First Discussion Topic:
Organ Cloning:
A paper published by Bhanu Telugu and co-inventor Chi-Hun Park of the
University of Maryland (UMD) Department of Animal and Avian Sciences lays out how
“newly established stem cells from pigs, when injected into embryos, contributed to the
development of only the organ of interest (the embryonic gut and liver), laying the
groundwork for stem cell therapeutics and organ transplantation.” (Park et al., 2021)
This is groundbreaking news, as the current shortage of organs for transplant is
staggering. According to the United Network for Organ Sharing (UNOS), there was an
all-time record set in 2021 for organ transplants with more than 40,000 transplants
performed for the first time ever.
1n 2021, 41,354 organ transplants were performed in the United States, an increase
of 5.9 percent over 2020 and the first time the annual total exceeded 40,000,
according to preliminary data from the United Network for Organ Sharing (UNOS),
which serves as the Organ Procurement and Transplantation Network under federal
contract.
The three organ types most commonly transplanted all set annual volume records.
o24,669 kidney transplants
o9,236 liver transplants
o3,817 heart transplants.
oLiver transplant totals have set annual records for the past nine years
oHeart transplants have set a new record each of the past 10 years.
(All-Time Records Again Set in 2021 for Organ Transplants, Organ Donation
from Deceased Donors, 2022)
Currently, these transplants rely largely on deceased organ donors to meet the
increasing demands. Cloned organs would relieve the need for voluntary donations as well
as remove the barriers to providing organs for less ideal candidates who have a need. One
of the significant challenges is the same ethical/legal questions that we have wrestled with
since the earliest days of cloning. So trying to navigate the legal hurdles to pursue cloning
will certainly be a challenge.
Robotic Surgery:
One of the primary challenges facing the implementation of robotic surgery over
the next 5 years is the cost of the surgery units themselves. According to Dr. Sandeep
Nayak of the MACS clinic, “The greatest challenge in robotic surgery is the cost of the
equipment and the resultant high rates for the patient. As this technology becomes more
common and more surgical robots come into the market, we expect the cost to come down
over the next few years.” (Nayak, 2019)
For example, the da Vinci system, one of the world’s best robotic surgery units
requires an upfront capital investment of between $0.5 to $2.5 million dollars, and
substantial reoccurring costs, including “annual service contracts (ranging in price from
$80,000–170,000 based on model and services desired), instrument and accessory costs
(ranging from $700–$3,500 per procedure). (Perez, 2019) These costs represent a
significant challenge to expanding the use of robotic surgeries in the next 5 years. These
technologies need more time to diffuse into the healthcare system and become more
widely adopted and thus driving down the costs. The service costs alone for the Da Vinci
unit could pay for an additional nurse or doctor at that facility. When facing a shortage of
healthcare staff already many healthcare providers are going to take a hard look at if the
benefit of the surgical unit outweighs the additional staff that could be hired with that
money?
The irony here is that the push for more full autonomous robotic surgeries for the
most common types or low-risk surgeries could be just what we need to address the
shortfall in healthcare staff. According to the Association of American Medical
Colleges. “By 2033, AAMC predicts that an aging population and accompanying
retirements will conspire to create a significant shortfall of anywhere from 54,100 to
139,000 physicians.” They go on to say that “one development that could mitigate the
gap, however, is the expanding role of autonomous surgical robots. The increasing
adoption of 5G networks, combined with advancements in autonomous and artificial
intelligence solutions and the secondary effects of pandemic-driven telemedicine
mandates, has created a unique opportunity for healthcare agencies. Robotic surgery tools
capable of assisting doctors in lifesaving efforts at a distance — or completing less
complex tasks with minimal oversight — may serve to augment human professionals in a
variety of roles.” (Bonderud, 2021)
Second Discussion Topic:
What is the likelihood that a different procedure would result in a better diagnosis?
I believe that yes, as the diagnosis is an ongoing part of treating a patient then using
a different procedure can result in better information to use in informing the
diagnosis, and thus over time with a well-reasoned choice of procedures a more
accurate diagnosis can be achieved.
If the problem is more accurately diagnosed, what is the likelihood of a better cure?
Yes, the more accurate the diagnosis the greater likelihood of a more positive
outcome for the patient. According to the National Library of Medicine website
“when a diagnosis is accurate and made in a timely manner, a patient has the best
opportunity for a positive health outcome because clinical decision making will be
tailored to a correct understanding of the patient's health problem.” (Balogh et al.,
2015)
References
All-time records again set in 2021 for organ transplants, organ donation from deceased
donors. (2022, November 1). Unos.Org. https://unos.org/news/2021-all-time-
records-organ-transplants-deceased-donor-donation/#:~:text=In%202021%2C
%2041%2C354%20organ%20transplants,and%20Transplantation%20Network
%20under%20federal
Bonderud, D. (2021, February 17).What Does the Future Hold for Robotic
Surgery?Technology Solutions That Drive Healthcare.
https://healthtechmagazine.net/article/2021/02/what-does-future-hold-robotic-
surgery-perfcon
Balogh, E. P., Miller, B. T., & Ball, J. R. (2015, December 29).Improving Diagnosis in
Health Care. Ncbi.Nlm.Nih.Gov.
https://www.ncbi.nlm.nih.gov/books/NBK338593/
Nayak, S. (2019, November 22).Challenges in Implementing Robotic & Laparoscopic
Surgery for Cancer. Macs Blogs. https://macsforcancer.com/blog/challenges-in-
implementing-robotic-laparoscopic-surgery-for-cancer/#:%7E:text=The
%20greatest%20challenge%20in%20robotic,down%20over%20next%20few
%20years.
Park, C. H., Jeoung, Y. H., Uh, K. J., Park, K. E., Bridge, J., Powell, A., Li, J., Pence, L.,
Zhang, L., Liu, T., Sun, H. X., Gu, Y., Shen, Y., Wu, J., Izpisua Belmonte, J. C., &
Telugu, B. P. (2021). Extraembryonic Endoderm (XEN) Cells Capable of
Contributing to Embryonic Chimeras Established from Pig Embryos.Stem Cell
Reports,16(1), 212–223. https://doi.org/10.1016/j.stemcr.2020.11.011
Perez, R. E. (2019, May 30).Robotic surgery: finding value in 2019 and beyond.
Https://Ales.Amegroups.Com. https://ales.amegroups.com/article/view/5205/html
