New World Worries: Will Autonomous Cars Drive Down Organ Transplants?

By: Bridget Clerkin July 10, 2017
Could self-driving cars—purportedly much safer than human-driven models—actually make donated organs scarcer because fewer people are dying on the road?
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It doesn’t take a certain kind of religious faith to know that life after death is real.

The thousands of workers at the dozens of organ donation organizations scattered throughout the country see it every day.

Beneath the bloody and sometimes scary imagery associated with organ transplants lies a true medical miracle: A deathly-ill individual can be pulled back from the brink and go on to live a happy and healthy life after receiving such a precious gift.

To date, nearly 200,000 donors have contributed to giving others that second chance at life, even after their own have ended.

But those numbers could soon fall due to a technology that has been given the fast-track for development precisely because of its ability to save lives: self-driving cars.

The new-age transportation has been hailed as a savior—and, in many ways, a silver bullet of traffic issues—by the federal government, which cites the technology’s potential to reduce auto accidents by up to 90% and auto-related deaths by more than 300,000 over the course of a decade in America alone.

But, while tragic, such accidents are an important source of donated organs every year, supplying transplants for thousands of those in need.

While science is working to fill in those gaps with artificial tissues, most potential procedures are still decades away from safe implementation—and the necessary experimentation often requires the procurement of the same donated organs that may soon be in shorter supply.

Statistically Speaking

Accidents increased in America in 2015 for the first time in nearly 60 years, a trend some self-driving car advocates hope to reverse.
Accidents increased in America in 2015 for the first time in nearly 60 years, a trend some self-driving car advocates hope to reverse.

Driving in America has become an increasingly deadly pursuit.

In 2015, a nearly 50-year record of declining traffic fatalities was snapped when the number of drivers who died on the road jumped up more than 7% from the previous year, totaling 35,092 lives lost. The statistics, compiled by the National Highway Traffic Safety Administration, are the latest available data on the subject.

While that final number actually represents a near-historic low, the single-year uptick was the largest since 1966, when fatalities increased by 8.1% year-over-year. Among other factors, experts attributed the shocking rise to the subsequent escalation of distracted driving—which could be alleviated by letting robotic hands take the wheel, many argue.

Meanwhile, the number of organ donors from motor vehicle accidents have declined slowly but steadily since 2006, when the number peaked at 1,644. And despite the large jump in automotive deaths in 2015, the percentage of donors increased just 0.1% from the previous year.

That seeming statistical abnormality is actually good news for the large network of organ donation organizations across the country. It signifies the supply of organ transplants coming from a much more diversified field of donors over the years, said Anne Paschke, of the United Network for Organ Sharing.

“It’s interesting that even though the percentage of those donors have gone down, the total numbers of donors have increased greatly,” she said. “A lot more come from people who die from natural causes. We’re utilizing more from different areas. Campaigns absolutely help.”

Still, she said, her organization doesn’t forecast future numbers outside of budgetary expenses, and many in the organ transplant world are unsure what they would do without the still-healthy percentage of donations that come from traffic accidents.

All told, 31,966 individuals have become organ donors in the wake of a deadly car crash since 1994, the year data on the issue started being collected. And each donor is capable of donating up to 8 life-saving organs, which could add up to a lot of missed opportunities for future patients should the numbers continue to decline.

Permission Granted

One solution could be the implementation of a “presumed consent” rule at DMVs across the country. An inverse to the current model where drivers must pledge to be an organ donor, the idea would have every license holder listed as such unless he or she specifically opted out of the program.

Such initiatives have succeeded overseas, with countries instituting “opt-out” systems found to collect more organs for transplants in a study on the topic spanning 48 different nations over the course of 13 years.

But what works abroad may not be so successful here, Paschke warned.

“DMVs are invaluable. That’s where most of the registered donors come from,” she said. “But ‘presumed consent’ would take changes in legislation. It’s been floated around for decades, but we don’t know if it would help or hurt donations. We don’t know either way.”

“The attitudes of Americans tend to be very different of those of people in Europe,” she continued. “There isn’t necessarily support for government-mandated decisions here. We don’t know if there would be a backlash.”

Besides, the initiative would only serve as a stop-gap at best. Once autonomous vehicles hit the road—and many manufacturers are eyeing the very-near year of 2021 for the first wave of such models to be released—the idea of having a license at all, let alone using it to establish an organ donor registry, would become moot; just another facet of the automotive world left in the rear-view mirror of self-driving vehicles.

Ultimately, to make up the difference, we may eventually need to turn to yet another rapidly-emerging technology: the artificial growth of human tissue.

Slow Growth

When 3D printing was first released on a wide scale, it was hailed as a huge innovation—and that was when it could only produce shapes made from plastic.

Indeed, the technology has, in many ways, lived up to its initial hype, advancing rapidly, and now used to print everything from the structure of a car to the structure of a human.

Bioengineering is a booming field, with a number of companies attempting to 3D-print human cells, tissues, and, eventually, entire organs.

And that’s just one of the methods the scientific community is using to artificially create the precious biomaterial.

Regenerating failing areas of an otherwise healthy organ by grafting on stem cell patches is another idea that has generated a lot of research, as well as utilizing an organ-shaped scaffold on which to grow cells. The structure could either be made from scratch or come from an animal, while the seeded cells would likely come directly from the patient.

The purest version of this vision is 3D printing the entire organ from scratch.

But no matter which route is taken, it will likely be decades before it’s used on a commercial level, said Sara Mills, a consultant for Dark Horse Consulting, a company focused on the quality control processes of organizations developing such technology.

“I would say that, the state of the bio-synthetic/artificial/bioengineering organ business is definitely in its infancy,” she wrote in an e-mail response. “There are some companies that currently can make small sizes of human tissue.”

And a realistic timeline of that technology coming to fruition ends far further in the future than the 2021 mark set by most automakers—or even the 40-year timeframe for autonomous autos projected by the most conservative industry members.

“To the best of my knowledge, no academic group or therapeutic company has a product ready for primary review for clinical trials with the [U.S. Food and Drug Administration],” Mills said, explaining that the review is referred to as an “IND,” standing for investigational new drug. “The process for a biologic to get through the IND process and into commercialization is no small task.”

Bio-engineered organs may be as many as 70 years away, while self-driving cars are right around the corner. 

Even in optimal regulatory conditions, the process is extraordinarily lengthy, she added.

If a company was submitting an IND today, if the FDA accepted the proposal without holds and if there were no safety or efficacy issues along the way (which would be surprising), we would be looking at commercialization in 20 years,” Mills said [emphasis hers]. “More likely, the best guess for a product such as this will be in 50-70 years. There is a lot left to learn.”

And a significant portion of that knowledge—including the information that has yet to be gleaned—comes from experimenting on tissues that themselves come from donated organs, Mills said. She noted that while progress is also being made in developing solutions for that issue, the need for such primary materials to originate from humans will also continue for the foreseeable future.

To solve the organ donation problem, it seems, we’re going to need even more organ donations.


The cause is certainly a worthy one, however.

Every day, 22 people die while waiting for an organ transplant, according to numbers compiled by several different government and private organizations. All told, more than 119,000 men, women, and children are currently on the national waiting list—with one more being added every 10 minutes.

And while 95% of adults have said they support the idea of organ donation, only 48% are signed up as donors, the aggregated statistics show.

Deciding to donate organs takes guts, but they’re the exact ingredients needed for the world to save lives—and grow hearts.

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