I was chatting with a high school friend earlier today about how I like to “nerd out” on science but that some people’s eyes kind of glaze over when I get going.
Before the regional story broke that I felt compelled to comment on yesterday, I found an article in Scientific American that really had me excited…but took a few reads to process fully before I could comment; since it was high-level, even for me, so I understand the eye glazing now…
One of the main complications post transplant is rejection. Through this journey & other friends I’ve made who have been transplanted I’ve learned more key details about this complication & how it is managed.
The first detail is there a big difference between acute rejection & chronic rejection. According to UNOS Transplant Living, acute rejection is common within the first year of transplant. It’s chronic rejection that’s the demon because it can lead to eventual organ function loss, & in severe cases require the need for another transplant. It’s important for any potential transplant patient or caregiver to know about the possibility of rejection so they can be aware & look out for symptoms that might be an indicator that it’s afoot so it can managed effectively & quickly.
It’s also important to note this because there is another rare but serious complication that can take place shortly after transplant that is just as concerning as rejection.
It’s called PGD or primary graft dysfunction. It’s a complex subject to understand, but in addition to the Scientific American article, this Penn Medicine press release boils it down in layman’s terms as well and outlines some concerns & risk factors. Basically, it’s when the organ itself appears to not get enough oxygen & starts to fail.
It is a main cause of mortality in lung transplant, especially within the first 72 hours, & like rejection, it has varying stages of severity. (I really like the Scientific American article because it also explains this well).
Testing is done to try & head this off ahead of time by analyzing key biomarkers prior to transplanting the organ. But the current process is a much slower one, & despite a surgeon’s care & best efforts it can still occur. The sensors mentioned in this article speed up that testing time & appear (at least in early findings) to increase accuracy of detecting PGD, which is critical not only for shortening the time test results reach the surgeon, but also because of the shorter viability window of lungs compared to other organs.
As the article reports, this can cut this time down from hours to less than 30 minutes. This improved method of testing & screening has life-changing & saving possibilities.
This amazing innovation is also profiled in Science Advances & Chemical & Engineering News. These sensors are made of fractal circuits, or in essence, a biomedical chip, that binds to the messenger RNA molecules associated with PGD.
While this is very high-level science & may be fairly complex to grasp (even for me it was a challenge to explain when I started digging in to find more information on this & PGD itself), it’s an important advance in picking up on potential complications before they happen.
It’s also another use of science that could potentially increase the donor pool because lungs that may be rejected now for precautionary measures (or inconclusive results with current methods) could effectively be analyzed & potentially found viable. This innovation could also ultimately lead to a decrease in the actual percentage of the incidence of PGD if further testing proves it continues to be as accurate as it currently seems to be.