What’s the one medical condition most likely to kill you? If you follow statistics, you’d probably say heart disease. Each year, more than a million Americans have a heart attack. And about one in four deaths in the US is due to the condition.

Though heart disease tops most “causes of death” lists, far more Americans die due to the transplant organ shortage. And heart transplants could prevent most cardiac arrest deaths.

By Mikael Häggström (See above. All used images are in public domain.) [Public domain], via Wikimedia Commons

The problems with transplants

More than 25 million people in the US are diagnosed with heart disease. But the waiting list for donor hearts is huge. Only about one tenth of 1% get transplants. That means a half million Americans who could be saved by heart transplants die each year.

The same kind of shortage exists for livers, kidneys, lungs, and other organs. An estimated 900,000 deaths per year could be prevented or delayed by organ or engineered tissue transplants. This represents about 35% of all US deaths. It also makes the lack of transplant tissues America’s leading cause of death.

The standard response to this statistic is to call for more donors. But that’s not the answer. Far more organs are donated than used. In fact, even if someone has checked the organ donor box on the back of their driver’s license, their organs are almost never used. But why?

The need for Cryobanking

Even the best preservation technologies can’t stop organs from deteriorating within hours after removal. And the whole transplant process takes time.

First, tests are run to make sure that organs are immune compatible with potential recipients. Often, the donor’s family must give consent for the extraction. This takes more time.

Then there are the logistical problems and costs of transport. These are immense and involve dozens of medical professionals. Total costs for organ transplantation can run to a million dollars or more.

Few people can afford a heart transplant or even an insurance policy that provides full coverage. And our healthcare system is already stumbling under the increase in costs associated with the aging demographic. No serious analyst thinks that spending another trillion on transplantation is feasible.

I’m not telling you that you shouldn’t become an organ donor. What I’m saying is that there may already be enough organs donated to save the lives of all those who need them. We just need to figure out a cost-efficient way to do it. We need to develop biotechnologies that allow organ banking.

In theory, organ banking could be done by freezing and then restoring organs as needed. Immune-matched organs could be supplied in a timely manner to patients at a reasonable cost.

Natural solutions for organ banking

Nature has shown us the way. Several types of fish that are native to polar waters produce antifreeze proteins (AFPs). AFPs protect cell structures and prevent harmful ice formation. This allows fish like the longhorn sculpin and the Antarctic eelpout to live in subzero temperatures.

Molecules similar to AFPs could be used to preserve organs. But extraction of AFPs from these fish won’t work. It takes a ton of these rare fish to produce just a few grams of antifreeze protein. That means the species would be extinct if we had to rely on them. Happily, we live in a time of rapid biotechnological progress.

In December 2014, the US Department of Defense launched a program called “Organ Cryobanking for Transplants.” This was the first high-profile and well-funded effort to encourage this type of research. The move was applauded by scientists and other groups searching for viable organ banking.

Then in 2015, the first Organ Banking Summit took place at Stanford University, NASA Research Park, and Lawrence Berkeley National Labs. The proceedings were published in the journal Cryobiology. (I’m irritated that the paper is not publicly available as tax monies were involved in its production.)

This growing consensus on the need for cryobanking is having a positive impact. Perhaps most important, it gives private biotechs that have been working on the problem more credibility. Yes, the Department of Defense grants are useful, but it will take private investment to make cryobanking a reality. The involvement of major governmental and research organizations will help attract the attention of institutional investors.

After speaking with scientists working on this problem, I’m impressed by the extremely rapid progress in this emergent biotechnology. That progress will benefit investors… as well as the millions of patients in the world who need transplants each year.

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