3D Bioprinting is the Future of Transplants

With the invention of 3D bioprinting, organ transplants will not only be more common but more suc

Imagine a world where there was no organ donor waiting list. A world where you would be able to get the organ you needed straight from a printer. According to Quartz, a Philadelphia-based company, BioBots, has released a printer that lets users 3D print human tissue and (potentially) human organs. In May of 2014, BioBots publicly launched at TechCrunch Disrupt in New York and printed a replica of Van Gogh’s ear for everyone to see. Currently, the printer works with a liquid mixture of different cells called “bio-ink.” This liquid is pressed through an extruder and fused together on the printer bed using blue light. A representative from the company told Quartz that the system could print out an object that has blood vessels and organ tissue at once, and the goal is to use this to create livers for drug testing and skins for cosmetic testing. This would eliminate the need for testing on humans and animals. However, BioBots isn’t the only company to create 3D printing for organs. 

3D printing, in general is used for creating tissue and organs, customizing prosthetics and anatomical models, and pharmaceutical research. While we can print tissue, research is currently being conducted on artificial hearts, kidneys, and liver structures, as well as other major organs.

In 2003, Thomas Boland of Clemson University patented the use of inkjet printing for cells. His technique involved a modified spotting system for the deposition of cells into organized 3D matrices placed on a substrate. Since this step forward, 3D bioprinting has evolved and now involves the production of tissue and organ structures instead of cell matrices. There has also been research into extrusion 3D bioprinting and how it can be incorporated into the production of organs. The only organs that have been printed in a clinical setting are flat (skin), vascular (blood vessels), or hollow (the bladder). Other organs are a little too complex for current printers to handle, so these basic organs will have to do for now. However, the organs prepared for transplants are often produced with the recipient's own cells. Similar to BioBots, the company Organovo produced a human liver using 3D bioprinting, but it can only be used for drug testing. The next step in organ printing is for the organs produced to be used for transplants.

How Does 3-D Bioprinting Work?

Image via Carnegie Mellon University

There are many benefits to 3D bioprinting, including the fact that we will be able to mass-produce working organs for those who need them. Scaffold structures are used to achieve this because this technique resembles the microstructure of a natural organ or tissue structure. Two of the most prominent types of organ printing are drop-based bioprinting and extrusion bioprinting. Drop-based bioprinting creates cellular constructs using individual droplets of a designated material, which has oftentimes been combined with a cell line. Although it is used because of its efficient speed, this aspect makes it less suitable for more complicated organ structures. On the other hand, extrusion bioprinting involves the constant emission of a particular printing material and cell line from an extruder, which is a type of mobile print head. Since extrusion bioprinting tends to be a more controlled and gentler process for material or cell creation, it allows for greater cell densities to be used to create 3D tissue or organ structures.

However, there are still a lot of setbacks when it comes to printing 3D organs that will actually work. Unfortunately, cell creation from 3D bioprinting is conducted in an artificial environment that lacks natural biological signaling and processes. The lack of these qualities affects the way 3D printers create organs and changes up the cellular morphology. When present, these conditions allow the printed organ to more accurately mimic in vivo conditions and adopt the corresponding structure and function, as opposed to growing as a shaped scaffold of cells. Another challenge is the need to vascularize artificial structures for cellular sustainability. Vascular structures like blood vessels along with artificial vascular constructs allow for the diffusion of key nutrients and oxygen. However, they have not been fully integrated into the technique of 3D bioprinting.

Is 3D Bioprinting Ethical?

Image via The Huffington Post

Then there are the ethical issues. Pete Basiliere, research director at Gartner, said that 3D organ printing “raises a number of questions that remain unanswered. What happens when complex 'enhanced' organs involving non-human cells are made? Who will control the ability to produce them? Who will ensure the quality of the resulting organs?” ABC Science reports that another ethical issue with 3D printing is the cost. Should these printed organs only be available to those who can pay the predictably large cost? If so, then those patients who don’t have money may not receive the organs they need in time. Also, how we can test that the treatment is safe and effective before it is offered as a clinical treatment? We couldn’t transplant these organs into animals because we don’t share the same exact organs as they do. However, one of the most important issues is whether or not we should use 3D printer to enhance humans.

As ABC Science points out, “If the technology can be used to develop replacement organs and bones, couldn't it also be used to develop human capacities beyond what is normal for human beings?” We could potentially replace our bones with a stronger substitute so that they won’t break. We could replace our muscle tissues with enhanced tissue that is stronger and less likely to wear out so that we can keep going longer. We could print new lungs that oxygenate blood better than our current lungs do. Athletes could easily replace any body part that isn’t working the way they want it to so that they can be better at their sport. Ultimately, we could enhance ourselves so much that we could elongate our lifespan or never die. If we did this, would we continue to be human?

3D printing for organs is a wonderful technique that can benefit us when it comes to replacing failing organs. Potentially, the organ waiting list could be erased and people would just print the organ they needed. At the point in time, we can print the less complex organs like skin and bladders but we still have a lot of advancements to make before we can print something like a heart. However, there are a lot of ethical issues that come with this since we can potentially create organs that work better than the ones we were born with. If that happens, people could enhance themselves until they became something like the mutants from the X-Men universe. Ultimately, we— as a society— must decide what is ethical when it comes to the future of transplants.

How Will 3D Bioprinting Be Integrated Into the Current Donor System?

Image via Medical Daily

Decades have passed since the first successful organ transplant occurred. The first successful transplant took place in 1954 with the donor being an identical twin of the receiving patient. Many successful organ transplants have occurred over the years as medical expert venture into discovering the most effective way of carrying out organ transplant without or with less harm to both the donor and the receiver. Jaboulay and Carrel first developed the technique required to perform vascular anastomoses around 1906 with Jaboulay being the first to make an attempt on human organ transplant. Organ transplantation has been as the process of surgically transferring a donated organ into a patient with end-stage organ failure.

Medical developments in the field of organ transplant continue to grow as the demand of organs for transplant keeps increasing. New improved methods and medicine are on the market, and have played a huge part in the saving of many lives for half a century since the first successful organ transplant. This will greatly aid in the enduring efforts of the medical experts who have dedicated their lives in saving humanity in the best way they can. 

The pursuit of successful organ transplant will make one appreciate the tireless efforts of men and women who dedicated their time in saving humanity. Continuous improvement in medical technology, particularly in relation to tissue “rejection” have brought about expansion of the practice and an increase in the demand for organs.

In the 1950s oncologists were evaluating drugs, including nitrogen mustard and 6-MP, for treatment of malignancies. Their findings were that 6- MP reduced the antibody response to bovine albumen and they made a report in 1960 that the drug modestly extended the survival of skin homograft. This result motivated Calne on his research on 6-MP and its derivative azathioprine. He demonstrated that in a canine kidney transplant rejection could sometimes be delayed substantially when the 6-MP and its derivative are stimulated. Calne’s observation led the Brigham team to use 6-MP and its derivative in a human Kidney recipient. Despite the achievements in canines, the results in humans, leading asking the question of what's next.

How Do We Stop Organ Rejection?

Image via Line Space Shape

The major problem associated with implanting an organ is the tendency of the body’s immune system to become activated against the “foreign” organ and to mount a response designed to kill the invader. To find a way to prevent rejection, patients are often given strong medications to suppress their entire immune system that in turn, leave them susceptible to life threatening infections. The immunosuppressive drug Cyclosporin was introduced in 1978 by J.F. Borel, that saw many of the problems of rejection controlled. Cyclosporin was initially developed as an anti fungal drug, and was found to be toxic in rodents and was noted to permit skin grafts between them. Cyclosporin dramatically improved the results of kidney transplantation, to the degree that 90–95% of kidney transplants on Cyclosporin survived at least 1 year longer than without. It also provided sufficient immunosuppressant to permit successful liver, pancreas, heart, and lung transplantation.

Medical developments keeps increasing and improving as demand for organs keeps on increasing. Medical practitioner from different field, surgeons and oncologist, have made efforts to come together in ensuring successful organ transplant, hopefully with the help of 3D bioprinting.

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3D Bioprinting is the Future of Transplants