Good morning. It's Wednesday, Feb. 11. Welcome to this week's Health & Medicine newsletter. Was this forwarded to you? Sign up here or click here to share with friends.
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Our theme this week is organ donation—tied to National Donor Day, which is also Valentine's Day! We're covering the latest research and developments in xenotransplantation and organ donation, and exploring death—the evolving ideas for defining it, "green" burial trends, what happens to the body, and more.
Feel free to send me a message! I appreciate all the love that you've been sending about the newsletter and your suggestions, too. I do read every email, thank you.
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—Dina Fine Maron, 1440 Health & Medicine Section Editor
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Xenotransplantation 101
Xenotransplantation, from the Greek “xénos” (foreigner, guest, stranger), is the transplantation of an organ, tissue, or cell from one species into another. Humans have attempted such procedures for more than 300 years with various animals’ blood, tissue, and organs.
Pigs are the main focus of modern xenotransplantation research, which seeks to replace failing human organs with animal parts. The animals are easy to raise and breed, produce large litters, and are similar in size to humans.
Simpler forms of xenotransplantation—such as using pig heart valves or corneas—have been a part of clinical practice for decades, but the human immune system typically has rejected whole animal organs within hours of transplant surgery. Whole organ transplants have remained a major medical goal because of massive demand: More than 100,000 patients are typically on America’s transplant waitlist.
Recent gene-editing breakthroughs have enabled scientists to modify the DNA of pig organs, so they appear less foreign to the human immune system. Since 2022, several patients have functioned with gene-edited pig kidneys and hearts for months before the organs needed to be removed or the patient died.
Explore everything else we've found on Xenotransplantation.
Also, check out ...
> In 1984, a dying infant survived for three weeks with a baboon heart. (Watch)
> Alpha-gal allergy is a problem for red meat lovers, and the sugar has been a problem for xenotransplants, too. (Listen)
> Pig organ transplants are apparently kosher—you just can’t eat them. (Listen)
> Pig heart valves have been placed in humans since 1965. (Watch)
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Understanding death
Death is an irreversible end of life marked by a cessation of brain function or circulatory or respiratory functions. It’s a crucial medical and legal determination in the healthcare system, and roughly 68 million people die worldwide annually. Throughout history, human death has been seen as a central life phase event. Communities have formed distinct rituals, mourning practices, and religious beliefs about the human experience tied to this milestone.
Approximately 3.1 million Americans die annually, with about 98% declared dead based on cardiopulmonary criteria—meaning they’re not breathing and have no heartbeat. The other 2% are declared brain-dead, a medical diagnosis based on an extensive series of neurological tests.
Death triggers a series of events in the body that ultimately lead to decomposition. Muscles relax, including the bladder and bowels, so feces and urine are typically expelled soon after death. Within hours, as the body stops producing adenosine triphosphate—a molecule needed to relax muscles—a rigid state called rigor mortis takes hold. This temporary condition fades within about 24 hours. Next, within 24 to 48 hours, the body begins to consume its own tissues through autolysis and produces discoloration, gas, and unpleasant odors.
Explore everything else we've found on Death.
Also, check out ...
> Abraham Lincoln’s assassination helped create the funeral business. (Watch)
> Cremations are America’s top choice for postmortem body treatment. (Listen)
> A girl was declared brain-dead but went through puberty on a ventilator. (Listen)
> Research advances suggest death takes much longer than we realized. (Read)
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Limited Replacements Available
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Organ donation, explained
Organ donation involves voluntarily giving an organ, or part of an organ, to someone else so they may live. Most donations come from the deceased, but living individuals can also gift an organ or part of an organ—usually a kidney or part of the liver. A single deceased organ donor can save up to eight lives, with donations most commonly leading to kidney, liver, heart, and lung transplants.
Since the first successful US organ transplantation in 1954, transplant procedures and survival rates have become a lifesaving option for thousands of people each year: In 2024, there were around 24,000 organ donations and more than 48,000 organ transplants in the US.
Demand for organs still consistently outpaces donor supply, with over 100,000 people awaiting organs on the national transplant list at any given time. Researchers, policymakers, and clinicians are seeking ways to improve the system, extend organ viability, and reduce the need for human organs.
Current bottlenecks in the system include logistical and technical barriers, including the fact that donors must generally be in the hospital when they die to donate their organs and that there’s only a short viability window for how long organs can survive outside the body. Other obstacles include the fact that only about 60% of American adults register to donate their organs, and not all donated organs are suitable for use.
Explore everything else we've found on Organ Donation.
Also, check out ...
> Medical students are learning their cadavers' names. (Read)
> This clinical trial aims to help kidney recipients avoid a lifetime of immunosuppressing drugs. (Read)
> Watch this video message (via Facebook) from a kidney recipient to his donor. (Watch)
> You could theoretically lose these organs and still survive. (Watch)
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Medical Developments Spotlight
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We love spending time learning about the latest medical breakthroughs and spotlighting research that piques our interest, influences future research directions, or informs healthcare conversations. Here's what we found this week.
> Diabetes before or during pregnancy is linked with higher offspring epilepsy risk
Pediatrics | Bénédicte Driollet, Asma M. Ahmed, and others. Maternal diabetes—Type 1, Type 2, or gestational—is associated with an increased epilepsy risk in offspring. That's according to a new Canadian study that retrospectively examined the medical records of more than 2 million kids born between 2002 and 2018. The explanation for this relationship is not yet clear. (Read)
> More than a quarter of Medicaid clinicians don't actually see Medicaid patients
Oregon Health & Science University | Erik Robinson. Researchers studying administrative claims from 2019-21 discovered that 28% of the clinicians enrolled in this program for lower-income patients didn't actually see any Medicaid patients in 2021. This revelation about "ghost" providers underscores that only a relatively small number of providers are seeing this patient population. (Read)
> There's no association between COVID vaccination and a decrease in childbirth
Communications Medicine | Dennis Nordvall, Thomas Schön, and others. A Swedish study investigating unfounded rumors linking the vaccine to reduced fertility analyzed the healthcare records of almost 60,000 adult women, 75.5% of whom had received COVID-19 shots. They found no statistically significant difference in childbirth rates or miscarriages between the vaccinated and the unvaccinated. Instead, financial constraints and behavioral changes during the pandemic may explain the decline in the number of kids. (Read)
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Keep Muscles Strong As You Age
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About 20% of the funeral home industry is owned by funeral home chains, and private equity-backed firms own about a quarter of those.
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Reporting from Markian Hawryluk at KFF Health News in 2022 highlighting the consolidation of the $23B funeral home industry
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