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A ‘Reversible’ Form of Death? Scientists Revive Cells in Dead Pigs’ Organs.

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The pigs had been lying dead in the lab for an hour — no blood was circulating in their bodies, their hearts were still, their brain waves flat. Then a group of Yale scientists pumped a custom-made solution into the dead pigs’ bodies with a device similar to a heart-lung machine.

What happened next adds questions to what science considers the wall between life and death. Although the pigs were not considered conscious in any way, their seemingly dead cells revived. Their hearts began to beat as the solution, which the scientists called OrganEx, circulated in veins and arteries. Cells in their organs, including the heart, liver, kidneys and brain, were functioning again, and the animals never got stiff like a typical dead pig.

Other pigs, dead for an hour, were treated with ECMO, a machine that pumped blood through their bodies. They became stiff, their organs swelled and became damaged, their blood vessels collapsed, and they had purple spots on their backs where blood pooled.

The group reported its results Wednesday in Nature.

The researchers say their goals are to one day increase the supply of human organs for transplant by allowing doctors to obtain viable organs long after death. And, they say, they hope their technology might also be used to prevent severe damage to hearts after a devastating heart attack or brains after a major stroke.

But the findings are just a first step, said Stephen Latham, a bioethicist at Yale University who worked closely with the group. The technology, he emphasized, is “very far away from use in humans.”

The group, led by Dr. Nenad Sestan, professor of neuroscience, of comparative medicine, of genetics and of psychiatry at the Yale School of Medicine, was stunned by its ability to revive cells.

“We did not know what to expect,” said Dr. David Andrijevic, also a neuroscientist at Yale and one of the authors of the paper. “Everything we restored was incredible to us.”

Others not associated with the work were similarly astonished.

“It’s unbelievable, mind blowing,” said Nita Farahany, a Duke law professor who studies ethical, legal and social implications of emerging technologies.

And, Dr. Farahany added, the work raises questions about the definition of death.

“We presume death is a thing, it is a state of being,” she said. “Are there forms of death that are reversible? Or not?”

The work began a few years ago when the group did a similar experiment with brains from dead pigs from a slaughterhouse. Four hours after the pigs died, the group infused a solution similar to OrganEx that they called BrainEx and saw that brain cells that should be dead could be revived.

That led them to ask if they could revive an entire body, said Dr. Zvonimir Vrselja, another member of the Yale team.

The OrganEx solution contained nutrients, anti-inflammatory medications, drugs to prevent cell death, nerve blockers — substances that dampen the activity of neurons and prevented any possibility of the pigs regaining consciousness — and an artificial hemoglobin mixed with each animal’s own blood.

When they treated the dead pigs, the investigators took precautions to make sure the animals did not suffer. The pigs were anesthetized before they were killed by stopping their hearts, and the deep anesthesia continued throughout the experiment. In addition, the nerve blockers in the OrganEx solution stop nerves from firing in order to ensure the brain was not active. The researchers also chilled the animals to slow chemical reactions. Individual brain cells were alive, but there was no indication of any organized global nerve activity in the brain.

There was one startling finding: The pigs treated with OrganEx jerked their heads when the researchers injected an iodine contrast solution for imaging. Dr. Latham emphasized that while the reason for the movement was not known, there was no indication of any involvement of the brain.

Yale has filed for a patent on the technology. The next step, Dr. Sestan said, will be to see if the organs function properly and could be successfully transplanted. Some time after that, the researchers hope to test whether the method can repair damaged hearts or brains.

The journal Nature asked two independent experts to write commentaries about the study. In one, Dr. Robert Porte, a transplant surgeon at the University of Groningen in the Netherlands, discussed the possible use of the system to expand the pool of organs available for transplant.

In a telephone interview, he explained that OrganEx might in the future be used in situations in which patients are not brain-dead but brain injured to the extent that life support is futile.

In most countries, Dr. Porte said, there is a five-minute “no touch” policy after the respirator is turned off and before transplant surgeons remove organs. But, he said, “before you rush to the O.R., additional minutes will pass by,” and by that time organs can be so damaged as to be unusable.

And sometimes patients don’t die immediately when life support is ceased, but their hearts beat too feebly for their organs to stay healthy.

“In most countries, transplant teams wait two hours” for patients to die, Dr. Porte said. Then, he said, if the patient is not yet dead, they do not try to retrieve organs.

As a result, 50 to 60 percent of patients who died after life support was ceased and whose families wanted to donate their organs cannot be donors.

If OrganEx could revive those organs, Dr. Porte said, the effect “would be huge” — a vast increase in the number of organs available for transplant.

The other comment was by Brendan Parent, a lawyer and ethicist who is director of transplant ethics and policy research at New York University’s Grossman School of Medicine.

In a telephone interview, he discussed what he said were “tricky questions around life and death” that OrganEx raises.

“By the accepted medical and legal definition of death, these pigs were dead,” Mr. Parent said. But, he added, “a critical question is: What function and what kind of function would change things?”

Would the pigs still be dead if the group did not use nerve blockers in its solution and their brains functioned again? That would create ethical problems if the goal was to preserve organs for transplant and the pigs regained some degree of consciousness during the process.

But restoring brain functions could be the goal if the patient had had a severe stroke or was a drowning victim.

“If we are going to get this technology to a point where it can help people, we will have to see what happens in the brain without nerve blockers,” Mr. Parent said.

In his opinion, the method would eventually have to be tried on people who could benefit, like stroke or drowning victims. But that would require a lot of deliberation by ethicists, neurologists and neuroscientists.

“How we get there is going to be a critical question,” Mr. Parent said. “When does the data we have justify making this jump?”

Another issue is the implications OrganEx might have for the definition of death.

If OrganEx continues to show that the length of time after blood and oxygen deprivation before which cells cannot recover is much longer than previously thought, then there has to be a change in the time when it is determined that a person is dead.

“It’s weird but no different than what we went through with the development of the ventilator,” Mr. Parent said.

“There is a whole population of people who in a different era might have been called dead,” he said.

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Lifestyle

A favor de las relaciones que se quedan 10 por ciento cortas

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En su departamento, se sentó frente al piano y empezó a tocar. Yo lo miraba desde el sofá, oscilando entre la expectación y el terror.

Las conversaciones del día me habían convencido de nuestra compatibilidad —los dos queríamos una vida de viajes con niños aventureros a nuestros pies—, pero sabía que en cuestión de segundos nuestras fantasías mutuas darían paso a la realidad de la piel y el aliento. Recé para que nuestro primer contacto fuera eléctrico. Yo no necesitaba fuegos artificiales para empezar una relación, pero de pronto temí que él sí.

Al día siguiente, tumbados en la cama con las piernas entrelazadas, me dijo que se sentía ansioso. Después de una primera cita tan perfecta como la nuestra, esperaba sentirse eufórico, pero en cambio percibía una vacilación inexplicable. Necesitaba tiempo para pensar.

El rechazo llegó una semana después, a través de un correo electrónico escrito con ternura. Nuestra relación se sentía 90 por ciento bien, tan bien como para enamorarse, pero tan mal como para no durar. Debíamos ponerle fin antes de que la inevitable ruptura se hiciera más difícil. No es que hubiera incompatibilidades flagrantes, y él nunca había experimentado una conexión intelectual tan poderosa como la nuestra, pero faltaba algo.

Leí el correo electrónico en la cama, agradecida de que no hubiera ningún policía que me viera llorar. Cuando se me secaron las lágrimas, me hundí en la almohada, cerré los ojos y me invadió la convicción de que todo este asunto del sentimiento perdido era una estafa o, en el mejor de los casos, una excusa educada, un modo irreprochable de terminar las cosas.

Hay un cuento sufí que me encanta sobre el sabio tonto, el mulá Nasreddin. Dice así: Había caído la oscuridad y Nasreddin había perdido sus llaves. Se arrodilló junto a una farola, buscando. Un amigo se unió a él y, tras un largo rato, le preguntó: “¿Dónde has perdido exactamente las llaves?”. “En mi casa”, contestó Nasreddin. El amigo dijo: “¿Qué? ¿En tu casa? ¿Por qué estamos buscando aquí?”. A lo que Nasreddin respondió: “Aquí hay más luz”.

Los tres únicos hombres con los que había imaginado un futuro me decían que faltaba algo, y yo había dejado que sus palabras me persiguieran durante años, rebuscando en mis recuerdos de nosotros en busca de defectos. Pero tal vez su búsqueda de un sentimiento ausente era un poco como la búsqueda inútil de Nasreddin: buscaban una relación para llenar un vacío emocional en lugar de buscar dentro de sí mismos.

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Day 3: Ice Skating in Style

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It started with Kristi Yamaguchi. My parents took me to see her in Stars on Ice when I was 7 and, from the moment her blades hit the ice, I was enchanted. After years of loving figure skating from afar, last winter I signed up for adult beginner classes at one of New York’s many public skating rinks: the LeFrak Center in Prospect Park. I’m still no Tessa Virtue, but I can reliably move both forward and backward now — wobbling, yes, but mostly without falling over. “It can be hard to keep your seen-it-all-before, New York cool while flat on your back(side), of course,” Emily Ludolph writes in this look at skating across the decades. “But it is the indomitable city spirit that gets us back on our feet and ready for more.”

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Inside Biden’s State Dinner: Hot Dog Talk and a Party That Lasted Until 1 A.M.

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No, this is not relatable to the rest of the country, or even to those who operate just beyond the privileged confines of a crowded white tent on the South Lawn.

But the human impulse to gather — particularly after the worst part of a lengthy pandemic — is universal. Officials who planned the event said the need for Mr. Biden and Mr. Macron to project a united front against the Russian invasion of Ukraine was urgent.

“The magnificence of American soft power was on full display,” Mr. Gifford said. “These personal relationships are such the crux of American foreign policy, and that’s why these matter so much.”

Mr. Gifford watched members of the French delegation closely to make sure they were enjoying themselves — and, crucially, the food, which included a selection of American cheeses and triple-cooked butter potatoes.

“The plates were empty, the glasses were empty,” he reported. In other words, none of the French pointed out that the brut rosé and chardonnay on offer was, after all, “American wine,” as the French ambassador did at the state dinner hosted by the Clintons in 1996.

As America’s old alliance was carefully nursed, flashes of bipartisanship that would perhaps surprise the more tribe-minded supporters of lawmakers appeared. Representative Steny H. Hoyer of Maryland, the No. 2 Democrat, approached Rep. Kevin McCarthy, the California Republican who is attempting to become the next House speaker, to shake hands. That happened more than once.

A senior White House official, who spoke anonymously to describe private conversations, said that conversations with Republicans were kept light — talk of sports took the place of more contentious topics including, say, looming oversight investigations. Guests were discouraged from working the room because of protocol reasons, an attendee said, so it became hard to get a good look at who was doing what.

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