The Effort To Save Thousands Of Donor Kidneys | Ocean Liner Will Become An Artificial Reef

Last year, 9,000 deceased donor kidneys were discarded due to storage and time limitations. A kidney “life support” machine could change that. Also, the SS United States will join Florida’s 4,300 artificial reefs—human-made places for fish and other marine life to live. How do these reefs work?

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

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• 0:18Flora Lichtman?

  This is Science Friday. I'm Flora Lichtman. Today in the podcast, we're diving into artificial reefs.

• 0:24Speaker 02

  Some of the first artificial reefs were shipwrecks. And so shipwrecks kind of gave a little clue that we might be able to put down these materials on purpose.

• 0:38Flora Lichtman?

  Last week, after a notable career, the SS United States, a 1950s ocean liner, took her sunset cruise. Like many retirees, the ship headed south, from Philadelphia to Florida, where she'll be reinventing herself. In this new chapter, the SS United States won't be a ship at all. She's taking up a new vocation at the bottom of the sea. The ship will be sunk and turned into an artificial reef, hopefully providing a new home for marine life. So how do these artificial reefs work? Are ships good candidates for them? What are the risks? Joining me now to dive into the science of artificial reefs is Scott Jackson. Scott has served Northwest Florida with the University of Florida Sea Grant Extension since 2000.

• 1:23Flora Lichtman?

  As Bay County Extension Director and as a Regional Specialized Agent, he focuses on artificial reefs, fisheries, and coastal resiliency. Scott, welcome to Science Friday.

• 1:33Speaker 02

  It's great to be here. Thank you for having me.

• 1:35Flora Lichtman?

  What is an artificial reef?

• 1:37Speaker 02

  Artificial reefs are man-made materials that we place in the ocean to create hard substrate. They mimic some of the natural things that we find, like a Northwest Florida limestone. But as you go further south, some of the coral reefs, those will be some good things that we're trying to mimic.

• 1:52Flora Lichtman?

  What is their purpose?

• 1:54Speaker 02

  The purpose is to create additional places for marine habitat to develop and grow. They also provide really great places for people to fish and dive. And so it benefits both the economy and also our ecology.

• 2:10Flora Lichtman?

  When did artificial reefs become a thing? Like, when did we first start experimenting with them?

• 2:16Speaker 02

  It's kind of an interesting story. Some of the first artificial reefs were shipwrecks. And so shipwrecks kind of gave a little clue that we might be able to put down these materials on purpose and not just wait for Mother Nature to have an impact that resulted in, you know, some type of tragedy or damage so that we could actually see some of the same things that we saw from these shipwrecks. And so in the late 1800s, I believe, it was South Carolina that started putting down log huts and some other things, but they quickly deteriorated.

• 2:51Flora Lichtman?

  The original artificial reef was a log hut? Okay.

• 2:55Speaker 02

  I would say after a shipwreck, then, you know, we started to look toward things that we could make. And so logs and timber were readily available. And so that was what some of the first artificial reefs were made out of. They just don't have the longevity or the durability that we need for a really successful reef.

• 3:15Flora Lichtman?

  I understand that Florida has really pioneered artificial reefs. How many do you have?

• 3:20Speaker 02

  Right now, Florida Fish and Wildlife estimates over 4,300. Where I live in Panama City and Bay County, we have over 700 spots that we have curated and put down. We continue to add to those numbers on a daily basis across the state of Florida. But we also work to monitor and keep up with what is going on with the reefs that we put down and learn from those monitoring trips and just make things continually better.

• 3:49Flora Lichtman?

  So where is the SS United States heading exactly?

• 3:53Speaker 02

  It's about 20 nautical miles or so offshore, and some of that may vary over time as they work with regulators and finally come to a spot. But ideally, it would be available to a number of resource and recreational users. It is going to be more of a, I think, in this case, an economic boost is what we're looking at. We try to prioritize and look at different purposes for artificial reefs. And sometimes we prioritize the economy over actually creating marine habitat, although they do both.

• 4:25Flora Lichtman?

  Well, what about the marine habitat version? You know, what's the sort of ideal for a marine habitat artificial reef?

• 4:32Speaker 02

  The marine habitat artificial reef, which we have studied over decades now in Florida with help from researchers, is a patch reef. It's smaller, usually made out of concrete materials that kind of mimics some of the limestone or some of the corals that we might see that are easy populated by encrusting or filing organisms, you know, like shellfish, barnacles, tunicaits, and some other things that start the parade that we see as the artificial reef develops.

• 5:02Flora Lichtman?

  What do you mean the parade? Tell me about it.

• 5:04Speaker 02

  So the parade kind of starts as soon as you put it down with usually bait fish that start to adopt this new substrate that's been added to the sandy bottom in our area in northwest Florida, anyway. We start to see after the bait fish show up, some of the predatory fish show up, too, because the artificial reef habitat is providing homes for predators to ambush from, but it's also providing protection for the small fish. So it just allows for everything to grow and take care of everything. And, you know, what we have seen over time is the presence of invasive species, too.

• 5:44Speaker 02

  And so sometimes some of the first fish that we see on an artificial reef are lionfish. And so over the years that we've been putting out reefs, we've seen an increased number of lionfish. And now we actually see the number of lionfish start to stabilize and, in some cases, be reduced. And that can be attributed just to general ecology as things adapt to the naturalization of lionfish. But we also have a robust group of people that usually are diving, that go out and target lionfish. In fact, you can go on a dive trip and actually go and get lionfish, and they're very tasty and very good to eat.

• 6:27Flora Lichtman?

  When you're doing this for marine life, do you need to think about where you're putting it? Like, are you creating a reef where there was no reef before?

• 6:34Speaker 02

  In northwest Florida, the predominant sediment on the bottom is usually unconsolidated sand. And just like you see on the beach, you see under the water throughout our area. Some have called it a desert. I think it's interrupted more by limestone ledges that come and go with storms and tides and such. And we have more than what we thought. But we try to purposefully put these down in areas that we want to increase that hard substrate and increase the productivity with the prize fish and marine life that we want to either go visit and see or eat or provide additional resources back to our coastal environment.

• 7:16Flora Lichtman?

  I mean, but is it sort of biologically complicated to create a structure where naturally there was no structure? Like, are people worried about that upsetting the ecosystem in some way?

• 7:26Speaker 02

  First of all, Mother Nature is very equipped to adopt such things. Even just some of the things that we would consider, like bottles or trash or marine debris, which we don't want to see in the ocean, quickly gets adopted and taken care of by Mother Nature with the things that start to form on that. We're just doing more of a purposeful seeding of life to make sure that there are no things that we would consider trash or pollutants to try to create that hard substrate so that things can start to grow and start that chain that we talked about earlier.

• 8:04Flora Lichtman?

  So how do you make sure that there are no toxic materials or chemicals that would end up polluting the water?

• 8:11Speaker 02

  There's a prescribed cleaning process that's set forth by the Environmental Protection Agency. We also have local regulators in our state offices here that work with the Department of Environmental Protection, also with Florida Fish and Wildlife Commission, to help us make sure and ensure that we don't have those types of things, like hydrocarbons, where we have oils, hydraulic fluids. Diesel fuel, gasoline, those are the ones that we most think of, you know, as far as potential pollutants. But then there's also things that we address with potential paint that peels. In some ways, that's why we look at not only ships, which tend to be

• 8:52Speaker 02

  preferred by the public as far as artificial reefs, but as people that manage coastal waters and those types of things. Having something engineered specifically to be an artificial reef from the get-go is what we what we're looking for. That helps us best because we can tailor that to specific species that we want to try to enhance. We can put it in different locations for different purposes, whether that's to address shoreline erosion in some cases, help us soften and increase the complexity of structures along seawalls that maybe have been there before and kind of complement living shoreline projects near

• 9:34Speaker 02

  shore. And we can also do a number of different things offshore with these engineered reefs.

• 9:41Flora Lichtman?

  You can tailor them to the needs of the ecosystem and the habitat. Have you visited any of these reefs? Like, have you scuba dived to see them?

• 9:52Speaker 02

  Yeah, I don't scuba dive, so I come at it from a different angle. And so a lot of things what I do is fish on top and we go out and we'll actually sample using hook and line for the types of things and the activities that I participate in, pull the fish up, measure, and then return those fish so that they can, you know, be caught by somebody else in the future. But we do look at the productivity, how many fish we catch, and then oftentimes we'll tag those fish.

• 10:20Flora Lichtman?

  You know, we know coral reefs, corals are threatened by warming seas. Is there anything that we can do for corals themselves with artificial reefs?

• 10:32Speaker 02

  That is one of the benefits that has been studied over time with some other reefs that were placed in South Florida. And they were able to to show that they were able to spare some of the pressure on the natural reefs and the coral reefs as far as the number of visitors and those types of things. There is a large segment that enjoys visiting wrecks, and that can provide additional opportunities so that everybody's not all the same.

• 10:59Speaker 02

  Precious coral all at the same time.

• 11:01Flora Lichtman?

  Oh, that's fascinating. So you can divert traffic from coral reefs to these artificial reefs and ease some of the pressure on the natural habitats.

• 11:10Speaker 02

  Right. Those were some of the early studies that were done, probably decades ago.

• 11:15Flora Lichtman?

  That's about all the time we have for now. I'd like to thank my guest. Scott Jackson has served Northwest Florida with the University of Florida Sea Grant Extension since 2000 as Bay County Extension Director and a Regionalized Specialized Agent. He focuses on artificial reefs, fisheries, and coastal resiliency. Scott, thanks for joining us.

• 11:33Speaker 02

  You're welcome. Thank you so much.

• 11:37Flora Lichtman?

  We have to take a break. And when we come back, why it's so hard to get a kidney transplant.

• 11:42Speaker 03

  So only about 100,000 people actually make it onto the transplant list. And only a quarter of those people get a kidney each year.

• 11:52Flora Lichtman?

  We'll talk about an organization trying to improve the system.

• 12:01Speaker 00

  Science Friday is supported by PBS, presenting Going Wild. If you love learning about the natural world and meeting the scientists who help us understand it, be sure to check out the new season of Going Wild with Dr. Ray Wynn Grant. It's the chart-topping and Webby Award-winning podcast from the folks at Nature on PBS, now with a video companion series. In this season of Going Wild, host acclaimed wildlife ecologist Dr. Ray Wynn Grant heads out into the field to explore the animals, people, and stories that make nature worth saving. Stops include a hibernating black bear den in Arkansas and an underwater shipwreck site off the Florida coast. If you're looking for a place to start, check out the season's debut episode, where Ray joins beloved biologist and influencer Jordan

• 12:43Speaker 00

  King in the Florida Everglades to learn about his unlikely journey into science and how to study a wetland when it's not very, well, wet. So don't miss out. Follow Going Wild with Dr. Ray Wynn Grant on Apple Podcasts, Spotify, YouTube, or wherever you get your podcasts. Support for Science Friday comes from the Hyating Simons Foundation. Unlocking knowledge, opportunity, and possibilities. More at hsfoundation.org.

• 13:13Flora Lichtman?

  And now it's time to check in on the state of science.

• 13:19Flora Lichtman?

  Iowa Public Radio News. Local science stories of national significance. Thirty-seven million people in the United States live with chronic kidney disease, an illness where your kidneys, whose job is to filter waste from the blood, gradually stop working. At the end stage of the disease, patients rely on dialysis or a kidney transplant to survive. But there aren't enough donor kidneys for all the patients who need them. And even worse, for various reasons, some of the donated kidneys from deceased patients are thrown away. Around 9,000 of those donor kidneys were tossed last year. But a lab in Indiana is trying to fix that. My next guest reported a story on their efforts.

• 14:00Flora Lichtman?

  Elizabeth Gabriel is a health reporter for WFYI and Side Effects Public Media, based in Indianapolis, Indiana. Welcome to Science Friday.

• 14:09Speaker 03

  Hi, thanks for having me.

• 14:11Flora Lichtman?

  Okay, so the waitlist for getting a donor kidney is, on average, five years long. Tell me about the state of kidney shortages.

• 14:19Speaker 03

  So over 700,000 people have kidney failure in the United States. The National Kidney Transplant List gives patients an opportunity to receive a kidney once it becomes available. Someone's placed on the list depends on their condition. But a national kidney shortage makes it hard to serve every patient. So only about 100,000 people actually make it onto the transplant list. And only a quarter of those people get a kidney each year.

• 14:48Flora Lichtman?

  Where do the donor kidneys come from?

• 14:51Speaker 03

  Kidney donations come from two sources: living donors and deceased donors. It's possible to get a kidney from a living donor, like a family member or a friend. But only 6,400 living donations were made last year.

• 15:05Flora Lichtman?

  Yeah, so why are so many kidneys thrown away?

• 15:08Speaker 03

  Great question. So about 9,000 deceased kidney donations were discarded last year, partially because transplant surgeons feared they wouldn't work efficiently once transplanted. Transplant surgeons can get a small biopsy of the organ, run imaging, and collect medical information from the donor. But that isn't always enough information. That's what Leonardo Riala told me. He's a transplant nephrologist with the Massachusetts General Hospital.

• 15:36Speaker 04

  These biopsies are processed very quickly, meaning we cannot do all the stains to look at all the different aspects of the kidney. So we may not be able to actually say what's going on with the rest of the kidney, because sometimes things can be spotty in terms of how they affect the kidney.

• 15:53Flora Lichtman?

  So you talked to a group of researchers in Indiana who are trying to solve this problem of of some kidneys being thrown away. What are they doing?

• 16:01Speaker 03

  So Thirty Four Lives is a company on West Lafayette, Indiana, and they're leading an observational study to try and salvage seemingly unusable kidneys. They hook kidneys up to a life support machine for 120 minutes, which allows Thirty Four Lives staff to run nearly three dozen tests. Then they can determine how much sodium, potassium, and urine a kidney is producing. They also provide a kidney with nutrients like sugar so it's able to heal itself. Here's what Chris James, the co-CEO of Thirty Four Lives, said.

• 16:35Speaker 05

  That allows us to warm it back up to body temperature. We almost trick it into thinking it's still inside a body, and it can start working and functioning just like it was inside a body still.

• 16:46Speaker 03

  A typical kidney can stay outside the body for just 24 to 36 hours, but the company has added nearly 20 extra hours to that timeframe.

• 16:56Flora Lichtman?

  Wow, that's amazing. So these changes seem pretty straightforward. Why has it taken so long to make them?

• 17:03Speaker 03

  Yeah. Hospitals don't have the funds or resources to repair damaged organs. The Food and Drug Administration hasn't actually approved a process for repairing kidneys. So if a hospital wanted to do something like this, they would have to conduct a research study, which can cost hundreds of thousands of dollars. That's why Thirty Four Lives is conducting this work under an observational study. They've received funds from donors as well as a $44 million award from the federal government. The federal government has drastically cut research funding recently, but as far as they know, their award is still intact.

• 17:41Flora Lichtman?

  Did you talk to anyone who benefited from these changes?

• 17:44Speaker 03

  Yeah, I spoke with Sylvia Miles, who lives in Indianapolis. She has lupus, a chronic autoimmune disease that causes the body's immune system to attack healthy tissue, including her kidney. Miles used to be in so much pain that she couldn't even move, which meant she also couldn't go to work. But she said everything changed once she got a kidney saved by 34 Lives.

• 18:11Speaker 06

  I tell you, I feel amazing. I haven't had a flare up since I had a transplant, which is a great deal for me.

• 18:20Flora Lichtman?

  How much of the donor kidney shortage does this address? Like, if the methods that 34 Lives are using were more widespread, would we solve the kidney shortage issue?

• 18:32Speaker 03

  Yeah, so 34 Lives hopes to salvage 50% of seemingly unusable kidneys over a five-year period. But even so, that's only a fraction of the kidneys needed to serve all patients. So even though this could be a huge step forward, Riella believes there needs to be an increase in other kidney transplant methods.

• 18:53Flora Lichtman?

  That's about all the time we have for now. I'd like to thank my guests. Elizabeth Gabriel, health reporter for WFYI and Side Effects Public Media, based in Indianapolis, Indiana. Thanks for joining us.

• 19:04Speaker 03

  Yeah, thanks for having me.

• 19:07Flora Lichtman?

  One last thing. Have you ever wondered what goes on inside your head? Teachers, parents, and anyone into brain stuff, which is everyone. Join Science Friday on March 7th for our livestream kickoff of Hack Your Brain. You'll dive deep into the workings of the brain with experts. RSVP today at sciencefriday.com/hackyourbrain to unlock the mysteries of your mind.

• 19:37Flora Lichtman?

  And that is about all we have time for. Lots of folks helped make this show happen, including

• 19:43Speaker 03

  Santiago Flores. Emma Gomez. Diana Plasker.

• 19:47Flora Lichtman?

  Sandy Roberts. I'm Flora Lichtman. Thanks for listening.