[HN Gopher] Man given genetically modified pig heart dies
       ___________________________________________________________________
        
       Man given genetically modified pig heart dies
        
       Author : otoolep
       Score  : 233 points
       Date   : 2022-03-09 15:39 UTC (7 hours ago)
        
 (HTM) web link (www.bbc.com)
 (TXT) w3m dump (www.bbc.com)
        
       | krallja wrote:
       | Man Given Genetically Modified Pig Heart Survives Two Months
        
       | slowhand09 wrote:
       | 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.
        
         | nonrandomstring wrote:
         | It's an amazing story of which your friend must be tremedously
         | proud. Now that it's been done, no doubt the results will
         | improve. What an amazing time to be alive seeing these leaps in
         | medicine. I think the pandemic has, in part, really made
         | biology and medicine super cool again.
        
         | sonicggg wrote:
         | Choosing a guy next to his deathbed is not the greatest PR
         | move. People will associate the death to the transplant.
        
           | harles wrote:
           | 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.
        
         | phkahler wrote:
         | Well that really raises the question of what did he die from?
         | If not from the heart, how do they proceed with the research?
         | Gotta do the next one on a person whose not already nearly
         | gone. That seems like a highly sensitive line, no doubt it's a
         | big discussion to move it.
        
           | diego_sandoval wrote:
           | My uneducated guess:
           | 
           | If he had survived for a long time, we would have known that
           | it worked. He didn't survive, so we didn't learn much.
           | 
           | If we try with enough people who are as critical as him,
           | eventually one could survive and we would know that the
           | procedure works for at least some people.
        
           | Jabbles wrote:
           | "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".
        
             | gpm wrote:
             | > "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 his cells,
             | because his lungs were bad at refreshing the air in them,
             | his heart was bad at pumping blood in circles, his veins
             | and arteries were in bad shape due to diet, and he wasn't
             | moving around much because he had a cold further reducing
             | circulation".
             | 
             | But also, we don't have perfect information. We have this
             | set of measurements we could make without harming the
             | patient, or consuming too much time on really expensive
             | equipment like MRIs. Many of those measurements are no
             | doubt themselves subject to some degree of interpretation
             | error and confounding factors.
             | 
             | Maybe I underestimate our doctors, or ovesestimate the
             | problem, but it doesn't sound easy to me.
        
               | data_acquired wrote:
               | One of Atul Gawande's books (Complications) mentions that
               | amongst deaths where an autopsy is done, the cause of
               | death was misdiagnosed by the doctor about 40% of the
               | time. Quote from book [Page 197, Chapter name : "Final
               | Cut"] ---
               | 
               | "How often do autopsies turn up a major misdiagnosis in
               | the cause of death? I would have guessed this happened
               | rarely, in 1 or 2 percent of cases at most. According to
               | three studies done in 1998 and 1999, however, the figure
               | is about 40 percent."
        
               | rurp wrote:
               | I think 100 years from now people will look back on our
               | current medicine the same way we view medicine from 100
               | years ago. There is some impressive progress, but we know
               | less than we think we do and conduct a lot of wasteful
               | and harmful procedures.
               | 
               | It's disturbing to learn how thin the evidence is for a
               | lot of modern medical operations. For example, the
               | recommendations for certain cancer screenings have
               | actually been reduced in recent years after it was found
               | they were causing net harm.
        
               | phkahler wrote:
               | 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 failure in our
               | understanding.
        
               | rurp wrote:
               | 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.
        
             | cannaceo wrote:
             | They're not. Attribution is difficult.
        
           | subsubzero wrote:
           | That was my biggest question too. patients die all the time
           | after receiving a human organ transplant just due to the body
           | being in a poor state and/or rejecting the organ. So it was
           | either that case in which even if he received a human heart
           | the same outcome of him dying would have happened. Or it was
           | the pig heart that was the problem. Hopefully it can be
           | determined which case happened, and I am glad he got to spend
           | a few more months with his family.
        
         | dheera wrote:
         | Well also, condolences to Edward Shumaker, who he murdered, and
         | Edward's family. [0]
         | 
         | [0] https://www.wionews.com/world/patient-in-ground-breaking-
         | hea...
        
           | [deleted]
        
         | verisimi wrote:
        
         | heyoni wrote:
         | Which is probably how they got approval to do a pig heart
         | transplant in the first place since he would never get on the
         | transplant list.
        
       | shadowgovt wrote:
       | > Exactly what has happened since and the precise cause of Mr
       | Bennett's death is not clear.
       | 
       | Which is the most useful information (next to the actual end of a
       | human life here).
       | 
       | Did he die because the heart was ultimately rejected, or did he
       | die from underlying complications that had made him ineligible
       | for a human heart transplant in the first place?
       | 
       | If the latter, I'd still call this whole story a significant
       | success and a possible step on the road to providing more
       | transplants for people worldwide who won't survive without a new
       | heart.
        
         | mateo1 wrote:
         | Yeah, I hate the clickbaity choice of putting this information
         | near the end of the article. This is bbc, I expect better.
        
       | notadoc wrote:
       | Porcine biologics have generally underperformed expectations,
       | often with neutral clinical effectiveness.
        
       | loudtieblahblah wrote:
        
         | thehappypm wrote:
        
           | dang wrote:
           | Please don't break the site guidelines, regardless of how
           | wrong another comment is or you feel it is.
           | 
           | https://news.ycombinator.com/newsguidelines.html
        
       | ceejayoz wrote:
       | Similarly, the first human heart transplant patient only lasted
       | 18 days. It's proof of concept, not the final iteration.
        
       | melling wrote:
       | "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.
        
         | fredsmith219 wrote:
         | Having trouble taking satisfactory breaths while laying flat?
         | See a doctor. Feeling out of breath abnormally while working
         | out? See a doctor. Got an Apple Watch? Just for kicks take your
         | ekg. It is crude but can detect abnormal heart rhythms.
        
           | MPSimmons wrote:
           | You probably know this, but for anyone else reading - I have
           | an Apple watch that has the EKG. It is a two-contact EKG, so
           | it's limited in what it can see. It also requires you to
           | actively look at it (you have to touch the crown while it's
           | reading).
           | 
           | It did successfully diagnose a bout of bigeminy that I had,
           | but unfortunately my cardiologist didn't think it was
           | important, and I ended up having a heart attack anyway. But I
           | lived, and now I have a new cardiologist, so there's that.
        
             | faeyanpiraat wrote:
             | Isn't that something that you could sue for?
        
               | als0 wrote:
               | I do wonder how it must feel to be a doctor who is one
               | bad call away from being sued or revoked.
        
               | [deleted]
        
               | kyleee wrote:
               | what's the alternative in practice; having no recourse if
               | a negligent doctor maims or kills you?
        
               | cbg0 wrote:
               | Is it just me or is this such a stereotypical American
               | comment?
        
               | frenchy wrote:
               | Maybe in the US, probably not anywhere else. You'd have
               | to prove actual negligence, and in this case, it's quite
               | possible the doctor's decision was reasonable. Benign
               | abnormal heart behavior is pretty common.
        
               | wonderwonder wrote:
               | Not a lawyer so this is only anecdotal but It is actually
               | very hard to sue a doctor unless its egregious to my
               | understanding and your rewards are limited to the point
               | where most lawyers are hesitant to take the case due to
               | that. Have a family member that got a colonoscopy and the
               | doctor commented after that there was a bit of a tough
               | time getting it in but he just pushed a little harder and
               | all was fine. That push actually perforated the bowel and
               | he got sepsis and spent 3 weeks in the hospital and many
               | months with a coloscopy bag. No lawyer would take the
               | case.
        
         | dt3ft wrote:
         | Or, change the way they live, work less and enjoy what little
         | life they have ahead?
        
           | hombre_fatal wrote:
           | Well, we certainly do set up people for [heart] failure in
           | our culture. Standard American diet is atrocious and I often
           | day-dream about what it might take to transition to a culture
           | around healthy, whole foods.
           | 
           | It's hard to imagine. And looking at the westernizing diet of
           | the rest of the world, maybe that's a ship that never sails
           | back. Maybe tech breakthroughs are the only hope we have if
           | major cultural reform around health and food never arrives.
        
           | idontknowifican wrote:
           | your view indicates a lack of empathy for folks that live
           | differently than you
        
             | DiffEq wrote:
             | I don't mean to be callous by this comment but if you mean
             | "live differently" as living unhealthy well I have a
             | problem with this. People that live in unhealthy ways cause
             | all sorts of grief to others as well as financial loss. It
             | is not right that I have to pay for people that decide to
             | essentially eat themselves to death; it is not right that
             | my wife and I had to care for my mother for months because
             | she decided to eat herself to death. Heart disease and
             | diabetes are all too common "paid" for by others - they
             | should choose differently and while we can't make them
             | choose differently we should for sure tell them that their
             | choices are not "o.k.".
        
               | jpatt wrote:
               | There are a whole host of heart diseases not spurred on
               | by unhealthy living. Particularly diseases affecting
               | younger folk who would inordinately benefit from a longer
               | lifespan if we got better at transplanting.
               | 
               | As a selfish example, I have ARVC. I was diagnosed at 24
               | while training for my first marathon. Lifestyle
               | treatments for my disease are to explicitly _avoid_
               | exercise as it exacerbates the deterioration of my heart
               | muscle. As I age, I expect to be at a much greater risk
               | for the heart diseases that you would recommend  "healthy
               | living" for, as I will be categorically barred from one
               | of the most important pillars of that, exercise.
               | 
               | I realize we're talking about the margins here, but as a
               | margin, I would _love_ more advancement in transplants.
        
               | ejb999 wrote:
               | I agree - people need to be able to be called out when
               | they are making bad decisions - especially w/regards to
               | their health, and they especially should be called out by
               | their health care providers - many doctors these days
               | won't even broach the subject of a patient's weight, for
               | fear of offending them - and I have seen patients file
               | formal complaints against doctors when the doctor notes
               | in their chart that the patient 'is obese'. It is right
               | to tell them they are obese and it is right to encourage
               | people to live healthier - how can you be a health care
               | provider and not be allowed to call out people who are
               | eating themselves to death?
        
               | mulmen wrote:
               | Living is unhealthy. It's universally fatal. In a free
               | society we (should) retain autonomy over our bodies. This
               | isn't purely philosophical, it is practical. Who decides
               | what is healthy? What if they are wrong?
               | 
               | How many eggs should I eat today to meet your personal
               | definition of healthy living? And what do I do when it
               | differs from someone else?
        
               | mrmuagi wrote:
               | > Living is unhealthy.
               | 
               | Tips fedora.
               | 
               | In all seriousness, I think there's obvious medical
               | definitions for unhealthy in regards to addictions,
               | weight, etc. Let's not philosophize some libertarian
               | defense of something that obviously restricts and
               | constricts one's freedom -- the ability to move an inch
               | without your joints buckling.
               | 
               | I can sympathise with you if you have suffered from anti-
               | fat bullying and adopt defensive attitudes in reaction --
               | but what the hell am I reading.
        
               | _jal wrote:
               | Welcome to being an adult. People will do all sorts of
               | things you think are not "OK", including people you're
               | attached to. If you have kids, they will, too.
               | 
               | How we choose to deal with watching people do things we
               | think they shouldn't is a matter of character.
               | 
               | I will say that I try hard to listen to people's
               | criticism with an open mind, but people who badger me
               | when they know I have considered their position, well, we
               | tend to spend progressively less time together the more
               | it happens. There's a difference between sharing
               | information and punishing people for not complying, and I
               | see no reason to accept punishment for something I don't
               | intend to change about myself. A second-best fix for the
               | problem, but better for everyone concerned.
        
               | danielovichdk wrote:
               | It's only one self that can determine if one self is in
               | balance or not. Just like we can lie to ourselves telling
               | "everything is alright" while in truth it's not really
               | the case.
               | 
               | But yes, as adults we can determine for ourselves. But
               | it's a poor character trait not to be responsible for how
               | you feel.
        
             | [deleted]
        
             | bob66 wrote:
        
           | lostlogin wrote:
           | How would you apply this to a child, or convey it to their
           | parents?
           | 
           | The procedure has a profound effect on the family that
           | receives the heart and on the donor family. Hearing donor
           | family members describe what it's like knowing their child's
           | heart is still beating somewhere is something you don't
           | forget.
        
         | tommoor wrote:
         | 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.
        
           | rmellow wrote:
           | In the US I presume?
           | 
           | Canadians have a harder time...
           | 
           | In Canada/Ontario, you have to convince your doctor to give
           | you a cholesterol test, e.g. family history. It won't be done
           | preventively [1].
           | 
           | Even if you manage to get tested, if you're under 40 the
           | doctor won't care and there will be no followup.
           | 
           | [1] https://exechealth.ca/ontario-drops-annual-physicals/
        
             | testesttest wrote:
             | A test in the US < $50 and is easy to schedule without
             | having a doctor involved at LabCore or similar. Is that an
             | option in CA?
        
               | Karawebnetwork wrote:
               | In Quebec at least, a doctor's prescription is required
               | for all blood tests even at private labs.
        
               | rmellow wrote:
               | There are private clinics one can become a member of, but
               | this is extremely uncommon and most people don't know
               | it's an option.
               | 
               | Costs upwards of $3,000 annually.
        
             | daniel-cussen wrote:
             | Meh. Might be an American thing, if you watch TV or news
             | the images of persons will be constantly telling you to ask
             | your doctor about this, consult a medical professional
             | before this other activity they advertise, and oh you gotta
             | see a dentist every six months. Just demand creation,
             | better just to get a blood-pressure test when you do see a
             | doctor and a cholesterol test based on the result.
        
           | nradov wrote:
           | Annual checkups are not justified from an evidence-based
           | medicine perspective for most healthy adults. They don't
           | produce better outcomes.
           | 
           | https://sciencebasedmedicine.org/is-the-annual-physical-
           | unne...
           | 
           | Annual checkups aren't necessarily fully covered by health
           | insurance plans. However, other preventative care services
           | are.
           | 
           | https://www.healthcare.gov/coverage/preventive-care-
           | benefits...
        
           | robbiep wrote:
           | 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
        
             | mrmuagi wrote:
             | Isn't there catch-it-early type diseases? Like breast
             | cancer, testicular cancer, colon cancer, etc... that prove
             | this wrong?
             | 
             | The funny thing is, the older you get, you are likely to
             | have some sort of symptom. Such is life.
             | 
             | For blood pressure, I would expand and add general
             | bloodwork for health conscious individuals or people with a
             | family history for certain issues -- diabetes, liver,
             | androgen, heart health markers.. Here in Canada you just
             | need to mention you are interested for health reasons and a
             | doctor refers you -- not sure how costly it is in USA --
             | but apparently private clinics are a choice to build custom
             | panels.
        
               | franga2000 wrote:
               | I've heard many experts talk about issues with "catching
               | disease early", one being that what doctors find might
               | have never developed far enough to cause harm and so the
               | treatment might actually be more harmful.
               | 
               | I don't want to risk trying to explain it from memory
               | since I have zero medical knowledge, but there's a
               | YouTube video by "MedlifeCrisis" about this that also has
               | sources cited in the description. The title is something
               | like "the problem with screening".
        
               | throwaway4aday wrote:
               | > one being that what doctors find might have never
               | developed far enough to cause harm and so the treatment
               | might actually be more harmful.
               | 
               | This is not a reason to not screen regularly. If treating
               | very early is the problem then you should still aim to
               | detect it early and then closely monitor it until you
               | have enough information to decide whether to act or not.
               | There are many people that will simply not go in for
               | testing until there is a major problem if you advise
               | against regular testing. A close family member of mine
               | just passed away recently because he didn't go in for
               | regular testing and they caught the cancer way too late.
        
               | robbiep wrote:
               | For 'catch it early' you are talking screening. That's
               | why there's cervical cancer screening (pap smear/the new
               | cytology test), mammograms, faecal occult blood tests, in
               | australia skin cancer screening, etc.
               | 
               | And that's why people should have a regular doctor and
               | that's why as you get older you see your doctor more
               | frequently. But for young(ish) otherwise healthy people,
               | the whole concept of something ther occurs annually
               | doesnt make sense.
               | 
               | In the other hand, since most screening and medical
               | engagement is with females, you are left with lots of men
               | who get into their 40s without ever having seen a doctor.
               | So - if thats you - go and see one, build a relationship,
               | and if everything is good ask when you need to come back
               | for prostate screening, FOBT, cholesterol or anything
               | else. All across the board is unnecessary.
               | 
               | With regards to your last point, I'm all for devolving
               | autonomy and power to the patient, but frankly across the
               | board wide ranging blood testing (especially regularly)
               | just doesn't make sense for a significant percentage of
               | people, unless there is a high pre test probability or a
               | significant family history. All blood results are managed
               | at the 95% CI so if you go in and have 20+ blood tests
               | then more than likely at least one is going to be out of
               | order. All you need to do is visit the askdocs subreddit
               | to see the immense anxiety and flow down effects that has
               | on a population who have absolutely no way of
               | understanding a slightly out of bounds result. Those
               | private clinics trying to spin up and do 'wellness
               | checks' are frankly in my opinion, and until the evidence
               | proves otherwise, a parasite on the worried well
        
             | WheatM wrote:
        
             | pkaye wrote:
             | > 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.
             | 
             | What problems does it create? Isn't preventive care a good
             | thing? Also Japan does annual physicals much more rigorous
             | that in the US. I wish what is done in the US was more
             | rigorous because it would have caught the autoimmune
             | disease that caused my kidney failure. Unfortunately by the
             | time there are visible symptoms, the damage cannot be
             | reversed.
        
               | retrac wrote:
               | 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.
               | You're terrified, the doctor's now worried about
               | something they would never have known about otherwise,
               | and maybe you have surgery to get it early. In the end
               | the complications of all that quite potentially add up to
               | a shorter life expectancy than simply not getting scanned
               | in the first place. On average. Though of course, if you
               | had a giant treatable tumour that shows up, well, you'd
               | want the scan. But most people don't have one, and all
               | those interventions can cause harm.
        
               | Footkerchief wrote:
               | The correct takeaway is to use information responsibly,
               | not to deny yourself information.
        
               | robbiep wrote:
               | I agree in principle, but health literacy is so
               | appallingly low - globally - that more often than not
               | people are not equipped to deal with this information. As
               | I said in an earlier post on this thread, look at the
               | askdocs subreddit. 90% of the posts there are worried
               | well asking for clarification of some unnecessary test
               | they went and specifically asked a doctor for, the result
               | of which they don't understand and which is causing a
               | cascade of health anxiety.
               | 
               | If every person understood enough to realise how many
               | 'abnormalities' enough investigations would show up, and
               | how in 99% of people they mean absolutely nothing, then
               | it would be fine. But that's not our current situation.
               | And if you're one of those people who are capable of
               | parsing the dense health literature and understanding the
               | implications (or not) of 'normal abnormal' findings, then
               | go for it. But for the population as a whole? It's not
               | viable or helpful
        
               | colinmhayes wrote:
               | People are too dumb to do that, even if they're actively
               | trying to.
        
               | MPSimmons wrote:
               | There are a couple of orders of magnitude difference
               | between findings from a full-body MRI and a routine
               | labwork run.
        
               | robbiep wrote:
               | Preventative care is different from the concept of all
               | round comprehensive annual physical as it has been
               | propagated through the culture from the American
               | experience (I practice in Australia, so am talking from
               | what I see from time working there, and the trickle
               | through effect culturally of Australians thinking this is
               | something they 'have' to have).
               | 
               | Preventative care consists of positive health messages
               | (smoking cessation, moderate alcohol consumption, healthy
               | diet, exercise), early identification of at risk
               | individuals through family history, obesity, and then
               | population wide cancer screening. Preventative care does
               | not mean take a dozen tubes of blood and a pot of urine
               | on every person every year.
               | 
               | I'm really sorry to hear about your kidney failure
        
               | thaway2839 wrote:
               | Annual checkups are just that. 1) Body weight
               | measurements. 2) The doctor talking to you about whether
               | you have any medical or life concerns. 3) The doctor
               | sharing advice on diet improvements, smoking
               | improvements, exercise plans, including providing
               | resources for them. 4) Recommended screenings based on
               | age. 5) 1-2 vials of blood to get basic health
               | information such as glucose levels, vitamin levels, etc.
               | 6) Urine samples are only required if you're sexually
               | active with multiple partners to screen for STDs and is
               | completely optional.
               | 
               | That's been my experience. Through the annual physical
               | I've been able to handle several minor issues, which have
               | materially improved my life, and identified a major
               | diagnosis that goes undiagnosed in the majority of people
               | throughout their lives, and leads to them living
               | significantly worse lives than they would have otherwise.
               | By identifying it early, I have a chance for a much
               | better lifestyle, and reducing the odds of an early death
               | greatly.
        
       | dang wrote:
       | Related:
       | 
       |  _US man who got first pig heart transplant dies after 2 months_
       | - https://news.ycombinator.com/item?id=30615375 - March 2022 (3
       | comments)
       | 
       |  _Two weeks later David Bennett is alive, his pig's heart beating
       | soundly_ - https://news.ycombinator.com/item?id=30080472 - Jan
       | 2022 (490 comments)
       | 
       |  _The doctor behind the first pig-to-human heart transplant_ -
       | https://news.ycombinator.com/item?id=30044630 - Jan 2022 (3
       | comments)
       | 
       |  _In a First, Man Receives a Heart from a Genetically Altered
       | Pig_ - https://news.ycombinator.com/item?id=29900921 - Jan 2022
       | (2 comments)
       | 
       |  _U.S. surgeons transplant pig heart into human patient_ -
       | https://news.ycombinator.com/item?id=29882912 - Jan 2022 (701
       | comments)
        
       | jjtheblunt wrote:
       | this is sad.
       | 
       | it's kind of bizarre from a mile high view, but all so normal
       | too, that no one comments on the sacrifice of a pig, i found
       | myself observing.
        
         | danielovichdk wrote:
         | The pig i don't care about. But I would really really like to
         | know if David Bennett lived his life being healthy and fit.
        
         | [deleted]
        
         | faeyanpiraat wrote:
         | I would also be happy to go vegan, but I don't see a way to be
         | healthy that way, so..
        
           | ben_w wrote:
           | If it's specifically pigs up for discussion, vegan and
           | vegetarian are the same, and vegetarian is easier -- I'm
           | vegetarian, and AFAIK there's no food made from pig's milk
           | (certainly nothing I've seen in the local supermarket).
           | 
           | But as for healthy? That's the easy part, there are so many
           | healthy vegan options it's silly. Food cravings however,
           | that's hard (and also _why_ I'm only vegetarian, not vegan --
           | I'm looking forward to improvements to vegan cheese[0] in
           | particular given everything else on sale around here now has
           | good enough non-dairy alternatives -- though the other part
           | is that I'm not hugely concerned about the ethics of free-
           | range no-kill eggs).
           | 
           | [0] smoked tofu slices is good for sandwiches, but it doesn't
           | melt nicely on pasta
        
         | missedthecue wrote:
         | I think most take it as a given that human life > swine life
        
       | jll29 wrote:
       | May he rest in peace - he had some additional happy days from
       | what it looks like, and he helped science advance a bit, kudos to
       | him.
       | 
       | What worried me was when I read he was "not eligible" to be a
       | recipient of a human heart; I hope this is not just because he
       | had a bad (or no) insurance.
        
         | thechao wrote:
         | He refused vaccination. Also, not the greatest human; but, he
         | served his time, so I don't think that had an impact.
        
         | conroydave wrote:
         | top comment currently references he was near multiple organ
         | failure prior to the transplant.
        
           | faeyanpiraat wrote:
           | Hopefully he had the opportunity to get out from the hospital
           | in the meantime.
        
       | Supermancho wrote:
       | 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.
        
         | ryeights wrote:
         | Wow, that's not great. I take it these are meant to be used as
         | a stopgap before an actual transplant?
        
           | Stevvo wrote:
           | Yea; it's a stopgap solution. The pump is in a backpack so
           | it's not perfect for mobility.
        
             | hwillis wrote:
             | LVADs are implanted in your chest. Blood doesn't leave your
             | body, but do they have external batteries. You have a wire
             | coming out of your chest (or neck/head, sometimes) which is
             | a constant infection worry. AFAIK the only external pumps
             | are like, countertop kind of things.
             | 
             | They're ideally a stopgap, but even still it's typically a
             | massive change in quality of life. The left ventricle is
             | what feeds your entire body blood; the right ventricle only
             | feeds the lungs. When the left ventricle fails, blood backs
             | up and starts overflowing into the lung space. It's
             | exceptionally unpleasant. The right ventricle is usually in
             | much better shape so an LVAD can be almost like having a
             | functioning transplant except for the risk of infection.
        
               | faeyanpiraat wrote:
               | Well, half of your hearth failing being "exceptionally
               | unpleasant" is not a surprise.
               | 
               | Anyways, wouldn't it be feasible to use wireless power
               | transfer?
        
             | [deleted]
        
             | [deleted]
        
           | throwthere wrote:
           | Not always, some are"destination" therapy meaning no
           | transplant planned in the immediate future.
           | 
           | https://my.clevelandclinic.org/health/treatments/17192-left-.
           | ..
        
             | rootusrootus wrote:
             | That's an LVAD, though -- isn't that an entirely different
             | beast than an artificial heart, with a different use case?
        
               | throwthere wrote:
               | Artificial heart is kind of a non-specific term. It
               | covers anything from LVAD, LBAD and RVAD together, ECMO
               | or biventrivular vad. So depends on what you're
               | specifically referring to but lvad is the most common of
               | those.
        
               | rootusrootus wrote:
               | Fair enough. I'm in no way experienced in the medical
               | field. I would have told you I thought an artificial
               | heart was a complete heart replacement, just like a full
               | transplant but with a mechanical device instead. TIL.
        
               | hwillis wrote:
               | It's still typically a massive change in quality of life.
               | The left ventricle is what feeds your entire body blood;
               | the right ventricle only feeds the lungs. When the left
               | ventricle fails, blood backs up and starts overflowing
               | into the lung space in addition to the rest of your body
               | slowly suffocating. It's exceptionally unpleasant.
               | 
               | The right ventricle is usually in much better shape so an
               | LVAD can be almost like having a functioning transplant,
               | except that there's a big wire going out of your
               | chest/neck (which is a constant infection risk and can't
               | really get wet) and you're now battery-powered.
               | 
               | Any kind of heart transplant comes with huge problems,
               | even besides the immunosupressants etc. The nerves don't
               | reconnect, so the heart doesn't respond to commands to
               | speed up. It makes any kind of exertion difficult and
               | unpleasant. Diet is critical, clots are a constant fear,
               | etc. By the time you get a transplant you've usually
               | spent a while with insufficient bloodflow, and your
               | organs have been slowly dying.
               | 
               | It's nothing short of incredible that people can get 20+
               | years out of transplants. The deck is stacked against us
               | _hard_.
        
               | sagarun wrote:
               | LVAD goes for 5 years
        
         | sebazzz wrote:
         | > He had already been bedridden for six weeks leading up to the
         | surgery, attached to a machine which was keeping him alive.
         | 
         | Slightly less.
        
         | momenti wrote:
         | Heart transplant recipients survive 15 years on average:
         | https://en.wikipedia.org/wiki/Heart_transplantation
        
           | msrenee wrote:
           | The Wikipedia page cites a documentary as the source, which
           | may be correct, but doesn't seem like an appropriate source.
           | Here's a paper that I skimmed the abstract of claiming ~9
           | years:
           | 
           | https://pubmed.ncbi.nlm.nih.gov/15280687/
        
             | MPSimmons wrote:
             | I don't know what the documentary source is, but this paper
             | is from 2004, and it's likely that procedures have improved
             | reliability since then.
        
               | maewsa wrote:
               | Documentary cited is from 2007 so that's a marked
               | improvement for 2-3 years...
               | 
               | I'd personally lean towards trusting published medical
               | journal.
        
             | sobren wrote:
        
           | sonicggg wrote:
           | To be honest, not sure why we spend so much resources on
           | heart transplants. For the most part, the underlying
           | condition that wrecked your old heart is probably still
           | there. We should be putting more resources into preventative
           | medicine.
        
         | dekhn wrote:
         | Artificial hearts are artificial hearts- mechanical plumbing.
         | This is far more akin to human heart transplantation (which is
         | a mature operation that has excellent outcomes).
        
       | willis936 wrote:
       | https://apnews.com/article/pig-heart-transplant-patient-dies...
       | 
       | >Bennett's doctors said he had heart failure and an irregular
       | heartbeat, plus a history of not complying with medical
       | instructions.
       | 
       | >Patients may see Bennett's death as suggesting a short life-
       | expectancy from xenotransplantation, but the experience of one
       | desperately ill person cannot predict how well this procedure
       | ultimately will work, said ethics expert Karen Maschke of The
       | Hastings Center. That will require careful studies of multiple
       | patients with similar medical histories.
        
       | [deleted]
        
       | martini333 wrote:
       | Sure. Everybody dies. He also lived way longer than expected with
       | the big heart.
        
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