Get Serious, Kevin (was Re: XENOTRANSPLANTATION ISSUES)

vast vast at ix.netcom.com
Sun Aug 27 01:01:32 EST 1995


In <41jfe2$2g6 at newsbf02.news.aol.com> kmshannon at aol.com (KMShannon)
writes: 
>
>Has anyone read the Aug. 21st issue of The Scientist?
>The front page reads something like this..."As Cross-Species
>Transplantation Forges Ahead, Some Researchers Call for Caution"
>
>As a 5th year student in Microbiology and, as a future virologist, I
am
>very concerned about this course of action in the medical world.
>
>I was very pleased to see that Thomas E. Starzl of the Univ. of
Pittsburg
>had put a hold on their xenotransplantation program until more science
has
>been conducted on this area.
>
>I was also very pleased to see a competent virologist, Jonathan S.
Allan
>of the SW Foundation for Biomed. research, say that cross-species
>transplantation could introduce viruses with epidemic potential into
the
>human population.
>
>But, [now you get to hear my opinion,]

     **** "cute" psyco-babble deleted ****

>I sincerely hope that this messege finds peers of myself (future
>virologists) who agree and this xeno-cross-species-nonsense is just a
>passing fad on the wannabe cutting edge of medicine.
>
>I welcome dialog on this matter,
>Kevin Shannon, The Univ. of Oklahoma                              
>  Internet-->KMShannon at aardvark.ucs.uoknor.edu
>  AOL---> KMShannon at aol.com
>Kevin Shannon
>AOL-->KMShannon
>Internet-->KSHANNON at aardvark.ucs.uoknor.edu

Well Kevin - your profound ignorance of this complex subject almost
leaves me at a loss where to start:

Xenotransplantation, even as a concept is incredibly complex.  The
principle problems are immunological.  The road to having someone with
real standing in medical history being able to seriously discuss the
possibility among knowledgable peers started, in Dr. Starzl's case in
the late 50s and early 60s with transplantation between twins.  Some of
you older folks may remember the early horrific work in total body
radiation, and the attempts to provide some immunosupressive protection
with ALG (hourse serum).  The development of steroid intervention
(Imuran, prednisone, etc) represented the first general hope for
treatment for entire classes of diseases that otherwise were terminal.
The cost of these attempts was high, both in mortality, and in
deformity (as those of you familiar with "moon-faced" children will
recall).  

The introduction of Cyclosporine A (and the continuing work on FK506)
have represented a virtual blossoming of the potential for
transplantation - and the possibility for widespread treatment of
otherwise terminal conditions.  Despite your flippant comments -Kevin -
some people actually care about this sort of thing.  Despite the power
of these advances, 35 years or more after the start of the effort,
Xenotransplantation could not really be called a credible possibility. 
The immunological problems (not to mention others) were overwhelming.

What is required for this to be possible is a method where
cross-species tolerance can be induced - a mythical beast if there even
was one in immunology - and utterly impossible according to
conventional (Medawar one way model) wisdom.

Methods now under development at Pittsburgh, originally called
"Chimerism", and now commonly know as the "two way" model of tolerance
have utterly changed the possibilities for Xenotransplantation, and
have successfully been used clinically in human transplantation.

Sorry, Kevin (boy Virologist)- this is not wannabe" cutting edge
medicine - its the real thing (don't worry, you'll get used to it
eventually, just take a deep breath and think about it for a while)

Also be aware that it isn't going to go away just because you saw
Outbreak either.  Why?? - Because today the biggest problem in
transplantation is not surgical techniques, or even control of
rejection or post operative infection - it is a profound lack of
organs.  Thousands upon thousands of productive, knowledgable,
real-live-people, just like you and me, die each year - despite the
fact that medical science can technically save them, because not enough
usable organs can be found.

Also keep in mind that the problem of viral infection is intrinsic to
the project of organ transplantation (especially in the area of Liver
transplantation [think about it, won't you].  That happens to be Dr.
Starzl's speciality. CMV, Hepatitis, HIV, EBV, and all the rest have
been accidentially transmitted through transplantation, to recipients
and to medical staff.  ALL transplanted organs are screened to the
maximum extent allowed by diagnostic technology prior to use.

My point is that the question of viral transmission through this medium
is a daily concern to the people conducting organ transplants.  I bet
they employ some real PhDs in virology over there in Pittsburgh.

Does this mean there is no risk - (LOL) NOT - what it does mean is that
the risk is accessed, managed, discussed, and technology is developed
to help counter the risk.  And there will still be risk !!  The recent
example of the transplanted SIV (from the TX animal facility)is an
excellent case in point.  So conferences are called, studies are
performed, diagnostics developed, etc, ect - pretty much the way
science usually makes progress.  And further attempts will be made.

Why ?? - because all those thousands of people dieing each year are
continuing to die Kevin.  That is also a risk.  Sorry, thats just the
way the world presents itself to us.  Get used to it.

You will see by my signature that I might be a bit biased in this
analysis, or perhaps just a bit better experienced/informed.  Maybe you
should spend some time in a liberal arts (say a philosophy class)
before you continue on in pursuit of your professional virology
objective, I did. It hasn't helped my spelling (sorry), but I like to
think that it has helped me avoid making the mistake of saying
amazingly stupid and flip things on a public forum for professionals.

Tim Starzl
VP OpTest - Dir. R&D
DDx Incorporated
 BTW we happen to develop and make high sensitivity, optically based
immunosensor diagnostics for micro, toxin, and other substances for the
DOD, USDA and several major food producing/processing corporations.

I speak utterly, solely, and exclusivly for myself - not Pittsburgh,
not Dr. Starzl, and not for DDx - I kinda like it that way : )



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