Heart patient who is waiting for a heart

Heart is the most important organ of
the body and the key of blood circulation. It is located beneath the sternum
(breastbone) and is about the size of our fist. The heart beats average seventy
beats per minute and pumps about 5 liters of blood per minute, in another term
total volume of blood in the human body each minute.

Humans are not able to survive without
hearts and many scientists have been focusing on technologies to mend a broken,
damaged, heart.

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There are four heart replacement
technologies that are most well-known to modern scientists: ‘Human Heart
Donation’, ‘Xenotransplantation’, ‘Tissue Engineering’, and ‘Artificial Heart’.
Each method has rescued many lives who suffered or could die from the
malfunction heart.

 

To begin with, I would like to describe
about ‘Human Heart Donation’. This method, as the name suggests, is a worldwide
activity (refer to Figure 1.) which
is an act of replacing the malfunction heart with healthy donor’s heart which
is donated from charity or possibly individual volunteers. “Donation is key to
saving the life of a patient who is waiting for a heart transplant as the
severity of the weakened heart is critical.” (Donors1.org, 2018)

Figure
1. 2009 rates of kidney transplantation from living and deceased donors for
countries. “Reproduced from Global
Observatory on Donation and Transplantation (GODT) by permission of WHO. “(Who.int, 2018)

As such, the situations applying this
method, can be when other treatments for heart damage have not worked, which
can lead to heart failure in the future. When the operation of heart
transportation is done, people will be able to recover in just a few weeks
although they will be weak at the beginning. It is also very crucial to have
simple activities to strengthen their body and health; “pushing, pulling or
heavy lifting until your breastbone is fully healed.” (Bhf.org.uk, 2018)

 

Second heart replacement technology is
‘Xenotransplantation’. As the prefix, ‘Xeno-‘means alien, strange, and guest,
this technology, unlike from ‘Human Heart Donation’, is “any procedure that
involves the transplantation, implantation or infusion into a human recipient
of either live cells, tissues, or organs from a nonhuman animal source.” (Fda.gov, 2018) This technology was
developed by the fact that the need for the human organs far exceeds the
current low supply. Figure 2.
is a statistic that shows thousands of people are waiting for organs.

Figure
2. A quarterly statistic of transplant waiting list in United Kingdom
(Organ Donation – English, 2018)

To elaboration on, there are
advantages of ‘Xenotransplantation’, not only increasing the supply of source but
also the therapeutic use. The technology can play a huge role in certain
diseases such as diabetes and neurodegenerative disorders, in situation where
human materials are not usually available. 

 

Third of all, there is a technology
called, ‘Tissue Engineering’. The heart muscle disease has been recognized a
tipping point for progression to heart failure. National statics from United
States indicates that there are over five million people damaged by heart
failure each year and about three hundred thousand deaths. Furthermore, the fully-grown
heart muscle cells cannot divide into injured cells. The scar tissues result
into area of damaged myocardium. Thus, the best approach to solve this issue is
to avoid such scar formation or simply replace the formed scar tissue with
functioning cardiac muscle tissue. On the contrary, there are limitations due
to short length of cell life and poor cellular integration with receiving the
heart tissue.

 

The final technology is replacing the
useless heart with ‘Artificial Heart’. An artificial heart, indicated in Figure 3. is a “prosthetic device that
is implanted into the body to replace the original biological heart.” (ScienceDaily,
2018)

Figure
3. A picture of a man with the ‘Artificial Heart’ (Baptist-health.com,
2018)

As I have mentioned above regarding
‘Xenotransplantation’, there is a short supply of human organs, thus there is
an obvious credit which would lower the demand for heart transplants when using
the artificial heart. Moreover, due to components of artificial heart are
metals and plastics, the components are not rejected by our body’s immune
system. On the contrary, patients have to take special drugs to thin the blood
cell in order to prevent from strokes. The situations can be serious when they
are hurt in some accidents where they bleed a lot.

 

In this regard, I would like to
explain about ‘Xenotransplantation’ in detail. To briefly summarize and outline some
emphasis of the previous points, I would like to discuss about its pros and
cons and, later on, about its ethical issues.

To begin with, heart transplants can save
thousands or more lives every year, however there is insufficient number of
human organs donated.

The shortage has led to attempts to
develop animal organs that can be transplanted into humans. Such developments had
resulted recuing lives more than expectations.

Furthermore, it decreased the opportunities
of organ trading on the black market. The sale of human organs on the black
market has been a huge issue. Some had kidnapped children to sell their organs
for huge amount of money and people died from diseased organs purchased in the
black-market. With this in our head, transplanting with organs from animals,
instead of using the organs from human, can tremendously reduce this type of
trade. (ConnectUS, 2018)

 

On the contrary, there are some cons,
disadvantages, regarding ‘Xenotransplantation’. Recipients might be infected by
unrecognized infectious agents and tremendous spread of infection through their
close contacts or into the huge human population. Referring to the document from the FDA, they commented
that “Moreover, infectious agents may not be readily identifiable with current
techniques.” (Fda.gov, 2018)

In addition, there are risks of
shorter life spans of animal organs. Most of animals have much shorter length of
humans, in another term, means that even though there are high success rate of
transplant, there would still be a risk or organs wearing our or dying before
prematurely. Thus, a person would need to have several transplants over his or
her life as the animal’s organs can wear out easily.

Furthermore, there is another consideration
regarding ethical issues. In current state, it is widely known that many
animals for the ‘Xenotransplantation’ are also susceptible to pain and
suffering similar to humans. Some who supports ‘Xenotransplantation’ insist
that there aren’t any logical evidences to differentiate the pain or suffering
felt by animals from those felt by humans. Pain is pain wherever and to
whenever it is caused. I strongly believe that it is wrong to weight the
suffering less heavily that those of animals to humans. We are all similar living
organisms and we all have rights to live and to choose freely. In this regard,
when evaluating the acceptability of using the organs of animals for
‘Xenotransplantation’, a judgment must be made regarding whether the pain and
suffering to animals is justified by the benefits for the humans. (Nuffield Bioethics, 2018)

 

Therefore, one of the four heart
replacement technology, ‘Xenotransplantation’ should be considered more before
using them for humans as animals also feel the same of amount of pain like
humans do. Also, each of the four replacement technologies need to be developed
by future scientists in order to save more than millions of lives who are
currently suffering greatly from broken heart. 

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