sir roger donald trump and plugging your putin and i were to tell our junkie mentary analyzes the difficult relationship between russia and the u.s. and between their presidents how does their rivalry and their dangerous mutual admiration affect the rest of the world prism bullies trump and putin starts august 3rd on d w. there is a global shortage of organ donors the illicit trade in human kidneys and hearts is booming it's a lucrative business but it doesn't only save lives it also kinds then i mean the fact that your life is in danger and you need a heart doesn't give any allowance to us physician to going kill somebody else for the cost. i pay money and i want to live

this is my last chance. how can we solve this problem do we need new laws or are artificial organs the only alternative. florence gomes is young and might look healthy but she faces big physical challenges a genetic disorder means that her kidneys barely function the 23 year old is only able to work part time. things will fail i'm just saying i'm a lot more restricted when it comes to certain things. and i have to learn not to allow myself to be defined by this thing on this is after this thing i have to just carry on as most of us live how much.

dialysis is her only chance of survival at the moment she has to go to hospital in the swiss canton of 3 times a week each dialysis session lasts and least 4 hours. her mother and her brother are unable to donate one of their kidneys to her because they have the same genetic disorder are kidneys filter toxins and waste out of the body and maintain our fluid balance florence gomez's body is unable to perform these functions. during dialysis a machine cleans her blood and removes excess fluid florence doesn't want to be filmed during the treatment. is scary more entire committee of clients are going to when i go on monday wednesday and friday afternoon then there's a long gap over the weekend off and jerry in this period i have to really watch what i eat and drink so i have to parry it from sunday evening to monday is always

terrible is have. i have the most fluid in my body at this point side. and the most toxins in my body it's a disease that. florence's life is full of restrictions especially when it comes to what she eats and drinks. she's only allowed to consume at most a leader of water each day and her diet has to be low and salt potassium and phosphorus westerfield are fine as are them because if i eat too much of those things in my heart starts to race my muscles cramp arkin it's very unpleasant i get on with mia and that can get very dangerous and it can also even develop into a heart attack if it's not treated in time by 30. florence gomez has been on the waiting list for a donor organ for 3 years now since then she hasn't been able to travel if an organ becomes available she has to be ready to go to the hospital almost immediately

staff have to be able to contact her 24 seventh's she dreams of one day leading a normal life is rest anything nice i don't want to have to wait for another 3 is when i have already waited 3 years. this is the result so many things i want to do and i've put all of them one held across as if. i'd like to travel the world to many other things. i'd like things to start moving forward with mark shields for it's good. in switzerland germany and austria there are some 15000 people waiting for a donor organ just like florence and in spain and italy the waiting lists are shorter these countries have an opt out system anyone who doesn't register their opposition is a potential donor and there are other factors that can affect the number of organs available in different nations do you know far more people die in traffic accidents

in countries where seatbelts are not mandatory and where cars on top of the same standards that's one reason when of course another significant factor is the high or even very high standard of preventative health care in germany france and switzerland where blood pressure is monitored and regulated if you have people die of complications such as a brain hemorrhage as a result and fewer people are therefore eligible to become organ donors quite if it's here something that is in fact positive has a negative impact on the number of organs available for transplant like germany switzerland compares unfavorably with other european countries in this respect. c'mon nobody stuff as we are concerned about the shortage of organs. people in countries like switzerland which also had very few donors 56 and 7 years ago quickly ask themselves whether there is any point of putting themselves on the waiting list here. in switzerland we have

a lot of 2nd generation immigrants whose parents come from italy portugal or spain who wonder whether they might not be better off in those countries as the donor numbers are 3 or 4 times higher than this is the the deficit's of the donor system and that's no doubt true of germany to pick people to look for solutions elsewhere within europe for that also beyond its borders open the who's who and who. many people turn to organ trafficking israel is one country where this used to flourish for decades the country had the world's lowest numbers of organ donors many see organ donation as incompatible with judaism according to the old testament bodies have to be buried promptly and should not be desecrated many orthodox jews believe in the physical resurrection of the dead and therefore i think it is essential that the body should remain intact as a result each year there were a 1000 more potential recipients than actual donors. moti was critically ill

only medication was keeping him alive he ended up in hospital for 18 months because of a virus his heart's performance was reduced to only 10 percent of what it should be his condition was deteriorating day by day. b. in the 1st place and the waiting list but. every time i don't have a donut because if it's your 1st at the most or it can give me that it's my blood is all. people with blood group oh can only receive a heart from someone with the same blood group could be a. multi has now been married 44 years and has grown children back then it was a race against time he knew that he would die without a transplant and he wanted to be around to see his grandchildren grow up but he

also realized that finding a suitable donor in israel would be difficult then by chance he met someone in the hospital who had just had a heart transplant and had bought the organ abroad. take it from were not. met with come from china i see a man in the us big that it tell me that now i come from china and make it in this china in china it is china that said siri. i have more office one full of china now one from colombia more places because this is big money back then israelis were among the world's leading transplant tourists maya brokers you could range operations in many parts of the world particularly in china eastern europe and south america. who was $55.00 at the time opted for china a broker in tel aviv organized the all inclusive deal for him 415-0000 us dollars

he bought himself a donor heart and surgery and his health insurer was even willing to reimburse the costs this is. a broken the this man's not speak with me speak with that insurance and give all the documents they give him all the documents and they gave them our need dave the are going to zap me they always get that well that is the. whole. we have people in china. one from here or one from china and then. let's all take the money from here and then me yeah yeah send me to china with a doctor. for it would fly would allow doctor oxygen a big balloon and that'll. make them jack up levy is the director of the heart transplantation unit of sheba medical center in tel aviv and

a leading cardiac surgeon when he heard about his patient morty's plans he questioned the service being provided in china and he came to me one day and told me that he's care jeweled to undergo heart transplantation in china and he designated the specific date of the transplant 2 weeks ahead of time and i looked at him and i told him what he did you listen to yourself how can a surgeon how can anybody promise you a heart transplant 2 weeks ahead of time you know that somebody has to die on that very day in order for you to get your heart and you told me i'm not asking question and that's what my insurance told the company told me and that's what's what i'm going to do. but in the absence of alternatives and with time running out moti brushed aside any moral scruples and flew to shanghai with his family there he was admitted into a renowned teaching hospital. and i go into hospital after 12

days come the professor professor jan. and c.m. their meal with probably because. blood these oh and it's a difficult problem with the side the man with the oh ok didn't we will have time and after. 3 days come another time the professor and tell me maybe tomorrow will. took a look. then the. nurse in. my for there and my family by the by and there. are heart on demand that's possible in china received a donor organ with blood group oh he was told it had come from a 23 year old man of roughly the same height and build who had been killed in

a road traffic accident. in china $4000.00 transplants are carried out each year more than in any other country. western transplant specialists regularly get invited to china to watch demonstrations of chinese expertise france imma a heart surgeon at the time got a surprising offer. of anything in response to my interest they said i could watch a heart transplant in the morning all the afternoon and this troubled me because of course an organ donation is a very seldom event we can never plan heart transplants and so that was the 1st thing that really took me aback and i asked myself how can a planet like that and how can that be possible that you got. the fact is the only way that a heart transplant can be scheduled is when the death of the donor can also be

pre-arranged since 198-4984 they cheney's have developed a huge industry of all in the nation based on organs from executed prisoners over the years it came out that not only formally executed music business where the source of organs in china but mainly prisoners of conscience among the following one petitioners among the wars among the tibetans amount of the new christians who were designated by the communist party as enemies of the party and they were concentrated in concentration camps that's the the the term concentration camps and the way they were have been executed by killing them and selling their organs to transplant tours not only from israel israel was only a small part from all over the world starting from the united states many european countries eastern asia 1000 intense with thousands of patients come each year until

today and get their organs in china escaped prisoners and even doctors have made such allegations beijing denies the practice not interested me nothing and not this is not my problem i pay money and i want to leave this is my last chance but in the earth into this and when that thing. moti didn't ask any questions about where his heart had really come from nor did the doctors in shanghai who performed the surgery those kinds of questions are frowned upon in china or going to or ism is a big moneymaker there's absolutely no ethical way to justify the killing of one human being in order to save the life of another human being i mean the fact that you your life is in danger and you need a heart doesn't give any allowance to us physician to go and kill somebody else for the this is because of the one of the missions of the medical community in the

world in order to stop that because this is a crime against humanity which by. the a couple of the has fought to change israeli law to stop or going to or ism and forced organ harvesting health insurance companies no longer reimburse the costs for transplants performed abroad new legislation gives people who register as organ donors preferential treatment if they subsequently needed donor organ this is led to a 20 percent jump in organ donations. and one of the clauses of the olden flows from floor is a unique clause again there's no such president in the world giving priority in all than a location to any candidate of organs as but they shouldn't who has been registered as an organ donor at least 3 years before he became a candidate. moti is happy to be healthy again and back at work at his store in the tennis club he's grateful to the chinese for saving his life even if they

sacrificed another person's life to make it happen. it's mostly poor people from emerging countries who sell their non fide organs to people from affluent countries the world health organization estimates that 10000 illegal transplants are performed annually generating more than 1000000000 euros often at the donor's expense. mideast because i know of an example from pakistan people who want to donate their kidney in return for payment have to stay in a hospital room until the recipient finally arrives. on the donors have to pay for their board and lodging themselves but just imagine and when the transplant is actually performed and they have had their kidney removed their only receive a very small sum for the organ and then these costs are subtracted from that these people are then sent home without any kind of medical care and of course these

living donors are at risk of getting an infection or developing complications that are so severe that these patients die can. 70000 people in europe are waiting for a donor kidney every day 12 of them die iran is the only country in the world where the organ trade is legal could we ever imagine that in europe economists retrenched bryer believes it could help curb organ trafficking and tourism down young because there are a shortage of kidneys and there are not enough organs donated after death i could imagine health insurance companies buying kidneys inland but domestically and not abroad a lot of the victims we shouldn't exploited people from developing countries. get payment could be offered to residents prepared to voluntarily donate a kidney. to lessen the kidney transplant costs 18000 euros while 10 years of dialysis costs 400000

euro. of course you also have to count the costs of the transplant but yet even if you generously factor in aftercare at 12000 euros a year that still leaves a saving of 200000 euros for the health insurers if the donor got half of that and it would be a win win situation for $31.00. would the introduction of an opt out system increase the number of organs donated if everyone were considered a potential donor unless they made a statement to the contrary. experts say this would only help in part frequently smaller hospitals are not equipped to perform transplants or even identify potential donors and then there is the question of the potential costs for that so it's all for a long time it was the case that if a hospital wasn't a transponder and just happened to have a patient who had been declared brain dead it would actually make a loss removing

a donor organ the form that the situation has been improved in germany with the reform and the transplantation law but nevertheless the efforts involved in removing a donor organ to disturb the hospital's daily routine that i'm calling all is dirt . the demand for donor organs continues to outstrip the supply even despite changes in the law german scientists are among those looking for alternatives to conventional organ donation. could pigs be the solution to the shortfall in human donor organs. the university of munich is breeding animals that might be used as potential donors in the future. try and its interest rates are relatively similar to humans anatomically and physiologically and you can read papers efficiently the gestation period of us hours just 3 months 3 weeks and 3 days that's $114.00 days in total and the

young animals are ready to breed at 6 months we fall off they have a lot of piglets between 8 and sometimes 14th and so you could actually produce a sufficient number of picks to act as organ donors for humans to cross species transplantation is called xenotransplantation if pictish human transplants were to work then they could provide an almost endless supply of organs but there are still many hurdles to overcome. side on from since the beginning of the 2000 so we have been able to genetically modify pigs in a very targeted manner which we can and inactivate certain problematic big genes and all modify them to include human genes and thereby reduce all completely overcome the risk of rejection. try any basis grow very quickly they weigh around a kilo at birth and can reach

a weight of almost 100 kilos within 6 months he will come and their inner organs obviously grow at the same pace. for the pre-clinical experiments involving transplants from takes to baboons in particular that means that the organs quickly become too big in addition to the other genetic modifications needed for the zennor transplantation we have knocked out of pig gene responsible for growth regulation these pigs only reach half the body weight of normal chaos and their organs are correspondingly small. although pigs are relatively similar to humans genetically only the organs of genetically modified pigs would be suitable for animal to human transplants then look for mention if the blood of humans or primates were to flow through the blood vessels of pigs then rejection processes take place this problem can be overcome with genetic

modification there are also problems with coagulation that after a few weeks small blood clots were observed and that a pillar of the smaller blood vessels that coursed organ failure called so we generated pigs that express human anticoagulants in their blood vessels were the root. and when we use those kinds of pigs there is no clotting. even if it's a book you know. december 28th scene the munich heart surgeon bono high shot transplanted a pig's heart into a bamboo it survived for 6 months scientists around the world hailed the development as a trailblazing success and yet it will take at least another 5 to 10 years before a human might get a pig's heart but is it ethically acceptable to breed animals in order to harvest their organs. if this animal experiments are needed in general most you have to be

able to ethically justify whether the expected benefit for people given their improved quality of life justifies the pain or suffering or hurt of the animals that our animals don't have any kind of pain suffering or if the genetic modifications don't influence the animals at all if we were able to save a life by transplanting a pig organ and then it would be ethically justified it is good if it. had come. from the booze. drugs. really like. the mouse could help revolutionize transplant procedures. the reader will be here the buyer can make or not toss that with 10 meg or

pat there's nontransparent biological tissue is transparent that our laws us to use laser scanning marco scopes and look to the intact or gods because they're like a glass now they live 10 gautreaux in the shows us ever the cells and cells and details inside there's literally the core of the technology read we have been to all the things so far. neurobiologist alley after aims to produce 3 d. printed organs researchers in munich have developed chemical processes that allow them to see inside cells and tissues and then create maps that could serve as bio printing templates to create functional organs artificially. a laser scanner registers every miniscule detail. here is the muscles in red organs one vite and there is

a green if i remove muscles you see now the nurse through the bones now i remove the bones you have this are now a really poor neuron are connected to off the mom's body so let's look at the in the treaty so again we will remove the layers muscles that way and then the bones now you can see for the 1st time all the details of the nurse or something coming from tall you can solve this one are strong connection to no connection all these details at the muscles are the muscles sark being controlled this is the vascular our details of again the most brain i will show you . here we use deploying. to cause trouble all these details and you can see all the waskow are details at the micro couple or as it is the the cells in the brain such a complicated network we didn't know before so you can imagine such

a network we generate for a human organ like a kidney you need this information. this detailed information about blood vessels nerve pathways and millions of cells should help to create artificial organs in the future that requires dillion is a piece of data to be fed into computers on the basis of this data ai based algorithms work out the 3 d. print job the printer then creates the structure of the organ using bio ink. this consists of cultured cells and a kind of glue 1st of all the biological scaffold of the organ is printed and then filled with stem cells millions of cells have to be cultured for this process. but miss we how to actually make such a printing machine we have to construct it so that for us the challenge additional challenges will be err on the cells what kind of cells to use because there are

hundreds of different types of cells we have to understand what will be minimal in that that's another challenge a 3rd challenge will be to generate a really large amount of cells to print because this printers we'll use billions they want trillions of cells but to find out whether the 3 d. printed organs really work researchers will 1st have to test them out on animals. if these experiments are successful they will launch clinical human trials. so when might the 1st human get a 3 d. printed kidney. maybe we will come to a point that 3 d. printers can generate the 1st organs maybe initially do more simpler ones hearts let's call it simpler compared to kidney or liver or maybe we're also working on pancreas for example for people who are having the debit it's as another target for

us at the moment. i expect in 10 to 15 years that say we might really have the 1st pro prototypes coming. corns gomez can't wait. at the moment she is number 40 on a waiting list of 1500 patients but she refuses to give up hope. mission much that thing and i desperately need a kidney a new kidney for you shall i am really looking forward to it this coming week i can't imagine this i won't get what. i don't want to an action it got as far as they.

stood as personal as 1st girl who could have a. lot of us are also some of the. saving was a walk over. the debris of what. is for me. is for her. is for. me to use her. beethoven is for. beethoven is for crayon. beethoven 2020. 5th anniversary here on de dano.

this is newsnight from berlin signs of optimism from e.u. leaders negotiating a massive coronavirus recovery plan e.u. council president shelby shadow says an agreement worth hundreds of billions of euros is not within reach after a new proposal and breaking 4 days of debt. program drugmaker astra zeneca appears to be leading the race to discuss i think corona virus vaccine.