Death Benefit

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Authors: Robin Cook
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causing the organ’s surface to pulsate slightly.
    “We find that we must keep the fluid in the baths in constant motion despite the organs being perfused internally. But it has to be carefully modulated. Occasionally the rigid bath sets up a wash that can disturb the organ.” Yamamoto had stepped over to join the students. He noticed Pia straighten, looking down the length of the room.
    “It’s quite something, isn’t it?” he said, speaking directly to her. “Of course, I see it every day, so I’ve come to take it all for granted.”
    “How are the organs started?” Pia asked.
    “They are started in tissue culture dishes designed to mimic the mouse uterine environment in terms of temperature and with pulsation waves close to the normal mouse heart rate of around five hundred and fifty beats a minute. As I said earlier, the whole process, first in the tissue culture dishes and then in these organ baths, is a ballet of gene expression with a careful adherence to sequence and timing. It starts with an aliquot of induced pluripotent stem cells held in close proximity by spiderweb-like restraints. Remember, to form a whole organ we have to involve all three germ layers: ectoderm, mesoderm, and endoderm. Once the organ has reached a size that can be manipulated, it is moved into these baths to develop to its full extent.”
    “Are there other organs in here besides kidneys?” Will asked.
    “Heavens yes,” Yamamoto said. “We’ve got all the usual transplantable organs such as livers, pancreases, lungs, and hearts so far. The kidney program is the most advanced, since it was kidneys we started with. To prove we are on track with what we have been doing, we have already transplanted some organs back into the individual mice from which the fibroblasts were taken with complete and utter success. And let me share another leap forward that we are in the process of making. We’ve found that carrying out organogenesis with multiple organs works even better than growing them singularly, meaning we have preparations in which the developing organs are helping each other, like the heart pumping the perfusing fluid and the kidneys removing waste.”
    “Do you think sometime in the future you could essentially make a whole new organism?” Pia asked with astonishment and not a little dismay.
    “At the rate we’re going, I see that as a definite possibility, although I can’t imagine what the rationale would be.”
    Pia reflexively shuddered as she realized that Frankenstein, that nineteenth-century nightmare, could very well resurrect itself to haunt the twenty-first in a frighteningly more plausible fashion. If the Rothman-Yamamoto organogenesis worked well with kidneys, hearts, and pancreases, there was no reason it couldn’t work just as well with brains.
    “Where are the human organs?” Pia asked.
    Yamamoto took a few steps down the kidney line and pointed into a larger Plexiglas container. “This is human, as you might expect considering the size. It’s also one of the composite preparations with a human heart to do the kidney’s internal profusion.”
    Pia stared into the bath, transfixed by what she was looking at. The kidney did look human, but the heart did not. She asked Yamamoto why.
    “Good question. Since oxygenation of the perfusing fluid is being done by the oxygenator on the lower shelf, we did not need a four-chambered heart as two would do. So we altered the design of the heart.”
    Once again Pia was amazed. “You have that much control of the organogenesis process to alter the overall three-dimensional architecture?”
    “Absolutely. As I mentioned, once we made the original organogenesis breakthroughs, our progress has been truly phenomenal and isn’t slowing down.”
    The figure Pia had seen earlier finished what he was doing, stood upright, and came toward the group. As he neared, and despite the surgical mask, Pia was further surprised. She could tell it was Rothman. Wearing some kind of

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