The 60 best HBO series streaming right now

“It’s not TV, it’s HBO!” It might sound a bit obnoxious, but considering the way HBO basically invented prestige TV with shows like Oz and The Sopranos, it’s earned the pompous slogan. Of course, the premium network hasn’t slowed down since then, continuing to push the envelope over the past two decades with blockbusters like Game of Thrones and genre-bending think pieces like I May Destroy You. With the advent of HBO Max, the TV library is even bigger, with some all-time classics from other networks available on the streamer, too. But while the list of available content grows longer, we keep pruning it to ensure only the cream of the crop stays on this list. These are the absolute best series on HBO right now.

Not finding what you’re looking for on HBO? We regularly update our lists of the best shows on Netflix, the best shows on Amazon Prime Video, the best shows on Disney+, and the best shows on Hulu as well. 

Oscar Isaac and Jessica Chastain standing, foreheads together, in a scene from Scenes from a Marriage.

Scenes from a Marriage

Oscar Isaac and Jessica Chastain star in this modern, American adaptation of Ingmar Bergman’s seminal 1973 Swedish TV miniseries about a marriage slowly falling apart. It’s not for everyone as it truly is an actor’s piece with very subtle, very slow drama. But that’s the point. Things like broken marriages don’t happen overnight, and this series intends to make you feel every slow, painful turn of the knife from all angles.

Created by: Hagai Levi
Cast: Jessica Chastain, Oscar Isaac, Nicole Beharie, Corey Stoll, Tovah Feldshuh
Number of seasons:  1

Watch on HBO Max

The Other Two siblings in their seats on an airplane.

The Other Two

Created by former SNL head writers Chris Kelly and Sarah Schneider, The Other Two follows two siblings desperately trying to find their place in the universe after their much younger teenage brother Chase becomes an internet sensation overnight. Cary is an aspiring actor who can hardly get commercial auditions, while his sister Brooke just has no direction at all. While Ken Marino and Molly Shannon deliver incredible supporting performances, it’s the chemistry and genius of the “other two” that make this series shine. Season 2 is now available to stream.

Created by: Chris Kelly, Sarah Schneider
Cast: Drew Tarver, Heléne Yorke, Case Walker, Ken Marino, Molly Shannon
Number of seasons: 2

Watch on HBO Max

Employees of The White Lotus resort greet guests.

The White Lotus

Rich people go on vacation. That’s The White Lotus in a nutshell, but this brilliantly written dramedy goes above and beyond, exploring the ticks, haunts, and obsessions of both the guests at an elite Hawaiian resort and the staff who bend over backward to ensure the guests have the best experience possible. But between the unhappy honeymooners (the husband of which is particularly dickish), the obsessively needy woman there to scatter her mother’s ashes in the sea, and the family oozing with white privilege, the staff of The White Lotus have their work cut out for them. Every cast member plays their role perfectly, creating an intricately woven tapestry of people reaching the precipice of their breaking points.

Created by: Mike White
Cast: Alexandra Daddario, Jake Lacy, Connie Britton, Steve Zahn, Jennifer Coolidge, Murray Bartlett, Sydney Sweeney, Brittany O’Grady
Number of seasons: 1

Watch on HBO

The Dallas Cowboys practice in Hard Knocks on HBO.

Hard Knocks

Since 2001, football fans have known the NFL season is just around the corner when Hard Knocks starts airing. Across 15 seasons, HBO’s documentary teams have followed 15 different football teams during training camp and preseason, where undrafted underdogs get their shots to make their NFL dreams come true, established stars gear up for a new season, and veteran and rookie coaches alike hope to make a strong impression and build the foundation of a winning team. It’s one of the best behind-the-scenes sports series on the planet, regardless of whether or not it’s covering your team. But this year, there’s bound to be a lot of happy new fans since it’s Hard Knocks: Dallas Cowboys.

Created by: N/A
Cast: Liev Schreiber, Paul Rudd
Number of seasons: 15

Watch on HBO

A group photo of the entire character lineup of South Park.

South Park

One of the longest-running shows of all time, South Park continually reinvents itself with the times, remaining as scathingly satirical and obnoxiously insightful as ever. The Emmy-winning series grows up a little more with each subsequent season, even if the four little boys at the center of it don’t. Although it’s often derided as potty humor, the show has been and remains one of the smartest, most creative, and influential shows in comedy.

Created by: Trey Parker, Matt Stone
Cast: Trey Parker, Matt Stone
Number of seasons: 24

Watch on HBO Max

Joey and Chandler sitting on the floor in Friends.

Friends

Before launch, HBO Max touted a Friends reunion special so much, it was easy to overlook that the platform is also home to the entire sitcom series. While NBC’s classic is often, rightfully criticized today for its lack of diversity and representation, it was nonetheless one of the most popular and talked-about shows on television for much of its 10-year run. The relationship dynamics between Rachel, Ross, Chandler, Monica, Joey, and Phoebe caused no shortage of drama and hijinks, immersing audiences into this group of friends so much that they actually felt like, well, your friends. There’s a reason many people have an honest, thoughtful answer when somebody asks “What ‘Friend’ are you?”

Created by: Marta Kauffman and David Crane
Cast: Jennifer Aniston, Courteney Cox, Lisa Kudrow, Matthew Perry, Matt LeBlanc, David Schwimmer
Number of seasons: 10

Watch on HBO Max

Rizzoli & Isles.

Rizzoli & Isles

Based on the crime thriller novels of Tess Gerritsen, Rizzoli & Isles premiered on TNT in the summer of 2010. While its beginnings were a little bumpy, by season 2, the police procedural found its footing. Angie Harmon stars as brash detective Jane Rizzoli, who forges an unlikely friendship with the much more cerebral medical examiner Dr. Maura Dorothea Isles, played by Sasha Alexander. Starting in June, HBO Max subscribers can stream all seven seasons of the series, beginning with the mystery that spans the first season about a serial killer known as The Surgeon.

Created by: Janet Tamaro
Cast: Angie Harmon, Sasha Alexander, Jordan Bridges
Number of seasons: 7

Watch on HBO Max

Betty

Betty

In 2018, critics were impressed with the film Skate Kitchen about a tight-knit group of girl skateboarders in New York City. Two years later, the film’s director brought most of the cast along with her to portray the same group of friends in the HBO original series Betty. Named after the derogatory term that male skaters use while gatekeeping their hobby, Betty is a teen dramedy focusing on the friendships between this diverse band of girls thumbing their noses at what society expects of them. Betty‘s second season premieres on June 11.

Created by: Crystal Moselle
Cast: Dede Lovelace, Kabrina Adams, Nina Moran
Number of seasons: 2

Watch on HBO Max

Off the Air

Off the Air

Digging into HBO Max’s library reveals some gems, and few are as intriguing as Adult Swim’s Off the Air. The anthology series presents 10- to 11-minute episodes of unpredictable madness. The episodes are often animated, sometimes they’re live-action, and sometimes you get little more than the kind of morphing and seemingly random psychedelic imagery you’d expect to find on the walls and racks of a head shop. For viewers who want something not only unexpected but also TV that challenges your expectations, Off the Air is perfect. Its 10th season premieres on HBO Max in June.

Created by: Dave Hughes
Cast: Various
Number of seasons: 10

Watch on HBO Max

Hacks

Hacks

Jean Smart has already given HBO a number of wonderful performances in original series like Watchmen and Mare of Easttown, but she takes center stage in Hacks. Smart plays Deborah Vance, a world-famous comedian who rules the roost in Las Vegas. But when Vance’s stage dates start getting canceled and the popularity of social media comedy starts chipping away at her throne, the queen of Vegas sees her reign coming to an end. To help make the inevitable become the impossible, Vance takes on the young writer Ava (Hannah Einbinder) in what HBO Max’s official description for the series calls “a dark mentorship.”

Created by: Paul W. Downs, Lucia Aniello, Jen Statsky
Cast: Jean Smart, Hannah Einbinder, Carl Clemons-Hopkins
Number of seasons: 1

Watch on HBO Max

That Damn Michael Che

That Damn Michael Che

As a veteran of both The Daily Show With Jon Stewart and Saturday Night Live, Michael Che is no stranger to using humor to illustrate things we should all be taking seriously. In his new six-episode series, That Damn Michael Che, the eponymous comedian uses sketches to illustrate the experience of being Black in America. From heavier issues like racial profiling to more universal experiences like falling in love, That Damn Michael Che promises to give some viewers a funny and poignant mirror while giving others the chance to laugh as they look at things in a new way.

Created by: Michael Che
Cast: Michael Che, Cecily Strong, Heidi Gardner
Number of seasons: 1

Watch on HBO Max

The Nevers

The Nevers

What if Marvel’s X-Men started their story in 19th-century London? That’s not exactly a complete description of The Nevers, but it’s a good start. HBO’s exciting new sci-fi drama transports us to a steampunk world where a group of women known as “the Touched” exhibit extraordinary abilities. Leading the gang of Touched heroes is the no-nonsense psychic Amelia True (Laura Donnelly), and she has a lot to contend with in this exciting new series. As is to be expected, Victorian England isn’t exactly ready for superpowers, and some of its citizens want to rid themselves of the Touched, some want to “cleanse” them, and still others seek to use them for their own twisted ends.

Created by: Joss Whedon
Cast: Laura Donnelly, Ann Skelly, Olivia Williams
Number of seasons: 1

Watch on HBO Max

Mare of Easttown

Mare of Easttown

Just reading the names of some of Mare of Easttown‘s cast — including Kate Winslet, Guy Pearce, Evan Peters, and Jean Smart — should make you eager to give the show a chance. Winslet stars as Mare Sheehan, a detective burdened with a dead son, local legend status she doesn’t want, and loneliness. When the young Erin (Cailee Spaeny) goes missing and later winds up dead, it’s clear Mare’s going to have to somehow chase down a killer while struggling to hold together her crumbling life. Compelling and character-driven, Mare of Easttown is a great crime drama no one should miss.

Created by: Brad Ingelsby
Cast: Kate Winslet, Julianne Nicholson, Jean Smart
Number of seasons: 1

Watch on HBO Max

Exterminate All the Brutes

Exterminate All the Brutes

No one wants to think the origins of a nation they call home could be steeped in blood and hatred. But director Raoul Peck — director of 2016’s I Am Not Your Negro — isn’t interested in nourishing our illusions. In his documentary miniseries Exterminate All the Brutes, Peck recounts the unforgivable violence toward Black and indigenous people with which the United States was founded. Using historical reenactments, documentary footage, and animation, among many other tools, Peck tells a weighty and ugly story, but an important one for us to contend with.

Created by: Raoul Peck
Cast: Raoul Peck, Josh Hartnett, Casia Ankarsparre
Number of seasons: 1

Watch on HBO Max

It's a Sin

It’s a Sin

Thankfully, AIDS is no longer a death sentence, but that wasn’t always the case. Set in the ’80s and early ’90s, the five-part dramatic miniseries It’s a Sin looks at the epidemic through the eyes of a group of friends in London —  in particular, how the disease tears through the LGBTQ community. It’s a Sin can be heartbreaking in its depiction of the virus but still manages to be uplifting and funny, while at the same time chronicling the intolerant political climate that left so many AIDS victims on their own.

Created by: Russell T. Davies
Cast: Olly Alexander, Nathaniel Curtis, Shaun Dooley
Number of seasons: 1

Beartown

Beartown

Based on Fredrik Backman’s 2017 novel of the same name, this limited series comes to an end on March 22. Powerful and dark, Beartown tells a sadly familiar story. In a small Scandinavian town that revolves around ice hockey, the young Maya (Miriam Ingrid) is sexually assaulted by the star of the local junior team, forcing the community to face its demons. One of the surprising strengths of this gripping drama is that while you’re likely to find so much of the story predictable, the familiarity doesn’t take away from your experience. If anything, the fact that the tale is so familiar is part of the point.

Created by: Fredrik Backman
Cast: Ulf Stenberg, Miriam Ingrid, Oliver Dufåker
Number of seasons: 1

Generation

Generation

High school isn’t quite what it used to be. Topics of sex, sexuality, gender, race, and more have risen to the surface. The lives of teens are simpler in some ways and much more complicated in others, and you get to see a slice of that in the new HBO Max dramedy Generation. Starring an ensemble cast of promising young actors, Generation is sometimes dark in its portrayal of the lives of modern high schoolers but still leaves enough room for plenty of laughs.

Created by: Zelda Barnz, Daniel Barnz
Cast: Haley Sanchez, Lukita Maxwell, Chloe East
Number of seasons: 1

The Investigation

The Investigation

In 2017, Swedish journalist Kim Wall boarded Nautilus — a submarine privately owned by Danish entrepreneur Peter Madsen. She never made it out alive. In February the Danish limited series The Investigation premiered on HBO Max, based on the real-life investigation to unearth the truth of what happened to Wall. The Investigation is an engrossing slow-burn that ignores most of the more familiar conventions of the murder mystery and brings to light many of the difficult truths of trying to find justice.

Created by: Tobias Lindholm
Cast: Søren Malling, Pilou Asbæk, Pernilla August
Number of seasons: 1

Roots

Roots

Based on the 1976 novel Roots: The Saga of an American Family and inspired by the real-life story of novelist Alex Haley’s ancestors, Roots was an event when it first aired on network TV. Attracting a massive viewership and a total of 37 Emmy nominations (with nine wins), the story of Kunta Kinte’s (LeVar Burton) enslavement in the late 18th century and his lineage stretching as far as post-Civil War America struck a powerful chord with American audiences in the late ’70s. Starting in February, HBO Max subscribers find out what all the fuss was about on their own.

Created by: Alex Haley
Cast: LeVar Burton, Robert Reed, John Amos
Number of seasons: 1

Gen:Lock

Gen:Lock

Production company Rooster Teeth — the same company behind the Halo parody series Red vs. Blue — has come a long way and the proof is Gen:Lock. With amazing voice talent including Michael B. Jordan, David Tennant, and Maisie Williams, Gen:Lock is an engrossing dystopian sci-fi saga about an underdog military outfit drawing a line in the sand against a global autocracy trying to absorb the entire population. Are there giant robots? Of course there are giant robots.

Created by: Gray G. Haddock
Cast: Michael B. Jordan, Golshifteh Farahani, David Tennant
Number of seasons: 1

Babylon 5

Babylon 5

If you’re a fan of any science fiction series that focuses on cataclysmic intergalactic warfare and/or the sensitive nature of navigating a political landscape that includes alien species — and if it premiered any time after the mid-’90s — you can bet you owe a debt of gratitude to Babylon 5. While some of the special effects may seem ancient compared to what we see today, echoes of Babylon 5 can easily be felt in later fare like The Expanse and the Battlestar Galactica reboot. The titular station, while administered by Earth’s military, is considered neutral ground for diplomats and traders of all cultures and worlds. Over its five seasons, an epic saga unveils including rebellions against corrupt governments, prophetic warnings, literal star-crossed romances, and the struggle to unite the galaxy against an ancient enemy.

Created by: J. Michael Straczynski
Cast: Mira Furlan, Richard Biggs, Stephen Furst
Number of seasons: 5

30 Coins

30 Coins

Initially released in November 2020, 30 Coins has proven to be one of HBO Max’s best-kept secrets. The Spanish language mystery horror series stars Eduard Fernández as Padre Vergara, a priest with a troubled past. Hoping to find shelter from that past, Vergara retreats to the small town of Pedraza. Unfortunately, along with shelter, Vergara finds troubling supernatural occurrences, which may or may not have something to do with the 30 silver coins paid to Judas for betraying Jesus. With a stellar lead cast, 30 Coins has been compared to the fiction of H.P Lovecraft and artifact quest stories like the National Treasure and Indiana Jones films.

Created by: Álex de la Iglesia
Cast: Eduard Fernández, Megan Montaner, Miguel Ángel Silvestre
Number of seasons: 1

Search Party

Search Party

Formerly on TBS, the darkly-comic mystery thriller Search Party has found its way to HBO Max. Alia Shawkat of Arrested Development fame stars as Dory, an unfulfilled personal assistant whose life changes radically when her friend Chantal disappears. Since then, Dory’s become an amateur detective along with her eccentric group of friends and been tried for murder along the way. Search Party‘s fourth funny and engaging season premieres this January, with the series lead finding herself in the terrifying position of being a hostage in someone’s basement.

Created by: Sarah-Violet Bliss, Charles Rogers, Michael Showalter
Cast: Alia Shawkat, John Reynolds, John Early
Number of seasons: 4

The Flight Attendant, on HBO

The Flight Attendant

Flight attendant Cassie Bowden was probably already on a bad path before she woke up next to a corpse. The young, flirty Cassie is a barely functional alcoholic when we meet her — passing out on subways, making it to work with seconds to spare, and sneaking shots of liquor between serving passengers. But when a first date with the charming and wealthy Alex (Michiel Sokolov) ends with Cassie waking up in a bed filled with blood and her date’s throat cut, things get a lot more complicated. Haunted by visions of Alex and desperately trying to sift through her drunken memory for the events of that night, Cassie is in a desperate race to find out what happened before either the FBI — or someone less forgiving — gets their hands on her. Starring Kaley Cuoco of The Big Bang Theory fame, The Flight Attendant is a gripping thriller that gives Cuoco a chance to show her range.

Created by: Steve Yockey
Cast: Kaley Cuoco, Merle Dandridge, Nolan Gerard Funk
Number of seasons: 1

Rick and Morty on HBO Max

Rick and Morty

At this point, there’s nothing particularly new about animated shows with adult humor, but even there, Rick and Morty stands apart from the pack. The show’s main hero is Rick — a beyond genius scientist who also happens to be alcoholic, chronically dishonest, as compassionate as a hungry shark, and possessing the moral compass of a mob boss. Morty is Rick’s hapless grandson, who gets dragged around on countless adventures with Rick across time, space, and alternate dimensions. It’s hilarious, merciless, and sends up the tropes of science fiction while reveling in them at the same time. The entire series is available on HBO Max, including the long-awaited fourth season.

Created by: Dan Harmon, Justin Rolland
Cast: Justin Roiland, Chris Parnell, Spencer Grammer
Number of seasons: 4

Raised by Wolves on HBO

Raised by Wolves

From director Ridley Scott, Raised By Wolves is a dark, mysterious foray into sci-fi for HBO Max. The story follows two androids tasked with raising human children on a brand new planet where religious differences threaten to tear apart a human colony. As the androids attempt to manage peace through logic, they soon learn that controlling and guiding the beliefs of humans is difficult and extremely treacherous.

Created by: Aaron Guzikowski
Cast:  Travis Fimmel, Amanda Collin, Abubakar Salim
Number of seasons: 1

Lovecraft Country on HBO

Lovecraft Country

History and supernatural horror merge in Lovecraft Country, which follows a Black soldier who returns home from World War II and then sets off on a journey through 1950s America to find his missing father. Jonathan Majors plays series protagonist Atticus Freeman, who’s joined on his rescue mission by childhood friend Letitia “Leti” Lewis (Jurnee Smollett) and his uncle, George Freeman (Courtney B. Vance). Series showrunner Misha Green expertly blends the real-world racial terrors of the Jim Crow era for Black people in the U.S. with the dark, eldritch horrors of H.P. Lovecraft in a story that continually surprises its audience with one shocking twist after another.

Created by: Misha Green
Cast:  Jonathan Majors, Jurnee Smollett, Courtney B. Vance
Number of seasons: 1

Perry Mason

This limited series brings the world’s most renowned fictional lawyer back to the small screen. Perry Mason is an origin story of the criminal defense attorney set in 1932 Los Angeles. The series takes an edgy, noir-ish tone and gives Perry Mason a new spin, with Matthew Rhys portraying him as a low-rent private investigator digging into the influential and enormously powerful evangelical preacher Sister Alice.

Created by: Ron Fitzgerald, Rolin Jones
Cast:  Matthew Rhys, Juliet Rylance, Chris Chalk
Number of seasons: 1

HBO's The Outsider

The Outsider

Based on Stephen King’s bestselling novel of the same name, this slow-burn series starts with a seemingly straightforward, cut-and-dried murder investigation. However, things spiral out of control as investigators encounter an insidious supernatural force that makes everything look different than it seemed before. Soon, the investigators begin to question everything they thought they knew. Featuring a first-rate cast of Jason Bateman, Ben Mendelsohn, and Cynthia Erivo, The Outsider is a truly gripping, supernatural crime drama that measures up to King’s novel.

Created by: Richard Price
Cast: Ben Mendelsohn, Bill Camp, Jeremy Bobb, Julianne Nicholson, Mare Winningham
Number of seasons: 1

Michaela Coel in I May Destroy You

I May Destroy You

Michaela Coel’s co-production for BBC One and HBO has established her as one of the most innovative and thoughtful new creators in television. Coel created, writes, co-directs, executive produces, and stars as Arabella, a young London woman who must rebuild her life after being sexually assaulted in a nightclub. Publicly feted as a millennial icon after the success of her debut novel “Chronicles of a Fed-Up Millennial,” Arabella is struggling under the pressu re of meeting the deadline for her second book. To de-stress, she meets up with friends for a night out in London, which becomes a complete blur. The next morning, she pieces together the events of the previous night, challenging social norms and the meaning of consent.

Created by: Michaela Coel
Cast: Michaela Coel, Weruche Opia, Paapa Essiedu
Number of seasons: 1

Watchmen on HBO

Watchmen

What could be more daunting than adapting Alan Moore’s iconic comic series Watchmen for TV? How about making a sequel? That’s what Damon Lindelof (Lost, The Leftovers) has done with Watchmen, which picks up decades after Moore’s story ended, following a new group of characters whose lives intertwine with the old cast. Set in Tulsa, Oklahoma, 34 years after the comic, Watchmen follows Angela Abar (Regina King), a cop who takes on the masked identity of Sister Night. The Tulsa police have been decimated by a white supremacist group called the Seventh Kavalry, forcing the remainder to adopt superhero personae for safety. After the police chief is murdered, Angela searches for the killer, uncovering a sinister conspiracy. In its willingness to challenge expectations for a sequel, Lindelof’s Watchmen proves a worthy successor to the original.

Created by: Damon Lindelof
Cast:  Regina King, Jean Smart, Yahya Abdul-Mateen II, Tom Mison, Jeremy Irons
Number of seasons: 1

Zendaya in Euphoria on HBO

Euphoria

Euphoria may be a teen drama, but it’s the kind that could only be made at HBO. It’s steamier, darker, and deeply, deeply provocative. An adaptation of the Israeli show of the same name, Euphoria follows 17-year-old Rue (Zendaya), a drug addict fresh from rehab with no plans to stay clean and an upsetting amount of responsibility. Around her are Jules, Nate, Chris, Cassie, and Kat, each with their own identity crises and high school crosses to bear. As they struggle to make sense of their present and future, the series takes a deep-dive into teenage substance abuse, sexual tension, and the anxiety-ridden life of modern high school. At times, Euphoria swings for the shock value fences but generally, it deals with serious issues with empathy and openness.

Created by: Sam Levinson
Cast: Zendaya, Sydney Sweeney, Maude Apatow
Number of seasons: 1

Nicole Kidman in Big Little Lies on HBO

Big Little Lies

Based on the novel of the same name by Liane Moriarty, Big Little Lies is set in a small, affluent town where Madeline Martha Mackenzie (Reese Witherspoon) and her friend Celeste Wright (Nicole Kidman) live in seeming bliss with their families. When Jane Chapman (Shailene Woodley) moves to town with her son, Ziggy, Madeline and Celeste take her under their wings, but an accusation against Ziggy — and a murder — threaten to upend their lives. Despite the mystery that opens the show, what really drives Big Little Lies is its portrayal of the lives — domestic and social — of women, the friendships they form, and the aggressions they endure. The central characters are complex, driven as much by competitiveness and arrogance as by friendship and family; Witherspoon is particularly great as the domineering Madeline.

Created by: David E. Kelley
Cast: Reese Witherspoon, Nicole Kidman, Shailene Woodley, Zöe Kravitz
Number of seasons: 2

Game of Thrones on hBO

Game of Thrones

George R.R. Martin’s “A Song of Fire and Ice” series attracted its fair share of fans when it hit bookstore shelves in the early ’90s. However, it was D.B. Weiss and David Benioff’s TV adaptation on HBO that really got the fantasy juices flowing when it debuted in 2011. Often heralded as not only one of the best shows on HBO, but also one of the best series of all time, Game of Thrones is an epic tale of royal feuds, dynastic conflict, and the struggle for ultimate control in the Seven Kingdoms of Westeros. Throughout the show’s eight seasons, and divisive conclusion, the creators have rarely shied away from egregious violence, sex, and massive bloodshed, making it one of the most controversial, yet wildly popular shows HBO has to offer.

Created by:  David Benioff, D.B. Weiss, George R.R. Martin (based on books)
Cast: Kit Harrington, Emilia Clarke, Sophie Turner, Peter Dinklage, Lena Heady, Maisie Williams
Number of seasons: 8

The Night Of on HBO

The Night of

Writer Steven Zaillian (Gangs of New York, Schindler’s List) delivers some of his most poignant material in this 2016 miniseries starring British actor and rapper Riz Ahmed, who portrays a Pakistani-American student who quickly finds himself in prison after a blurry one-night stand turns into a mysterious and brutal murder. The show chronicles his descent from innocent youth to hardened inmate, with the help of Michael K. Williams (The Wire). The latter plays prison kingpin Freddy, who’s more than willing to provide his young protégé with some protection from his violent neighbors — for a price. John Turturro also delivers an excellent performance as embattled defense lawyer John Stone. Turturro’s presence provides a small sense of levity to help balance the all-too-serious subject matter.

Created by: Richard Price, Steven Zaillian
Cast: Riz Ahmed, John Turturro, Bill Camp
Number of seasons: 1

Wendell Pierce in Treme, on HBO

Treme

David Simon is no stranger to the HBO network, having worked on The Wire, Generation Kill, The Corner, Show Me a Hero, and this New Orleans-themed drama, Treme. Set just three months after the events of Hurricane Katrina, Treme follows the eclectic mix of people living in New Orleans who attempt to repair and rebuild their lives after the catastrophic storm. Featuring some familiar faces from Simon’s other works, the show received most of its critical praise for accurately portraying the storm-torn Louisiana city and for capturing the region’s unique culture. Like The Wire, the excellent narrative pulls the viewer in and makes it incredibly hard to look away.

Created by: Eric Ellis Overmyer, David Simon
Cast: Khandi Alexander, Rob Brown, Kim Dickens, Wendell Pierce, Clarke Peters, Melissa Leo
Number of seasons: 4

Harley Quinn on HBO

Harley Quinn

There’s been a glut of Harley Quinn-related media over the past few years. Along with video games and comics, since 2016, Margot Robbie has played the ruthless Joker spin-off in two live-action films, and the character has made appearances in plenty of DC’s animated features. The animated Harley Quinn series is, believe it or not, the best of them. The series opens with a final, decisive break between her and the Joker, and what remains deals with her learning to be her own woman and villain in the aftermath. Supported by her best friend Poison Ivy, Harley forms a crew composed of the hopeless theater geek Clayface, the psychic Professor Psycho (who’s persona non-grata among DC’s villains for using the wrong sexist slur too often), and King Shark, who initially just wants to do tech support. As both an animated series and one free of content restrictions in terms of language or violence, Harley Quinn is the best send-up of the superhero world since The Tick. It’s hilarious, bloody, sometimes heartbreaking, and regularly features an alcoholic Commissioner Gordon who doesn’t understand why Batman won’t hang out socially.

Created by: Justin Halpern, Dean Lorey, Patrick Schumacker
Cast: Kaley Cuoco, Lake Bell, Alan Tudyk
Number of seasons: 2

Olive Kitterage on HBO

Olive Kitteridge

Few people outside of diehard HBO fans knew what Olive Kitteridge was before it swept the 67th Primetime Emmy’s with eight awards. Taking place over the course of four hour-long episodes, this miniseries concerns the life of retired schoolteacher Olive Kitteridge (Frances McDormand) and her husband, Henry (Richard Jenkins). As each episode of the show focuses on a different period of their lives, viewers get an up-close and personal look at the depression, jealousy, and family tension that comes to shape Olive and those around her. Fantastic acting from everyone billed, along with an incredibly tight narrative, make this one of the best four hours of TV available on all of HBO.

Created by: Jane Anderson (teleplay), Elizabeth Strout (based on the novel by)
Cast: Frances McDormand, Richard Jenkins, Bill Murray, John Gallagher Jr., Rosemarie DeWitt, Peter Mullan, Zoe Kazan
Number of seasons: 1

The Wire on HBO

The Wire

Chances are incredibly high you’ve heard of the David Simon-produced crime drama The Wire and need little to sway you to watch an episode of what many call the greatest television show of all time. However, if you’ve yet to introduce yourself to the likes of Jimmy McNulty and Avon Barksdale, now is the perfect time. Set in Baltimore, The Wire is a fictionalized and highly realistic take on the relationship between the city’s drug culture, the law enforcement details tasked with cleaning it up, and everybody caught in the middle. Few shows feature such tight dialogue and storytelling as Simon’s opus, making The Wire must-watch television for anyone.

Created by: David Simon
Cast: Dominic West, Sonja Sohn, Lance Reddick, Wendell Pierce, Idris Elba, Wood Harris, Frankie R. Faison
Number of seasons: 5

True Detective on HBO

True Detective

HBO’s crime anthology True Detective burst on the television scene in 2014, taking viewers on an especially dark and twisted ride with Matthew McConaughey and Woody Harrelson as the leads. Throughout eight hour-long episodes, writer Nic Pizzolatto and director Cary Fukunaga tell a harrowing tale of murder, deception, and the polarity of religion and logic. This certainly isn’t the first show to play with these thematic elements, but few programs consistently hit on all cylinders as True Detective did during its first season. Although season 2 didn’t quite live up to the first, Mahershala Ali (Moonlight) is a tour de force in the third season.

Created by: Nic Pizzolatto
Cast: Matthew McConaughey, Woody Harrelson, Michelle Monaghan, Michael Potts, Colin Farrell, Vince Vaughn, Rachel McAdams, Mahershala Ali
Number of seasons: 3

The Sopranos on HBO

The Sopranos

Few television series have garnered as much critical buzz as David Chase’s The Sopranos, which aired on HBO from 1999 to 2007. During its impressive six-season run, the show consistently saw stage time during award shows, bagging 21 Primetime Emmy Awards, five Golden Globes, and two Peabody Awards. Needless to say, Chase and his crew knew a thing or two about producing high-quality television. The late James Gandolfini stars as Tony Soprano, an underboss for a notorious New Jersey-based crime family who consistently battles managing his home life and his workload. Edie Falco, Michael Imperioli, and Lorraine Bracco costar in this gritty series that somehow managed to humanize the mafia.

Created by: David Chase
Cast: James Gandolfini, Edie Falco, Lorraine Bracco, Michael Imperioli, Dominic Chianese, Nancy Marchand
Number of seasons: 6

Steve Buscemi in Boardwalk Empire

Boardwalk Empire

Created and produced by Terence Winter (The Sopranos, The Wolf of Wall Street), Boardwalk Empire tells the story of Prohibition-era Atlantic City, New Jersey, and the crooks who came to power during this time. Starring Steve Buscemi as Nucky Thompson (based on real-life politician Enoch L. Johnson), the show depicts Thompson’s rise and his dealings with the city’s mobsters and criminal underbelly, as well as government agents and townsfolk. The show, based on the Nelson Johnson book of the same name, features several real-life historical figures during each of its five seasons (Al Capone, Lucky Luciano, Arnold Rothstein, etc.), and paints a near-accurate portrait of what New Jersey was like in the 1920s and ’30s.

Created by: Terence Winter
Cast: Steve Buscemi, Michael Pitt, Kelly Macdonald, Michael Shannon, Gretchen Mol, Shea Whigham, Bobby Cannavale
Number of seasons: 5

Amy Adams in Sharp Objects

Sharp Objects

Sharp Objects, a miniseries based on Gillian Flynn’s best-selling novel of the same name, is the best kind of slow burn. The eight-episode drama stars Amy Adams (Arrival, Enchanted) as Camille Parker, a distraught reporter who has recently been discharged from a psychiatric hospital and sent to her hometown of Wind Gap, Missouri, to cover the murder of two young girls. She is welcomed back with less-than-open arms by her mother, Adora (Patricia Clarkson), who forces her to confront some of her personal demons. As Camille searches for answers to these brutal murders, she uncovers things from her past that she had tried to forget, resulting in a narrative that’s as grim as it is mesmerizing.

Created by: Marti Noxon
Cast: Amy Adams, Patricia Clarkson, Chris Messina, Eliza Scanlen, Matt Craven
Number of seasons: 1

Random Acts of Flyness

Random Acts of Flyness

Created by the daring Terence Nance, Random Acts of Flyness is a show that tackles issues of sexuality, white supremacy, and the patriarchy through short, thought-provoking sketches. “We definitely try and not to have creative no-go zones,” said Nance. “What I’m most excited about in the show is how much we engage with the irresolute.” The series is a visual and audio experience unlike anything before, which, given Nance’s avant-garde approach to Sundance hit An Oversimplification of Her Beauty, isn’t particularly surprising.

Created by: Terence Nance
Cast: Terence Nance, Tonya Pinkins, Robert Kirk, Orlagh Cassidy, Djore Nance, Eugenia Bess, Brianna Turner, Jamil O’Quinn
Number of seasons: 1

Looking on HBO

Looking

Although it ran for only two seasons (there was also a subsequent movie), Looking burned brightly, garnering praise from critics and love from a small but enthusiastic audience. Looking is a slice-of-life series about three gay men living in San Francisco: Game designer Patrick (Jonathan Groff), artist’s assistant Agustín (Frankie J. Alvarez), and waiter Dom (Murray Bartlett). Each of the protagonists — all of them in their late 20s or 30s — struggles with the fact that their lives haven’t turned out quite how they’ve expected. They’re disappointed with their sputtering careers and their love lives (or lack thereof), and that sense of millennial ennui runs through the show. That doesn’t mean Looking is dreary, however. As in real life, drama and laughter go hand in hand, and the characters have plenty of heartwarming moments to balance out the melancholy.

Created by: Michael Lannan
Cast: Jonathan Groff, Frankie J. Alvarez, Murray Bartlett, Lauren Weedman, Russell Tovey, Raul Castillo
Number of seasons: 2

Kieran Culkin in Succession

Succession

Succession is the story of the Roy family, a clan of wealthy, emotionally damaged scoundrels vying for power. Family patriarch Logan (Brian Cox) built one of the biggest media companies in the world, but now that he’s old and his health is failing, his children — Kendall (Jeremy Strong), Roman (Kieran Culkin), and Shiv (Sarah Snook) — all plot how best to advance their careers and maybe even secure the throne of their father’s empire. Succession bears a passing resemblance to King Lear, and like Shakespeare’s play, the show is rife with drama and backstabbing. Although the characters may seem loathsome at first glance (and maybe for a few glances after that), they are a complicated lot, which makes their squabbling all the more compelling.

Created by: Jesse Armstrong
Cast: Hiam Abbass, Nicholas Braun, Brian Cox, Kieran Culkin, Peter Friedman, Natalie Gold, Matthew Macfadyen
Number of seasons: 2

Insecure on HBO Max

Insecure

Daily Show veteran Larry Wilmore and Issa Rae — creator of the popular YouTube series Awkward Black Girl — partnered to create Insecure, a semi-autobiographical comedy that deftly explores the Black experience in contemporary Los Angeles. Rae plays a version of herself who is trying to balance her professional and personal life while working at a nonprofit organization that benefits children of color. Yvonne Orji and Jay Ellis provide convincing, relatable performances as Issa’s best friend and boyfriend, respectively, and the show is clever and sincere enough that anyone — regardless of color or gender — can enjoy it.

Created by: Issa Rae
Cast: Issa Rae, Yvonne Orji, Jay Ellis, Lisa Joyce, Catherine Curtin, Langston Kerman, Y’lan Noel
Number of seasons: 4

Silicon Valley on HBO

Silicon Valley

From the brilliant mind of Mike Judge — of Beavis and Butthead and King of the Hill fame — comes Silicon Valley, a comedic take on the startup culture taking place in the show’s namesake region. According to Judge, the series is pseudo-inspired by events that occurred in his own life during the late ’80s while he was an engineer in Silicon Valley. The show itself follows a motley crew of programmers and entrepreneurs struggling (albeit comically) to make it in the competitive world of tech startups. Perhaps most hilarious is just how unfit for success many of the main characters seem, which gives the show a rather humanizing angle not often achieved with modern sitcoms. Even though it ended its run at the end of 2019, Silicon Valley’s sharp writing still holds up, and the acting is witty and well-timed, making this not just one of HBO’s best comedies, but one of the best shows the network has to offer.

Created by: Mike Judge
Cast: Thomas Middleditch, Josh Brener, T.J. Miller, Zach Woods, Kumail Nanjiani, Martin Starr
Number of seasons: 6

Flight of the Conchords on HBO

Flight of the Conchords

Bret McKenzie and Jemaine Clement’s comedy troupe first began when the duo roomed together in 1998 at the Victoria University of Wellington in New Zealand, but it didn’t officially burst onto the scene until the mid-2000s. After developing a bit of a following in their native country in the early aughts, Bret and Jemaine caught the attention of HBO, which signed them up to bring their comedy band schtick to premium cable. After creating Flight of the Conchords — Bret and Jemaine’s fictional folk band — the duo moves to New York City intent on finding fame and fortune. Much to their chagrin, fame and fortune always seem just outside their reach. The Conchords play original “folk” songs throughout each episode, which, in turn, incite some of the show’s best laughs. After watching these bumbling New Zealanders try to make it big, you can’t help but hum their tunes in your head.

Created by: James Bobin, Jemaine Clement, Bret McKenzie
Cast: Jemaine Clement, Bret McKenzie, Rhys Darby, Kristen Schaal
Number of seasons: 2

Girls on HBO

Girls

Girls, a dramedy created by and starring Lena Dunham, delves into the daily experiences of a group of twenty-something young women living in New York City. Culled from actual experiences in Dunham’s own life, the show often deals with humiliating and disastrous events centering on becoming an adult, relationships, and sexuality. In addition to Dunham, Girls features outstanding performances from Adam Driver, Allison Williams, Jemima Kirk, and Zosia Mamet, each of whom battle being young (and dumb) while trying to figure out just what the hell being an adult means. You’d be hard-pressed to find many other shows that provide as real — and funny — a portrayal of human interaction and emerging adulthood as Girls.

Created by: Lena Dunham, Judd Apatow
Cast: Lena Dunham, Jemima Kirke, Allison Williams, Zosia Mamet, Adam Driver, Alex Karpovsky
Number of seasons: 6

High Maintenance on HBO

High Maintenance

This free-form web series was so successful and hilarious that HBO picked it up in 2016 and ordered six episodes, while also adding the first six seasons to its streaming platforms. Co-creators (and married couple) Katja Blichfeld and Ben Sinclair provide pre-episode commentary, often alongside guest actors who appeared in the episode. Sinclair stars as The Guy, a New York City-based bicycle messenger who delivers marijuana all over the boroughs. The real star of the show, though, is the rotating cast of customers who call The Guy looking for some pot. High Maintenance doesn’t always conform to the typical 30-minute episode format, either, though each story is crafted with a beginning, middle, and end, even if it takes as few as six minutes. The well-crafted set includes tons of little details that you might miss on the first watch, but you’ll notice more and more with each viewing. The show also takes an objective stance toward the drug that drives its storylines, avoiding stereotypes while simultaneously creating memorable characters that you can’t help but love (and hate).

Created by: Ben Sinclair, Katja Blichfeld
Cast: Ben Sinclair, Max Jenkins, Helene York, Keilyn Durrel Jones, Kevin Mambo, Marisol Miranda
Number of seasons: 4

Julia Louis-Dreyfus in Veep

Veep

Seinfeld alum Julia Louis-Dreyfus stars in this political satire about a female vice president and her attempts to make a lasting impression on the United States without getting swept up by politics. Joining Louis-Dreyfus on screen is the hilarious Tony Hale, who plays the VP’s ultra-obedient personal assistant, Gary. With sharp, witty writing, brilliant acting, and handfuls of laugh-out-loud moments during each episode, Veep is one of the best comedies HBO has to offer. We recommend hopping on board with this show sooner rather than later, as this is political comedy at its finest.

Created by: Armando Iannucci
Cast: Julia Louis-Dreyfus, Anna Chlumsky, Tony Hale, Reid Scott, Timothy C. Simons, Matt Walsh
Number of seasons: 7

Curb Your Enthusiasm Mary Joseph & Larry

Curb Your Enthusiasm

From the comedic brilliance of Larry David? (who also stars in the show) comes Curb Your Enthusiasm, a somewhat fictionalized take on David’s actual life as a retired television writer and producer. What makes the show particularly funny is how nearly every scene is almost entirely improvised by the actors on screen. According to David, he writes a general outline of each episode, though the actual dialogue and conversation come right off the top of the head of the actors. If you liked the humor native to David’s Seinfeld, you’ll probably enjoy watching all 10 seasons of Curb Your Enthusiasm.

Created by: Larry David
Cast: Larry David, Jeff Garlin, Cheryl Hines, Richard Lewis, Kathy Griffin, Sofia Milos, Ted Danson, Mary Steenburgen
Number of seasons: 10

Bill Hader in Barry, on HBO

Barry

Iraq War veteran Barry Berkman (Bill Hader) is like many people in the 21st century: His work/life balance is out of whack. He travels for work, returns home, and kills time with video games before passing out. Barry is the portrait of Information Age ennui, with the one wrinkle being that his line of work is murder. As a hitman, Barry takes missions assigned to him by a man named Fuches (Stephen Root). It’s a career that makes use of Barry’s skills but doesn’t leave him satisfied. When he pursues his latest target to an acting class, however, Barry stumbles into a new world, one that ignites his passions. Pursuing the life of an actor, he encounters some problems in his day job and tension with his boss. Barry is a superb dark comedy, and Hader’s performance is full of subtle gestures that speak to his character’s inner turmoil.

Created by: Bill Hader, Alec Berg
Cast: Bill Hader, Stephen Root, Sarah Goldberg, Glenn Fleshler, Anthony Carrigan, Henry Winkler
Number of seasons: 2

The Jinx: The Life and Deaths of Robert Durst on HBO

The Jinx: The Life and Deaths of Robert Durst

For more than 30 years, real estate icon Robert Durst systematically dodged a series of murder allegations and pointed fingers for the disappearances of his wife, his best friend, and one of his neighbors. After seeing a Ryan Gosling-starring movie loosely based on his life reach the silver screen (All Good Things), the defiant Durst decided to reach out to the film’s director (Andrew Jarecki) and offer an exclusive interview. Over several sit-downs and multiple years of cooperation with Jarecki and HBO’s production crew, a six-episode miniseries was commissioned to tell Durst’s side of the story. For fans of the podcast Serial and murder mysteries in general, The Jinx is a terrific piece of storytelling and filmmaking that is sure to leave your jaw on the ground once the credits roll on its final episode.

Created by: Andrew Jarecki
Cast: Robert Durst
Number of seasons: 1

Last Week Tonight with John Oliver

Last Week Tonight with John Oliver

Though classified as a satirical news show, Last Week Tonight with John Oliver airs some of the most honest and hard-hitting satirical journalism of any network television program. Each week, comedian and former The Daily Show correspondent John Oliver tackles the prior week’s most newsworthy or political happenings and deconstructs them with his signature wit (and British accent). Chock full of hilarious analogies, spot-on critique, and tight, fluid writing, Oliver’s weekly program consistently feels fresh and is, oftentimes, incredibly informative. Whether it’s the bribery scandal that rocked FIFA or the troubled system of standardized tests, there’s no topic Oliver won’t cover and subsequently shred to pieces.

Created by: NA
Cast: John Oliver
Number of seasons: 8

Chernobyl on HBO

Chernobyl

It’s commonplace to hear something along the lines of “the first step to solving a problem is acknowledging it exists.” To see this proven true on a scale that costs still untold numbers of lives, watch HBO’s Chernobyl. Three decades after the events that some say marked the beginning of the end for the Soviet Union, this chilling mini-series unveils not only the science behind the chain of events leading to the Chernobyl disaster but the lengths to which the USSR went to keep the accident a secret and the monstrous scope of the cost. With a worthy cast including Stellan Skarsgård and Jared Harris, Chernobyl is a revealing picture of hell on Earth and the criminal neglect that creates it.

Created by: Craig Mazin
Cast: Jared Harris, Stellan Skarsgård, Emily Watson, Jessie Buckley
Number of seasons: 1

Doom Patrol on HBO

Doom Patrol

A terminally enraged robot with a human brain. A Hollywood beauty cursed to occasionally turn into a colossal blob. An experimental pilot burned beyond recognition and harboring an ethereal alien. A traumatized woman with dozens of splintered personalities — each with their own superpower. These self-styled freaks and more make up the cast of Doom Patrol. While their name comes from a Golden Age DC Comics superhero team, this show’s heroes aren’t crime-fighters so much as they are broken misfits desperately trying to find purpose in the world. Doom Patrol is infinitely bizarre and hilarious, yet no matter how weird things get or how many fourth walls are broken, it’s arguably the most relatable live-action superhero series you’re going to find.

Created by: Jeremy Carver
Cast: Diane Guerrero, April Bowlby, Matt Bomer
Number of seasons: 2

Six Feet Under on HBO

Six Feet Under

One of HBO’s very first original series remains one of its best. Premiering in 2001, Six Feet Under opens with the death of the Fisher family patriarch, Nathaniel (Richard Jenkins), prompting the return of his wayward son Nate (Peter Krause). Running a funeral home, the Fisher family is both uniquely capable and incapable of weathering the death of Nathaniel, and he continues to appear throughout the series in visions. Often funny, sometimes sexy, and always confronting difficult truths, Six Feet Under is a brilliant drama dealing with the one place we’re all going, and simultaneously the one place we’re unwilling to talk about.

Created by: Alan Ball
Cast: Peter Krause, Frances Conroy, Michael C. Hall, Lauren Ambrose, Rachel Griffiths
Number of seasons: 5

Shot from Deadwood

Deadwood

It will be a freezing day in a hot place before another Western series comes along equal to HBO’s Deadwood. David Milch’s frontier drama about a lawless camp that grows to become a part of the annexed South Dakota territory has its shoot-outs, but its focus is the lives of the townsfolk — from prostitute to doctor, from sheriff to petty crook. While in the beginning, you might think it will be the adventures of the noble Seth Bullock (Timothy Olyphant) that will occupy most of the show, the true beacon is Ian McShane as the poetically profane saloon owner and crime boss Al Swearengen. There is an intense Shakespearean quality to Swearengen, whose sometimes feverish monologues make him appear as much a Hamlet as he is a Tony Soprano. The rest of the ensemble shouldn’t be forgotten, including the alcoholic doctor played by Brad Dourif, William Sanderson as the hilariously treacherous E.B. Farnum, and Paula Malcomson as the fiery prostitute Trixie.

Created by: David Milch
Cast: Timothy Olyphant, Ian McShane, Molly Parker
Number of seasons: 3

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日本と桁が違う…!連日コロナのニュースで埋もれてしまってますが、医療の世界はブレイクスルー続き。アメリカでは、昨年1年間で臓器移植の実施件数がクリスマスの1週間前に4万件の大台に乗って、2019年の約3万9700件をしのぐ過去最高に達しました。最終的には年間41万5000件前後となる見込みで、1日に114人の命が救われた計算です。アルゴリズムがドナーと患者をマッチングこれだけの数を裁くのは容易なことではありません。移植先進国アメリカですら1954年の肝臓移植初成功からずっと30年も移植はだいたい同じ病院で繰り返されていました。近隣で移植待ちの患者さんが見つからなければ臓器はポイ、だったのです。転機が訪れたのは1984年。全米規模に拡大してマッチングを民間NPOに一任することが国会で決まり、UNOS(全米臓器分配ネットワーク:United Network for Organ Sharing)というところが全米57のOPO(臓器調達機関:Organ Procurement Organization)と病院からデータを集めて、アルゴリズムでレシピエント選定(血液型や抗体反応、大きさといった適応条件のすりあわせ)を進めるスタイルになって規模が拡大しました。2004年から2012年までは2万8000件前後で横ばいだったのが、2013年から50%近く急増。2020年には8週間移植できない期間があったので減少に転じましたが、それを取り返したかたちです。UNOSの地元メディアのRichmond Times--Dispatchが気になるマッチングの流れをくわしく取材しているのですが、アルゴリズムは常に改善していて、改定時には44人から成る理事会が審理にかけて承認しているんだそうですよ。アルゴリズムで考慮するのは、移植でどれくらい延命できるか、移植に持ちこたえられる体かどうか。有名人、金持ち、いい保険に入ってる人が優先されることはないとのこと。さらに次のようなデータまで追跡しています。・臓器待ち患者の数・臓器到着前に死亡する患者の数(病院別)・若い臓器、健康な臓器を選り好みする病院・医師・断られた臓器のその後(ほかの病院で移植に活用されたか)・臓器移植しない場合の患者の余命 医師が臓器を引き取りに行って直に検分しなくてもいいように、写真や映像で事前に臓器の状態を確認できるしくみも準備中。いろいろすごい。国民の過半数がドナーアメリカでは運転免許をとるとき「死後献体します」っていう項目を選ぶと、免許証に表示されて救急車の人がひと目でわかるようになっています。そんな手軽さもあってか、UNOSのBrian Shepard CEOによると、献体登録しているアメリカ人は5割をちょっと出るほどもいるんだとか。なんと国民の過半数がドナーだったのです! そういや訳者も永住組だけど、献体はYES選んでますもんね。ちなみにオピオイド鎮痛薬中毒で2019年だけで5万人が死亡したアメリカですが、薬物過剰摂取による死亡者(2020年は9万3331人)は献体増加分の1%ぽっち。COVID-19による死亡者も献体はできないので、やはりこんなどん底の混乱のなかで人の役に立ちたいと考える健康体ドナーが増えたことが大きいみたい。秋にはブタの腎臓を脳死患者に初移植、しっかり尿ができた!しかしまあ、これだけ国民の理解と協力、関連団体の尽力があっても1日約110人が移植待ちで、うち30人は臓器を待ちきれなくて死亡・病態悪化しているのが現実です。圧倒的な臓器不足。これをなんとかしようと医師らが目を付けたのがブタの臓器で。昨年9月にはニューヨーク大ランゴン移植研究所が初の移植手術に成功し、11月下旬の2度目の手術にも成功、大きな希望の光となりました。気になるレシピエントは次の2人の方々です。・9月:生命維持装置を外す直前の脳死患者。家族は「研究のためになるなら」と同意。・11月:人工呼吸器を外すと体機能を維持できないドナー希望者。NY一円に登録ドナー650万人を抱える非営利団体LiveOnNYの協力で探し当てた。腎臓は元の部位ではなく上腿の血管につなげて保護材でカバーしながら54時間経過を観察したのですが、2回とも拒否反応は出なくて、人間の臓器移植と同量の尿がすぐできました。手術を率いたRobert Montgomery医師は声明のなかでこう喜びを語っています。「2回目も初回手術の結果を再現できました。これにより、(拒否反応が出ないよう)遺伝子操作を加えた臓器が、命のギフトを待ちわびる世界中の人たちへの再生可能な臓器の提供源になりうることが引き続き示されたことになります」ほかの哺乳類と違って、人の臓器はα-gal(アルファガル)という糖分を生成できません。なので、生成できる臓器をできない臓器に移植するとどうしても拒否反応が出てしまうのですが、同大が移植で使ったブタの腎臓はα-galを生成しないように遺伝子が操作された臓器(遺伝子操作の部分はユナイテッド・セラピューティクスの子会社Revivicorが担当しました)。だからアレルギーを引き起こす心配がないというわけです。動物の臓器には抵抗を感じる人もいるかと思ったら、意外と世論調査では大多数の人が「広まれば支持する」と答えているのだそう。異種移植の実用化はまだ先のことだけど、臓器を待ちながらこの世を去る人がひとりでも減ってくれるのならこんなに励まされるニュースはありませんね!Sources: Richmond Times--Dispatch、 NYU Langone Health、Gizmodo US
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