The Future of Making Organs for Self-Transplantation

Scientists have been able to create a new windpipe using stem cells. They took a windpipe from a dead patient, removed all the cells, and placed stem cells from a patient onto the remaining scaffolding to create what was in effect a new windpipe, with the patient’s own cells. The patient had an irreparably damaged her windpipe from TB.

The significance of this is that it opens the door to creating whole organs, like kidneys, livers and perhaps even hearts and lungs. This is a radical advance because up until now, stem cells have only really been useful to replace tissue, or bits of the body without a complex organized structure. But this means we could potentially replace any part of the body with a person’s own stem cells. New livers for people with liver failure, new kidneys from those with kidney failure – and because the cells would come from the patient, there would be no rejection. Indeed, this patient has shown no signs of rejection.

Does this raise any ethical issues?

In one way, it is just better medicine. There is a huge shortage of organs for transplantation and this is one way of addressing that shortage. It also opens up the door to repairing damage to structure of organs like the heart or brain.

One issue that people are often concerned about is inequality. Those in rich countries will have access to expensive technology that means that they can have their own organs replaced while those who are poorer have cadaveric organs or no transplant at all. This means the rich get better treatment. There are two points to make to this objection based on inequality. Firstly, it is possible that such radical advances may be cheaper than their alternatives. Immunosuppression therapy is expensive and dangerous with associated health costs. This may benefit the poor, in the long term. Secondly, for every person who leaves the potential organ recipient pool because they get a tailor-made personalized organ, there are more organs to go around from the cadaveric pool. So those who would have been denied a transplant from conventional sources would stand a greater chance of getting one.

The only real ethical issue of such technology comes to when we start to tinker, large scale, with the brain. What will happen when we can replace half of a person’s brain which has been wiped out by a massive stroke? What would such a person be like? Should we allow radical brain reconstruction after stroke or injury or cancer? What kinds of research should be done before we start to entertain tinkering with mind, or soul? Fortunately, brain reconstruction is some way off, so we have a bit of time to think about it.

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