Hello and welcome to the gifted life podcast where we have conversations about organ tissue and ideonation and transplantation. You can always find us at thegiftedlife.org. I'm Maurice Neal. I'm Joey Boudreau.
I'm Sarah Blakemore. On this episode today, we'll be diving into research that could potentially be the biggest life-saving change in 40 years in organ donation transplantation. Wow. Alright, and we're also going to be talking about social anxiety and how to cope with it, especially after the pandemic.
I'm feeling it. I'm feeling it. All that and more on the Gifted Life. Hang in there.
Here on the Gifted Life Podcast, we are excited. Some new research coming our way. We're going to get the inside scoop here on this episode. We have LSU Mechanical Engineering Professor Dr.
Ron Deveretti joining us now by phone. Hey, Dr. I'm glad to be here. Yeah, we appreciate it.
So, Joey, you were pretty excited about what was coming out of his research. I am and it excites me when I see someone, especially someone in a different field, that's also excited and passionate about the same things that I am and that's saving lives through organ transplants. So I'm curious, Doc. So what, you know, being an mechanical engineer kind of throws me off here.
So what drew you interest into organ tissue donations? Right now, I guess let me tell you a little bit about myself. So I came from India. So after I finished my mechanical engineering undergraduate degree, I was applying to graduate schools in the US.
And I got into University of Colorado at Boulder for my master's. And there I was trying to help the Navy create better combustors, you know, better trash burning machines, so to speak. And that was essentially computational work. I was spending time in front of a computer.
And one thing that I wanted to do when I was growing up to be a mechanical engineer was to get my hands dirty, I guess, I guess, being a lab. So then I decided to apply for a graduate for PhD doctoral studies and I applied to different schools and I got this email from a professor in Minnesota. He said, you know, my lab is trying to do this freezing work in tissues and biological systems. And at least in India, we don't do biology after 10 to eight.
So once you decide you want to become an engineer, your biology stops at 10 to eight. So he emailed back the professor and said, you know, my biology is really at high school level. I'm not sure I'm good enough for this. And he said something that I think is true for my research today, which is we use engineering principles on biological systems.
So then I thought that was kind of cool. I like engineering principles and biological systems are interesting, new, back then at least 95. I guess I chomped in and I went to Minnesota and I spent the first year and a half, two years in the medical school, trying to get myself understand at least some of the biology. And so then from then basically 95 from my graduate school work, essentially back then we were trying to make measurements of what happens to cells and tissues when you freeze them.
The idea being if I understand this process better, maybe we can model it, we can predict it, we can minimize the damage and we can store these organs for long periods of time. And that problem still exists. I mean, this is a wrong standing problem. When we freeze anything, like we do say we put water in the refrigerator and next morning it becomes an ice cube.
And that ice cube inside a tissue and ice cube forms inside a cell, those ice cubes tend to expand, which is the reason why ice floats on water, which is very unique in that sense. A solid substance is less dense than a liquid substance. What that means is water that is in a liquid phase occupies less volume than ice in the solid phase. So imagine I'm a bag of, I'm a cell right now, I'm a bag of water and I freeze it.
When I freeze it, my water wants to occupy more volume and that causes damage, like that is crystallization damage. And that has been the fundamental problem. How do we prevent damage to tissues and organs when we freeze them? When we freeze them, water wants to become ice.
That's not something we can prevent. So that's essentially how I got into it. How do we minimize these as an engineering problem? What can we do as engineers to understand this process better and hopefully get towards the stage where we can transport organs over a longer distance than we can currently do?
I was fortunate to go to Boston, actually Harvard Medical. And I was the OPO version, the Organ Procurement Organization, Rub-O-Mise-the-Road type person. Speaking with a lot of scientists there, the word vitrification was pretty new to me and it was used quite a bit. So this sounds a lot like the presentations and the conversations that I had in Boston.
So is that basically what you're trying to accomplish? That is the end goal. The vitrification essentially is just a fancy way of saying you form glass. So what it does here is if you can take water and if I can freeze it really fast, if the case can remove heat from it at a very fast rate, then it doesn't form ice.
It forms what we call as glass, which is vitrification. So that has been shown to be less damaging to cells. Now that is not physics, but we know we understand that physics. But the problem again in terms of engineering is how do I assume I have an organ, which is in size.
I want to freeze it really rapidly. We're talking about freezing at tens of thousands of degrees C per minute. So how do we do that in a large organ? If we don't do it, the problem of certification is this.
We can't have partial vitrification. There's no partial success. If you do, we don't get full vitrification. Essentially you've got glass, you've got ice formation, which is essentially damaging to the tissue.
So that is the engineering challenge. The physics is established. We know we can take water, at least we can take a micro-droplet of water. And if I freeze it really fast, it forms glass.
When I say glass, you can see through it. It's not like ice cube that we get from the refrigerator, which is opaque. So we want to do something similar in a large organ. How do we form glass in an organ?
And the ultimate goal is to, like you said, have organs that are transplantable in longer periods of time, because now we have that time clock once we recover an organ. That time starts where we have to transplant it. So the ultimate goal is to have more organs for transplantation for longer periods of time to help as many people as possible. Absolutely.
So I think you probably know this better than I do. So hundreds of thousands of people are waiting for organs as we speak right now for donation in this country and in the world. And hundreds of thousands of people are dying every day for natural causes around the world. The problem is, the person dies in India and he or she has a liver that a patient in Chicago needs.
How do we get it from India to Chicago within right now, so four to six hours of time, essentially after which point the organ becomes unusual. How do we do that? How do we get it from India to where the patient is? And essentially the only way we can do it is by getting to a freezing start, storing it at low temperatures.
And so how essentially that is the goal, that is the goal of saving lives that we are interested in. Just to expound upon what Sarah was talking about right now, we are storing and transporting at four degrees Celsius in a preservation solution so to speak. Our is the one we use as the University of Wisconsin, which is a common one that is used throughout this country at least. So what happens is, let's say a liver, for instance, we flush the liver so that the blood, all the blood products and everything flushes out so that there is no blood clots that can potentially form and cause further problems.
And then we store it in the same solution, keep it at that same temperature at four degrees, just above freezing. And then we put it on ice and transport it that way. But of course this only gives us, as you said, four to six hours in general. Liver maybe six hours, kidneys have the longest, it is at 24 hours, but it is still a big challenge.
You don't have all 24 hours. Oftentimes you are in a time crunch because you are getting through a list of you talked about 100,000 people. You are getting through a list that might include 12,000 or 10,000. And the most suitable candidate, like you said, you even use India as an example, could be out of the country or could be at one of the corners of the country.
And now by the time we get there, we don't have flights to get out. There's a lot of logistical problems in place to logistics cause nightmares to the organ donation transplant community industry. Plus that I think four to six hours, 24 hours you mentioned include the transplantation. You are getting ready prepped and then transplanted.
So how that becomes a bottle. So what you're talking about, you know, and getting to that ultimate goal of fitification. So what type of timeframe would you say that you, what are you guys projecting as possible as far as being able to store? No, yes, believe in question.
But if so, once I can get it to a notification, once I can take an organ and freeze it. And I remember there's another problem here. I still have to talk about it. It's not just the feeling you are bringing it back from minus 80, back to room temperature, freshen up all the chemicals and then transplant it.
If you can solve those two problems, part one, freezing, part two, deploying, then essentially the timelines are infinite. I mean, once if I put in the refrigerator, essentially it's there till I need it. I'm assuming you don't, you know, if refrigerator works. So, so you can solve it.
If I can store it for a day, I can store it for 24 years, whatever the timeline is. So, yes, actually if this works, then you will solve the organ transplant problem, you know, for the world, not just for the US. Right, because what it would do is it would eliminate organs that are good for transplant that get discarded for whatever reason. It would eliminate that problem totally.
Right, so things like, I'm sorry, but things like, like, like hurricane out of that here, just, you know, a couple months ago, we were in a tight timeframe with, you know, they're still, we still have to save as many lives as possible, but then you've got this hurricane bearing down on you. So you have to go to a quicker timeframe because the safety, obviously. So in these situations, I can imagine instead of us, so right now, just to back up a little bit, the rest of our current process is that it takes us on average 40 hours from the time of family says yes to the time we're in the operating room to be able to do that recovery. And in that timeframe includes the diagnostics on each of the, on each of the organs because we have to figure out which organs are viable.
And then it includes in most situations finding the best home for that potential recipient. Now, what this, and I'm getting, that's what excites me is because it's not only just finding, right now we're finding the best home based on the logistics that we're working within the timeframes that we're working within. I can imagine having no timeframe and to be able to find instead of a good match, the perfect match. Yeah.
And now you're taking people off of the list, not just maybe for six, seven years, they might be taking off the list forever. You know, so that's, that's really, really exciting to me. So that's, you know, I'm just throwing that all in there. No, we're excited.
This is big. I'm not just, there are lots of people. I mean, Joe, you mentioned, I think Howard that there's a group of Howard that's working with my, I was in Minnesota, they got about $20 million from NSF to address this problem. And they're addressing the toying problem, more than the freezing problem.
So essentially, like I said, you know, you still have to once you store it, you still have to be able to tie it out. In other words, you can actually do more damage during toying just by the ice customization process. The same crystals that, you know, that form to increasing can also form during toying. You don't do it correctly.
So you're back to square one. So just for, so where are your focuses and what are your big challenges that you guys are seeing specifically? So right now we still don't fully understand how these ice forms and how glass forms inside these tissues are audience. So we're trying to develop new methods of actually making these measurements inside these tissue systems that traditional techniques don't work.
So traditionally people are put them on a microscope and you watch the ice formation. We can't do that if the tissue itself is hot. I can't watch what is happening inside a hot tissue. It's just not transparent enough, particularly.
So we're trying to develop new methods to make those measurements. I can go into further details. So I'm going to you guys. So I, I, I can.
Yes. I'm kind of understanding. So instead of, so what we're seeing, what you're able to measure is everything on the surface level, the tissue that's on the surface level, but to actually get in as far the heart, the myocytes that are, that are deep down in there. So that's what you're trying to develop.
So kind of measure that. Exactly. How do you access what is happening within the tissue system rather than just optically on the outside? Just a single cell level.
We can do a single cell level, right? That's also a lot of issue. But I want to do it within an intact issue, which is interacting within its environment because we know they behave differently than when they are within the organ or outside the organ. So I guess I was saying that developing different methods, we have two different methods.
One method is to measure how much heat comes out. And so there's some mathematical models we can use that will tell me what is happening to the tissue. And other one is to essentially, you know, create very, very small thermocouples, think of it as temperature, so you know, how we make temperature measurements. We just want to make them to be so small that I can put them within an organ and then I can then correlate those temperature changes to what is happening during the freezing process.
So when you talk about the freezing process, and I mentioned four degrees Celsius for the current transportation. So where are you? What's your target? What is that?
Okay. So that's the start of the day. So what do we do? So we take it to show what a cell, like the first thing we do is we add chemicals to it.
Now why do we add chemicals? So this is back in the 1940s, pure accident. They found that if you add chemicals to cells and you freeze them, the cells do better. Now what kind of chemicals do we use?
The short answer is pretty much everything has been thrown into the box. But mostly right now, DMSO, Diamethal, Sulfoxide, Glyphonol, and methanol for aquatic species are the most commonly used chemicals. So step one, take a cell, we add chemicals to it. And essentially we're changing the composition of the media, the cell's array.
And then we bring them down to four degrees, so quite a couple of four degrees Celsius, a four to zero degrees Celsius. Just for ice starts to form. And then once ice forms, then you have to freeze them really, really rapidly. Basically that's zero degrees to minus 40 degrees Celsius.
That's where the damage problem is. That's where the ice forms, that's what you've got to minimize the damage. If I once I get to minus 40, then essentially all the processes are stopped. You can store them at the point, you just have to store them at a low enough temperature that all the metabolic processes are stopped.
And essentially minus 120 or below the cells are safe. So your damage mechanism is zero to 40 degrees. How do you take something that's just about to nucleate ice and how do you take it from there as fast as possible, as rapidly as possible, so we can form glass, we can multiply it down to minus 40. So now when you throw it back out again, I have to remove the chemicals, because these chemicals are not good in the low function.
So we flush out the chemicals and we transplant them in. So that's the five steps. Now, it's not always, at least in the liver and kidneys, going from root temperature to four degrees Celsius is not a problem. It's essentially, they do well.
But if I'm freezing embryos, for example, ovarian tissue, going from root temperature to four degrees itself, all this damage. And it's not freezing damage, but it's chilling damage, essentially the cells tend to fall apart. And that's also important because we've been trying to work on cryopies or ovarian tissues because if you're covering cancer treatment, chemotherapy, and one of the functions that we lose is reproductive function. Both men and women, that's the secondary effect of chemotherapy.
So can I extract the tissue before the patient goes for chemotherapy and then resale and then re-sauceline them after the success of the cancer? So which meant we had to work with those tissues, take them from room temperature, like I said, to minus one point and back. Wow. So this has bigger implications.
This is bigger implications. This is much far reaching than what I was even imagining. Oh, yes, but people thought that's not what cancer so why was there? It's a big problem because if you think about it, if you have 25-hour-in-game cancer, you can lose your sperm count.
Same thing happens to females. Yeah. So back with, of course, with the focus on organ donation, I can see this, I can envision a world where we have organ banks much similar to what we have with tissue. We've got tissue banks.
If somebody needs some type of orthopedic procedure and they have a ligament transplant or something like that tendons, that orthopedus contacts the bank, the tissue processing in bank. And then they obtain the allograph is what it's called and they use it for the surgery. So this would be very similar. If someone all of a sudden develops liver failure for whatever reason, you can take a look at the organ bank and potentially have it stored, if you can store it for 24 hours, you can store it for 24 years.
The impact on the number of lives saved is just astronomical. And you know, people tend to forget that, you know, these liver diseases and these kidney problems are not because the patient was at fault or, you know, this is just things that happened to you and what you would consider to be good people. Yeah, and healthy. That would be absolutely.
So what we see oftentimes when we're helping facilitate heart transplants, for instance, that is someone who's completely healthy and then they develop some kind of virus. It could be like a cold and it causes viral cardiomyopathy and completely destroys the heart. So, you know, it's not just someone who's done damage. And again, we're talking, like you mentioned, hundreds of thousands of people who are needing, you know, life saving organs.
There's hundreds of thousands more who are not on the list, you know, because it's hard to get on the list because it's such a challenge with trying to save as many of the sickest patients. Precious commodity, I guess. Precious commodity, exactly. Yeah.
So how do we follow the progress of your research doc? Yeah, I published papers. We've got a conference. We have not universities are not in the selling business.
I don't know exactly how I'm like. So we don't go around, you know, we don't do what companies do, like put everything out as a business. But, you know, but you know, if you're a research expert, this is not, I wouldn't, first of all, if anybody comes and tells you they can solve this problem in the next six months to a year, they're selling your same coin. So that's something you shouldn't, this is not going to happen.
So it is a long term problem. You make science always works, you know, in small steps, but if you look back on it on 23 years, you know, that's when you see the change. You will not see it in a six month timeframe. So I can see it in my 25 years.
I'm really, you know, tremendous change, you know, abilities when I was doing research, we could freeze on these cells. Now we can please, you know, organize at about, you know, 30 meters level, right? 70 meters size, 80 meters, maybe maybe an inch. So that's a huge and 25 years ago, it's been a tough.
Now 20 years we got ourselves in a heart, right? So that's what I'm seeing. So I don't want to promise you that, you know, you want to hear from me next week. I saw the problem.
I don't see that. We'll call you in 25 years. Yeah. Yeah, we appreciate our partnership with LSU.
We partner with Dr. Jynx Bruceard and Sadie Wilkes in the PR and campaigns department. And so they help us to educate folks about donations. So for me, it was kind of neat to hear you in your research and how education, just as key in all these elements.
Glad to be here. Thank you for that. All right, Dr. Rahm, Deva, ready.
Thank you very much. And we hope to hear from you again here on the Get to Life. Here on the Get to Life, we take a moment for mental health. Social anxiety, Sarah, I'm very anxious to see what you got to say about this.
Yeah, so today we're going to talk about social anxiety, not just like, you know, this doesn't mean that you're simply, you know, an introverted person. Social anxiety disorder is real and it actually affects about 7% of Americans. So that's a pretty big number, especially when the pandemic started. We're seeing a lot of adolescents and children really start experiencing this now that, you know, we're starting to open back up.
People aren't wearing masks as much. We're going to restaurants. We're going out. Big venues, concerts.
They're back. Like it's, it's, it's all happening. And it's just not knowing how to act again in front of you. So that definitely is compounding the issue.
So if you already have social anxiety, this is going to work. It's going to work in it. The pandemic has really, really taken into a long people, especially now that we're getting back. And even, you know, we were talking with our engineer Troy earlier and he and I both were saying, yeah, and big crowds.
Like we feel it. We feel that social anxiety of how do we talk? What do we, how do we interact normally? Like we did before this.
So it's definitely real and it's definitely affecting a lot of people. Is it just like they don't feel like they belong or they just can't function in that environment? So the signs of social anxiety disorder, it's dread, fear of rejection, worry, judgment, and no social environments. So it's avoiding them.
It's not being able to go into social. I mean, we all know people who, when you talk about going to a party, they get just so anxious and they almost can't do it. Or they leave early or it's just very, very difficult. They have a lot of dread in that moment.
A lot of internalization of what do I say? How do I say it? How do I interact? I see how the pandemic could completely negatively impact those who've suffered from social anxiety in the past.
And then now you have this pandemic that everyone is isolated. Everyone is. So these things aren't taking place. And so it almost drives that comfort zone of being alone for a while now.
You don't have to worry about all this other stuff, these parties and these concerts. And now that things are back open, it seems like it's like opening up a gaping wound. Yeah, well, all those skills that people who are socially anxious learned, they unlearned when they're doing it. They didn't have to do it.
So now they have to pick back up on their skills. And it's going to be a process. So my first thing would be just take your time. If you have to go to a social event, know that you can leave early.
If you're feeling very anxious and you need to get out of there, that's okay. But take that first step. Try to expand that comfort zone. Also silence that inner saboteur.
So we are our own worst enemies and we put a lot of pressure on ourselves. Everybody does. So socially interact well. Silence it.
Let them know. You are loved. You are a good person. People want to be with you.
Challenge those negative thoughts that you have. And just take that first step. Tell people, I'm feeling anxious, but I'm going to come and I need help and I have to leave early. It's not because I'm being rude and I don't want to be there.
It's just because I'm struggling relearning these skills that I had previously. My first public event, like after it was over, I was exhausted because you had done it for months. And then I was like, I haven't been too loud. You know, those questions.
I was so excited to interact with people. I agree. I totally agree. But you know, I think everybody, once you kind of get back and swing things, you'll take a couple of them before you kind of feel like normal.
Just unnatural. Yeah. Because it was natural for so long and then all of a sudden we get closed up. Now imagine you said you were so excited to be with people.
Imagine if it was you had so much dread fear worrying about being with people. And then you know, and then after you had those negative thoughts of like, oh my gosh, did I make a good impression on this stuff? Well, that's doubly worse and concurable and isolate and create symptoms of depression for people who have social anxiety. So I can say it's exhausting.
It's exhausting. Yes. So we're very excited to be back together. You know, do not your own pace everybody and take your time and don't be so hard on yourself.
Exactly. All right. You have a topic you'd like Sarah to cover info at thegiftedlife.org. We'd love to hear from you.
In our question and answer segment today, TV shows often show organs being transported from the donor to a recipient in an ice chest. Is it really ice and an ice chest? Well, the answer is yes. It is.
And of course, we talked earlier about, you know, freezing and all that. Well, currently the way organs are transported is through a medium through a perfusion solution, so to speak, that's cold to keep the organs at a certain temperature. And of course, you need ice for that to remain at that same temperature. And they're carried on depending on some reusable ice chest or styrofoam ice chest, but that's how we're transporting.
That's why it's so exciting looking at this potential new future there. Yeah, I was even, I had a family friend text me because they were on a commercial airline and there was somebody on the plane with an ice chest and they were wearing scrubs and the plane asked everybody to stay seated to somebody, kid, de-board and it was the person with ice chest and they immediately text me, they're like, was that an organ? Like, was that going somewhere? Can they do that?
Where was the security? Lots of questions. And so I had to say yes, they are transported in an ice chest. It's a solution that keeps them safe and keeps them temperature controlled and that it can be on a commercial airline, a helicopter, an ambulance.
It all depends on the organ and how fast it has to get to where it's going. So it's real. We use of course, we use commercial for kidneys all the time because they have the 24 hour period as opposed to six hours. Right.
Right. It's like for a heart, it might be a helicopter because it has to get there quicker and it's yeah. Or a chart of flight. Right.
I'm almost an exciting in person. Like I heard some of this, I see it because I just see it in TV and Grey's Anatomy and those kinds of things. So here's the truth behind what you're saying guys. All right, maybe you have a question for us.
You can give us a call, 5046483477. In every episode of the gifted life, we honor a hero. Today's hero is Jacob Duane Henry. And we learn about Jacob from his family.
Jacob was born May 21, 1993. Jacob was a pre-me, three months early and weighed three pounds and six ounces. He was perfect. Absolutely nothing wrong.
We were so blessed. Jacob was an absolute great child. Then he became a very outstanding young man. He loved everyone.
He was the happiest person I have ever known. He would help anyone. He found his dream job at SafeLight and he was great at it. Jacob loved writing his motorcycle, playing games online, camping, fishing and work.
Then one night in June, Jacob was writing his motorcycle and got into a serious accident. He was on life support for three days. Then he passed away. He was a donor.
He's still helping people even after he's gone from our lives. He will always be our hero. We love you, Jacob, forever 28. And now we pause and say thank you to Jacob for the gift of life.
And that is going to do it for episode 178 of the Gifted Life. Thanks for listening, guys. Remember, you can register as an organ, eye and tissue donor anytime, register me.org. Thanks also to Dr.
Rahm Deveretti for playing such a big role in potentially saving so many more organs and tissues later. Yeah, we're all excited about what's to come and what he's working on and then just the potential. Wow. And he explained it to where we can all understand, right?
Good stuff, right? Even me, right? The best place to find us guys is on our website, thegiftedlife.org. You can listen to any of our episodes on our website or anywhere you listen to your podcast, whether it's Apple, Google, Spotify or iHeartRadio.
And always remember to rate, review and subscribe so that others can find us. On social media, please like our page on Facebook, the Gifted Life podcast. You can also follow us on Twitter and Instagram at GiftedLifePod. Our hope is that you share what you heard here on the Gifted Life and these episodes.
We hope that you go out and do something you would normally do to help us make life happen. This is a production of LOPA, or the Louisiana Organ Procurement Agency. The Gifted Life is hosted by Lori Steele, Joey Boudreau and Sarah Blakemore. Our executive producer is Kirsten Heins, producer is Shalom Caraway.
Intern is Rebecca Rannam and we are recorded, engineered and mixed in our Covington, Louisiana studio by Troy Perez.