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Man given genetically modified pig heart dies

bbc.com

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Re: Man given genetically modified pig heart dies

#111

Post by Fomite »

gpm wrote: post #88
Jabbles wrote: post #84

Earlier quoted context omitted.

"What people die of" seems like the sort of question the medical community should be quite good at answering. People are waiting for human heart transplants and dying from the wait. I don't think there will be a shortage of patients who we can ethically treat whilst researching this new technique. It certainly isn't binary with a hard "sensitive line".

> "What people die of" seems like the sort of question the medical community should be quite good at answering. Does it? I'm definitely not a doctor, but it seems like a very difficult question to answer. Even with perfect information, it seems unlikely there is always a simple/single answer. I would naively expect things like (and I'm making a bit up here, because I'm really not a doctor) "not enough oxygen reached…

You're not overestimating the problem - and it's not an easy one to solve. Cause specific mortality is hard, which is why measures like all-cause and excess mortality are often used. For example, the whole "With vs. From COVID?" question is, in the actual field, not actually a controversy because this is how we've measured all infectious disease deaths basically forever.

This is especially true for severe cases like this, people in the ICU, etc.

If someone is in the ICU for multi-system organ failure, gets an infection, and then dies of multi-system organ failure, did the infection kill them? Was it a contributory cause? The same sort of question arises as in this case.

Re: Man given genetically modified pig heart dies

#112

Post by Fomite »

rurp wrote: post #101
phkahler wrote: post #96

Earlier quoted context omitted.

That's why I'm noticing studies that use "all cause mortality". In other words, some people receive X treatment and a similar control group does not. Then you look at how many died in each group regardless of cause because it's just too difficult (and death is pretty much a binary measure). For example, cholesterol lowering drugs (I don't have a source) seem to have no impact on all-cause-mortality, suggesting a fail…

Certain invasive cancer treatments can look a lot more effective than they really are, if all cause mortality isn't measured. It's possible to reduce the risk of a patient dying from the particular cancer they have while also lowering their overall life expectancy, since the procedure itself can be extremely harmful.

I have a slide in a lecture somewhere noting that no one would ever die of a healthcare-associated infection if, when admitted to the hospital, they were put in a room full of ozone or hydrogen peroxide fog and intense UV light, while never being seen by a nurse or doctor.

Re: Man given genetically modified pig heart dies

#113

Post by astrange »

Footkerchief wrote: post #74
retrac wrote: post #51

Earlier quoted context omitted.

Medicine can hurt as well as heal. A concrete example. Many doctors will advise you not to get a full body MRI scan. You can pretty easily buy such a service, and hire some radiologists to pour over every cubic millimetre of your body. But it's a really bad idea. Because they will almost certainly find something ambiguous or troubling. And they're gonna biopsy. And then, well, maybe that's ambiguous. Another biopsy.…

The correct takeaway is to use information responsibly, not to deny yourself information.

You can't do that unless you know the prior probability of everything you're looking for.

Re: Man given genetically modified pig heart dies

#114

Post by Fomite »

sonicggg wrote: post #103
slowhand09 wrote: post #5

My friend was a member of the transplant team at Johns Hopkins. "They" said he was near multiple organ failure prior to the transplant. And he survived significantly longer than expected. Recovery under those circumstances was a very long shot already. Kudos to him for undergoing the procedure, and furthering the research. Condolences to he and his family.

Choosing a guy next to his deathbed is not the greatest PR move. People will associate the death to the transplant.

Choosing someone not next to their deathbed is very likely something that would never get approved by an ethics board.

Re: Man given genetically modified pig heart dies

#115

Post by majormajor »

sonicggg wrote: post #103
slowhand09 wrote: post #5

My friend was a member of the transplant team at Johns Hopkins. "They" said he was near multiple organ failure prior to the transplant. And he survived significantly longer than expected. Recovery under those circumstances was a very long shot already. Kudos to him for undergoing the procedure, and furthering the research. Condolences to he and his family.

Choosing a guy next to his deathbed is not the greatest PR move. People will associate the death to the transplant.

People needing an organ less urgently are going to be unlikely to take a huge risk on something unproven. People needing an organ urgently but with fewer red flags otherwise would similarly likely prefer the human organ they could get over the experimental one.

Re: Man given genetically modified pig heart dies

#116

Post by astrange »

robbiep wrote: post #31
tommoor wrote: post #19

Earlier quoted context omitted.

To everyone that reads this: If you've not had a checkup in the last year go and get one! It'll be included on your health insurance and the blood draw will include things like if you have high cholesterol.

There is no real medical need for an ‘annual physical’ it is a creation of the American medical-industrial complex and creates more problems than it solves. Having said that seeing a doctor occasionally for blood pressure etc is useful, but the interval for someone young and otherwise not experiencing any symptoms doesn’t need to be annually

It's a legal requirement for employers in Japan and they seem to have come up with it on their own.

https://www.city-cost.com/blogs/City-Cost/MPyry-medical

Being Japan, it's pointlessly thorough and invasive.

Re: Man given genetically modified pig heart dies

#117

Post by sonicggg »

harles wrote: post #104
sonicggg wrote: post #103

Earlier quoted context omitted.

Choosing a guy next to his deathbed is not the greatest PR move. People will associate the death to the transplant.

I’m glad this team was more concerned about science and minimizing risk than PR. Hopefully negative press doesn’t cause much of a hinderance.

Not sure about that aspect either. They invested a boatload of money into a guy that can't even make a 1-year follow-up. How are they supposed to observe the transplant long term?

Re: Man given genetically modified pig heart dies

#118

Post by johnmarcus »

melling wrote: post #2

“Currently 17 people die every day in the US waiting for a transplant, with more than 100,000 reportedly on the waiting list.” David Bennett was only 57. Heart disease, and related issues are a big problem. While I’m hopeful for this technology, I wish there was a way for people to see heart issues coming much earlier in life so they can attempt to treat, or delay, the problem.

I wish the effect smoking has on the heart was advertised more.

People are terrified of cancer and that's all they think about with smoking, but actually far more people die from heart and stroke related illness after smoking than from cancer. I don't know the exact number, but it's a multitude.

Re: Man given genetically modified pig heart dies

#119

Post by majormajor »

sonicggg wrote: post #117
harles wrote: post #104

Earlier quoted context omitted.

I’m glad this team was more concerned about science and minimizing risk than PR. Hopefully negative press doesn’t cause much of a hinderance.

Not sure about that aspect either. They invested a boatload of money into a guy that can't even make a 1-year follow-up. How are they supposed to observe the transplant long term?

Why are you so concerned about being able to observe it long-term when prior to this it had never even been able to be observed short term?

Do you think they should be doing this on a bunch of healthy people to "learn more"? Like you think there will be volunteers?

Or do you think it's simply impossible and shouldn't have been done at all?

Or are you just being contrary to be contrary?

Re: Man given genetically modified pig heart dies

#120

Post by xmprt »

momenti wrote: post #17
Supermancho wrote: post #3

He lasted 2 months. For reference, artificial hearts generally do 130 days - (2018) https://syncardia.com/patients/media/blog/2018/08/seven-thin... with some notable outliers that live for years, and human to human transplant is about 9 years. Usually it's some related systemic problem that kills you under these conditions eg consistent brain clotting causing stroke or organ failure due to drug cocktails.

Heart transplant recipients survive 15 years on average: https://en.wikipedia.org/wiki/Heart_transplantation

Is that mean or median? And is it after taking out outliers (like people who pass away within a week or before they're discharged)?
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