Updated: Oct 2
By: Natalie Oulikhanian
The demand for organ donations have significantly increased across the globe. With growing cases of organ failure and an unavailability of suitable organs, it is common to see that the waiting list of those who need a transplant are often far longer than the list of those willing to donate. As a result, a growing trend exists where patients are being added to the waiting list, often for long periods of time, and where several of those waiting, die on the list. In America alone, a patient is added to the already large transplantation list of over 120,000 patients every ten minutes. These patients must obtain an organ compatible with their specific situation. For example, a valid organ must match a patient’s blood type, size, severity for a transplant, and the proximity from a possible organ to them. Accepting an organ that does not match all these requirements is a risk to the patient’s health, which might be presented through the physical response of organ rejection. Having a consistent supply and production of compatible and effective organs whenever there is a need will eliminate the shortage. As of right now, the only way for organs to become available is to wait for a transplant from living or deceased donors. However, revolutionary 3D bioprinting technology that can be used to manufacture artificial organs may offer the solution to transplantation of organs outside the need for donations.
New breakthroughs in 3D printing seem to always make headlines. For example, the first 3D printed house and school was printed in Africa in a fraction of the time and money it would typically cost. With further involvement from the operations, the technology can benefit in combating the growing housing issue in Nigeria. However, there is a key obstacle between the printers that are most commonly used and ones that need to print living objects. The creations that typical 3D printers create use artificial and abiotic materials: perfect for creating houses, but not as much when forming complex organ structures for a living person. Using similar methods that traditional 3D printing machines use, “bioprinters” aim to use biomaterial to create living entities. These printers are able to move in all three dimensions where they will distribute different types of materials in a process of layering known as “additive manufacturing”. With this, organs can be printed as soon as there is a need for one, reducing the necessity built upon donors in the organ transplantation crisis. Further, these “artificial organs” reduce the chance of organ rejection and can ensure compatibility between the recipient. This is due to the bioprinter’s ability to incorporate a patient’s own cells as the building blocks of a new organ and the lack of necessity of donor’s organs which might completely be discarded as a potential transplant due to factors like size. Ensuring this compatibility can save the 17 people that die each day in America alone, waiting for an agreeing transplant.
The process in 3D bioprinting falls under the general three steps of: pre-bioprinting, the bioprinting process itself, and post-bioprinting, which maintains the structure of the object. In the first, a model of the patient’s organ is designed or scanned from procedures such as an X-ray or an MRI scan, rather than a digital file which is commonly used in abiotic 3D printing technology. The material which will be used must also be determined in this step. The biomaterial, such as living cells, are retrieved in large quantities from the patient’s needed organ to form a liquid substance known as “bio-ink”. If the required cells are not available, researchers are able to take advantage of adult stem cell’s important ability to develop into the needed cells in different tissues. In either circumstance, the slurry of cells and a synthetic glue that provides nutrients, oxygen, and stabilisation, are loaded into the printer.
After the bio-ink is applied into the printing cartridge, the researchers are able to print out the ink into geometries which cannot be done with other techniques besides 3D printing. This portion of the process can be completed using a variety of different methods that are differentiated by the biomaterial used or the additional technology involved. These common methods often fall under one of the three categories: extrusion, droplet-based, or laser-based. Each of these procedures have different techniques of delivering the bio-ink using the power of other technology, such as the abilities of a laser in laser-based printing.
Once the structure of the future organ is built, the object will then go through an incubation period inside a pool of nutrients. This process works similar to the baking of a layered cake. Instead of ingredients forming chemical reactions under heat, this period of time will allow cells to seek out other cells around them and become interconnected to the point of forming an efficient tissue, or a finished product.
A major obstacle which researchers aim to overcome is the complexity of organs that require transplantation. Although advancements are occurring at a rapid rate, it is only simple organs that have shown evident success in the research community. For example, the skin’s structure being multilayered is incredibly suited to 3D bioprinting technology which prints in layers. This opportunity has already been taken advantage of where researchers in North Carolina have designed a successful printer that can print skin cells directly over wounds to help treat burns. In comparison to surgical procedures that don’t involve bioprinting, the researchers only needed a patch of skin a tenth of the size of the burn. Similar in lack of complexity, artificial blood vessels have seen success in the bioprinting world, possibly replacing the lengths of veins, arteries, and capillaries in a human body if they ever do begin to fail. The most in-demand organs for transplant, being largely kidneys followed by livers, hearts, and lungs according to the Health Resources and Services Administration of America, are contrastingly much more complex. These desired organs drastically involve more complicated and interconnected processes which require a variety of structures and cell types, making it harder for researchers to replicate. Amazingly, major breakthroughs in bioprinting might be able to help provide these intricate and requested organs. Bioengineers have successfully printed out a tiny fully functioning liver which can rest on the flat of your fingers, and although it only survived for five days, the progress that was made can form a solid starting point for further research on extending its life expectancy. In the University of Minnesota, researchers have printed a human heart pump, and although at a centimeter scale, this discovery can have colossal impacts for solving heart disease and heart transplants.
The possibility of reducing the need for organ donations may be far closer than we think, but we still have a long way to go. Groundbreaking advancements in 3D bioprinting are becoming far more common, however, the human body is incredibly complex and replicating its process is difficult. Although functioning internal organs in a human scale has not quite been accomplished, these developments might be able to help problems of a closer reach than complete transplants. For example, the use of the printed organs or organoids can provide the research and medical community significant help in testing or practice procedures outside of animal testing or unrealistic models. These printed organs might not be able to provide a complete replacement to organs unlike donations just yet, but their production can also help reduce the chance of imminent death while waiting for a transplant. Many individuals can have their quality of life significantly increased if a replacement increases their organ function by several percent. When working with the intricacy of living objects and the early stages of a new technology, it will probably not be for a long time that this technology becomes a common procedure. However, the potential between using a variety of fields such as engineering and medicine is evident. There is no doubt that the future of medicine and organ transplantation will change with the accomplishments bioprinting is able to accomplish.
Q: What is bioprinting and how does it work?
A: Bioprinting is a novel new technology that uses traditional 3D printing techniques to develop living entities. Rather than the use of plastic or other abiotic materials, these bioprinters use living materials such as cells in the printing process. Researchers develop a model of the object they want to replicate, often an organ, and the biomaterial is then layered on each other from bioprinter nozzles. The result is a fully printed living object completely formed by mechanical processes.
Q: How can bioprinting help the organ transplantation crisis?
A: Currently, the source for organs for transplantation come from either living or deceased donors. This creates a huge shortage in the amount of compatible organs that are available to those that need them. Being able to print a production of suitable organs without the chance of organ rejection and without the necessity of other humans, can help save hundreds of thousands of people’s lives and well beings.
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