Sunday, April 28, 2019

Real Life Resurrection: Overcoming Brain Death?

Scientific American posted an article in June 2017 titled “Resurrected: A Controversial Trial to Bring the Dead Back to Life” discussing the current research to reverse brain death. A research company, Bioquark, located in Philadelphia, aims to use injected stem cells and a protein blend along with electrical nerve stimulation and brain laser therapy in order to grow new neurons with new synaptic connections, thereby reversing brain death. Researchers will analyze behavior and EEG for signs that the treatment is successful (Sheridan). In his presentation, Dr. Vukov explained that brain death is diagnosed using EEG and monitoring pupil dilations. Physicians have found that only a single test, in contrast from the two tests performed pre-2010, is sufficient for diagnosis (Powell). Trials of this four part treatment have not yet been conducted on animal models, only single treatments for other conditions such as stroke or coma (Sheridan).
This controversial study originally launched in Rudrapur, India, and in April 2016 was shut down due to lack of Drug Controller General approval. Bioquark is now planning conduct trials in Latin America. Neurologist, Dr. Ariane Lewis wrote an article in response to this initial study launch. Lewis calls this study out for having “no scientific foundation” and argues it gives families “a cruel false hope of recovery” (Lewis). Lewis brings up very valid ethical issues, which this study is rich with. Sheridan adds that if patients do regain brain activity, what would they be capable of? Additionally, trial paperwork becomes an issue since participants are legally dead (Sheridan). Another ethical issue related to this study involves the future of organ transplants. Dr. Vukov touched on the “Dead Donor Rule” regarding organ transplant. Legally in the US, brain death is synonymous with death and many of the organs transplanted in the US are harvested from brain dead patients. If long-term recovery becomes a possibility due to the technological advancements in this study, an important question arises: What is to come of organ transplant? Theoretically, if techniques in this study prove successful, traditional organ transplant must be abandoned.
Brain death is very distinct from other disorders of consciousness, despite common confusion of the terminology. A coma is defined as lacking both arousal, manifested by spontaneous eye opening, and awareness, assessed by looking for responses (Powell). Coma is just one of the many disorders of consciousness that Vukov described throughout his presentation. Brain death, on the other hand, is very unique and specific. To be diagnosed brain dead, patients must exhibit three specific criteria: the patient is in a demonstrably irreversible coma, there is a complete absence of brainstem function and, absence of spontaneous respiration. The Scientific American article goes on to state that the technique Bioquark is developing has a very slim chance of working. An orthopedic surgeon interviewed for this article explained that this technique “relies on there being a functional brain stem... If there’s no functional brain stem, then it can’t work (Sheridan). In order to be diagnosed as brain dead, a physician must be certain that the brain stem is nonfunctional. Despite the obstacles Bioquark faces, this article sparks imagination in an often confused area of science.


References:
Lewis, Ariane, and Arthur Caplan. “Response to a Trial on Reversal of Death by Neurologic Criteria.”Critical Care (London, England), BioMed Central, 22 Nov. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5118884/.

Powell, Tia. “Brain Death: What Health Professionals Should Know” American Journal of Critical Care, 7 April 2018, https://www.dropbox.com/sh/yrruoccwcc8fc6i/AADV3iapxtsrrO019ar7ZD3oa/(04.02.19)%20-%20Joe%20Vukov?dl=0&preview=Powell_Brain_Death.pdf&subfolder_nav_tracking=1.

Sheridan, Kate. “Resurrected: A Controversial Trial to Bring the Dead Back to Life.” Scientific American, 1 June 2017, www.scientificamerican.com/article/resurrected-a-controversial-trial-  
to-bring-the-dead-back-to-life/.

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