Be Still, My Ticking Heart? Introducing The Artificial Organs Of The Future

As demand for organ transplants skyrockets, a new artificial heart and other sophisticated prostheses are among the medical-tech advancements raising troubling questions.

"Rex" and Bertolt Meyer, the man who lent his face to the bionic exoskeleton
"Rex" and Bertolt Meyer, the man who lent his face to the bionic exoskeleton
Paul Molga

PARIS — Meet Rex, the robotic exoskeleton that was presented a few months ago at London’s Science Museum. His heart is made of plastic, his pancreas is an insulin pump, silicon filters act as kidneys, his trachea is made of human tissue, he has an autonomous blood circulation system as well as visual and hearing implants all attached to a structure that can replicate the most important human movements.

Rex is a collection of all the recent scientific progress in artificial organ designing. “These products are not all implantable yet, and this pipe dream still lacks vital organs, like a stomach,” explains Bertolt Meyer, a Swiss psychologist who lent his face to this sort of bionic Frankenstein. “But Rex is proof of how quickly we’ve gone from the wooden leg to such sophisticated prostheses that there is hope that one day they could be as good as or even better than the level of perfection of biological constructions.”

In just a few months, Carmat’s artificial heart, invented by French surgeon Alain Carpentier, will be implanted in four patients, and this will illustrate the imminent future Meyer describes. “This worldwide first will make everything else possible,” says philosopher Roger-Pol Droit, who outlined in his 2012 book Human the physical mutations that will shake up our human condition.

Spare parts

By “everything else,” Droit means the surprising (or worrying?) innovations that are brewing in laboratories: nano pores made out of composite polymers so as to produce insulin in place of a failing pancreas, bionic retinae with tiny electrodes that can replace damaged photoreceptors, and prostheses made from collagen and glycoprotein fibers to build resorbable scaffolding that enable bone recolonization. Then, of course, there are the artificial uteri for “outside womb pregnancies” that would make babies born like soil-less plants.

“Rex shows that we can reproduce up to 60% or 70% of a human being, but we’re still a long way away from reconstructing a whole body,” explains Rich Walker, managing director of the robotics team Shadow that built Rex. “What we’re starting to obtain are prostheses that resemble human parts. But they still lack the ability to transmit sensory information.” In other words, what science delivers, for now, are mere spare part of a body, like a jigsaw puzzle.

Substitute organs

Even as things stand, doctors have no doubt whatsoever that these evolutions are positive. In France, the number of organs is nowhere near enough for transplants. Since the end of the 1990s, the number of people donating organs increased by 56.5%, but the number of people on waiting lists also rose significantly. There were a total of 5,023 transplants performed in 2012, according to the French Biomedicine Agency.

Surgery itself is not to blame: surgeons can successfully — and with very low rejection rates — transplant the following six vital organs: kidney (which represent 60% of operations), liver (23%), heart (8%), lungs (6.4%), pancreas (1.4%) and intestines. With an aging population, one in five people over 65 in France have already had at least one body part replaced, be it a new organ, a prosthesis, a dental implant or a valve.

Carmat, a company valued at more than half a billion euros, symbolizes the hopes aroused by new technological substitutes. Philippe Pouletty, its founder, explains how the artificial heart they have invented functions. “It mimes exactly the human heart. It has two ventricles that mobilize the blood like the cardiac muscle would, and sensors that allow it to accelerate or decelerate the beats, depending, for example, on whether the person is going up or down the stairs,” he says.

“From the point of view of anthropology, we are now reaching a breaking point that will represent a fracture from the totality of human experience,” says sociologist and philosopher Marcel Gauchet. “I am convinced that scientific and technical mutations will have deep repercussions on human identity. By increasing life span, the medical world is already blurring the definition of death. We used to have the impression of a clean frontier, but with organ transplants, it appears that we don’t really know when we die,” he explains

Upcoming revolutions will raise this and other issues even more strongly. For instance, artificial uteri will undoubtedly spark debates about the descendancy chain. “Imagine that for the sake of equality, men demand to be allowed to use it,” suggests anthropologist Françoise Héritier. “The male gender will then be able to give birth to children, and women will lose the fundamental certainty they have acquired thanks to maternity.”

The ethical challenges that these technological breakthroughs raise are at least as important as the scientific barriers they overcome. Rex’s artificial organs were created to restore lost functions or to replace failing parts of the body, but what will it be tomorrow? Will we have substitute organs that offer better possibilities than the original ones? Who will be allowed to have them? How will the selection be made? How much will it cost? And what will be our legal and moral relationship with post-humans whose capacities will be superior to our own?

In the end, will the announced revolution of the “enhanced human” be digested as easily as the invention of the steam engine? “On an individual scale, there’s no doubt about that,” argues psychologist Bertolt Meyer, who was born without a left hand. “I have such a sophisticated bionic prothesis that it allows me to make the finest movements. I have developed a very emotional relationship with this limb. Just like my right hand, it’s part of my identity and of the image I have of my own body.”

Keep up with the world. Break out of the bubble.
Sign up to our expressly international daily newsletter!

Iran-Saudi Arabia Rivalry May Be Set To Ease, Or Get Much Worse

The Saudis may be awaiting the outcome of Iran's nuclear talks with the West, to see whether Tehran will moderate its regional policies, or lash out like never before.

Military parade in Tehran, Iran, on Oct. 3


LONDON — The Iranian Foreign Ministry spokesman Saeed Khatibzadeh said earlier this month that Iranian and Saudi negotiators had so far had four rounds of "continuous" talks, though both sides had agreed to keep them private. The talks are to ease fraught relations between Iran's radical Shia regime and the Saudi kingdom, a key Western ally in the Middle East.

Iran's Foreign Minister Hossein Amirabdollahian has said that the talks were going in the right direction, while an Iranian trade official was recently hopeful these might even allow trade opportunities for Iranian businessmen in Saudi Arabia. As the broadcaster France 24 observed separately, it will take more than positive signals to heal a five-year-rift and decades of mutual suspicions.

Agence France-Presse news agency, meanwhile, has cited an unnamed French diplomat as saying that Saudi Arabia wants to end its costly discord with Tehran. The sides may already have agreed to reopen consular offices. For Saudi Arabia, the costs include its war on Iran-backed Houthis rebels fighting an UN-recognized government in next-door Yemen.

The role of the nuclear pact

Bilateral relations were severed in January 2016, after regime militiamen stormed the Saudi embassy in Tehran. Amirabdollahian was then the deputy foreign minister for Arab affairs. In 2019, he told the website Iranian Diplomacy that Saudi Arabia had taken measures vis-a-vis Iran's nuclear pact with the world powers.

It's unlikely Ali Khamenei will tolerate the Saudi kingdom's rising power in the region.

He said "the Saudis' insane conduct toward [the pact] led them to conclude that they must prevent [its implementation] in a peaceful environment ... I think the Saudis are quite deluded, and their delusion consists in thinking that Trump is an opportunity for them to place themselves on the path of conflict with the Islamic Republic while relying on Trump." He meant the administration led by the U.S. President Donald J.Trump, which was hostile to Iran's regime. This, he said, "is not how we view Saudi Arabia. I think Yemen should have been a big lesson for the Saudis."

The minister was effectively admitting the Houthis were the Islamic Republic's tool for getting back at Saudi Arabia.

Yet in the past two years, both sides have taken steps to improve relations, without firm results as yet. Nor is the situation likely to change this time.

Photo of Iranian Supreme Leader Ali Khamenei in 2020

Iranian Supreme Leader Ali Khamenei in 2020

Riyadh's warming relations with Israel

Iran's former ambassador in Lebanon, Ahmad Dastmalchian, told the ILNA news agency in Tehran that Saudi Arabia is doing Israel's bidding in the region, and has "entrusted its national security, and life and death to Tel Aviv." Riyadh, he said, had been financing a good many "security and political projects in the region," or acting as a "logistical supplier."

The United States, said Dastmalchian, has "in turn tried to provide intelligence and security backing, while Israel has simply followed its own interests in all this."

Furthermore, it seems unlikely Iran's Supreme Leader Ali Khamenei will tolerate, even in this weak period of his leadership, the kingdom's rising power in the region and beyond, and especially its financial clout. He is usually disparaging when he speaks of Riyadh's princely rulers. In 2017, he compared them to "dairy cows," saying, "the idiots think that by giving money and aid, they can attract the goodwill of Islam's enemies."

Iranian regime officials are hopeful of moving toward better diplomatic ties and a reopening of embassies. Yet the balance of power between the sides began to change in Riyadh's favor years ago. For the kingdom's power has shifted from relying mostly on arms, to economic and political clout. The countries might have had peaceful relations before in considerably quieter, and more equitable, conditions than today's acute clash of interests.

If nuclear talks break down, Iran's regime may become more aggressive.

Beyond this, the Abraham Accord or reconciliation of Arab states and Israel has been possible thanks to the green light that the Saudis gave their regional partners, and it is a considerable political and ideological defeat for the Islamic Republic.

Assuming all Houthis follow Tehran's instructions — and they may not — improved ties may curb attacks on Saudi interests and aid its economy. Tehran will also benefit from no longer having to support them. Unlike Iran's regime, the Saudis are not pressed for cash or resources and could even offer the Houthis a better deal. Presently, they may consider it more convenient to keep the softer approach toward Tehran.

For if nuclear talks with the West break down, Iran's regime may become more aggressive, and as experience has shown, tensions often prompt a renewal of missile or drone attacks on the Saudis, on tankers and on foreign shipping. Riyadh must have a way of keeping the Tehran regime quiet, in a distinctly unquiet time.

Keep up with the world. Break out of the bubble.
Sign up to our expressly international daily newsletter!