeon and chief medical officer for the New England Organ Bank. They have information about how donation works. http://neob.org/ — as does the United Network for Organ Sharing, which manages the US organ transplant system: https://www.unos.org/

  • The Forum Moderator

    The panelists referenced the first penis transplant in the US, which took place at Massachusetts General Hospital. The news release describing that advance is here: http://www.massgeneral.org/about/pressrelease.aspx?id=1937

  • The Forum Moderator

    We will post the video early next week on this site as well as on YouTube and iTunesU.

  • Another question from our staff: what would the United States need to do in order for presumed consent to become national policy?

    • The Forum Moderator

      Thanks! I’ve passed along the question.

  • J.Solomon-Duarte

    Question from my patient: a migrant working professional ( was e-mailed at 9:30am). According to UNOS.org., as of 9:30am today, there are 120,859 people waiting for life saving transplant.
    “Some patients waiting for organ transplant are migrants, working legally here in the Unites States like myself. As a migrant, my sibling who is willing to donate an organ reside outside the Unites States.
    Will there be an opportunity to allow out of country donors to come to the Unites States through temporary visa ( for the duration of surgery to recovery) to donate an organ to their loved one? “

    • The Forum Moderator

      Thanks! We saw the email and I believe that they question will be asked shortly. Thanks for posting here!

  • The Forum Moderator

    Just a quick reminder that we will post this video online here early next week. We also will post on iTunesU. We also will post the audio on SoundCloud and iTunesU.

  • The Forum Moderator

    Our conversation is coming to an end. Our apologies if we were unable to get to your question. We will ask our panelists if they can come here and respond to the comments.

  • The Forum Moderator

    Thank you all for joining us today.

  • The Forum Moderator

    We also thank the Cohn family, The Huffington Post and Harvard Health Publications.

  • Kristen Dweck

    Question sent by email

    I was born in the UK and live in the US. However, I cannot donate blood. Can I donate my organs?

    How is donor list being affected by levels of rising issues of obesity and age degenerative diseases?

    Thanks
    Andi

  • Kristen Dweck

    Question sent by email

    Question’s for the panel,

    1)Working as a organ procurement procurement for 6 years does the panel feel in today’s society with all the advancements in media and marketing does marketing jobs have a place in the organ donation community.

    2) Organ donations makes up a small percentage of a hospitals in-patients one can argue, the value of just one donor is beneficial to that hospital and with that being said, does the panel feel organ donation numbers were affected locally, regionally or nationally by the “bump” in the Obamacare ACA rollout.

    If so what are some examples.

    Thank you for taking my questions.

    Tina Greco, RN

    Vitas Healthcare

  • Kristen Dweck

    Question sent by email

    Hello,

    Regarding donating bone marrow… Is there any recent development (last 3-5 years) we should be aware of?

    Thanks.

    Leila

  • Kristen Dweck

    Question sent by email

    In light of the anticipated advances with the artificial pancreas and islet cell transplantation, what are your thoughts about pancreas transplants?

    I would specifically be interested in knowing your thoughts around pros and cons regarding a pancreas transplant for a post-kidney transplant diabetic. At this point, is it better to wait for the technology of an artificial pancreas to be realized and avoid a traumatic surgery, or does the control achieved by having a functioning pancreas outweigh the risks?

  • Kristen Dweck

    Question via Facebook

    I studied bioethics (and researched) the ethics of embryonic and adult stem cell research, what ethical standards can we also include to make sure embryo donors have informed consent, – Michelle Waterman via Facebook

  • Kristen Dweck

    Question via chat

    Question: what can the average person do to effectively promote organ donation and dispel common organ donor myths?

  • Kristen Dweck

    Question via Facebook

    What problems arise with using 3D printing for building new tissues and organs? #organtransplant

  • Kristen Dweck

    Question via Facebook

    How does informed consent of organs for research purposes play into the moral calculus?

  • Kristen Dweck

    Question via chat

    Another question from our staff: what would the United States need to do in order for presumed consent to become national policy?

  • Kristen Dweck

    Question via email

    What is the difference between donating organs and donating your entire body to medical research? Are those different things?

  • Kristen Dweck

    Question via email

    How can we move legislation forward so that “presumed consent” becomes standard in this country, as it is an Spain and other nations? Is this a situation that is controlled at the state or national level?

  • Kristen Dweck

    Question via email
    The challenges seem immense in bioprinting – especially of creating the vascular structure that can support tissues with nutrients. How is this tissue kept alive and useable in the lab. And, isn’t it created from both human and non-human sources?

  • Kristen Dweck

    Question via email

    What do you think about therapeutic cloning to meet the organ demand? Scientists have cloned sheep, dogs and have been trying for years to clone monkeys – they probably have already and we just don’t know it. But this same technique can be used not to create cloned babies, but to turn adult skin cells into embryonic stem cells that can then grow into any type of tissue or organ that matches the DNA of the patient. It was done in Britain a few years back using the cells of a 75 year old man. Is there any hope for this process given the ethical debate about the use embryos, even if the goal is not to clone an individual but create tissues and cure disease?

  • Kristen Dweck

    Question via email

    What organs are in greatest demand, with the longest waiting lists?

  • Kristen Dweck

    Question via email

    What are the ethics around the determination of death in a case where organs are being donated? If someone is on life support their organs often are eligible for donation before they are actually dead. I had a friend who was in this situation when her brother died suddenly and it was extremely difficult for the family. They were not prepared for the process and the decisions that had to be made.

  • Kristen Dweck

    Question via email

    I’ve been reading a lot about the impact of chronic diseases like diabetes and obesity on the organ shortage. It seems the demand for kidneys and pancreases is up because of the increase in diabetic patients, and the obesity of potential donors is resulting in fewer useable organs. Can you comment on this and any trends you see around chronic diseases like these and others impacting the future supply?

  • Kristen Dweck

    Question via email

    The latest news on the MGH penis transplant is everywhere. As technologies advance, are we going to see more demand for organs or body parts beyond those considered life saving or vital?

    • Doris Taylor

      Quality of life issues may become an important piece of this conversation as donor organs and tissues become more available. I look forward to the day that no one in need goes without a good solution.