LET’S PRINT OUR ORGANS!
We all have dreamt of a magical pencil, one using which whatever we draw comes to life. But what if we realise that now there is something that has made this dream a reality. We are talking about 3D printers that can bring your wishes to life. 3D printers work on the mechanism whereby you upload a design into the computer which after understanding it gives command to the printer. With help of the printer’s precision tool the design is made step by step into the 3D design we initially uploaded in the computer. It has been quite a recent invention as it was first introduced in 1981, but it has made significant development in its usage since then. The latest and the most talked about advancement is the introduction of a 3D bioprinter. It is a printer that can print from a basic biological cell to a well functioning organ. Is it true! Just like that, a lot of problems faced by scientists and doctors are solved? What does it mean? Does it mean we don’t need to have long waitlists for transplant? Does it mean we can make a genetically similar organ for ourselves? Does it mean no more organ rejections?
Yes, 3D bioprinting has opened the possibility for so many things that everyone is in awe. But we first need to see how it all started. The first bioprinting was done in 1988 by demonstrating 2D micropositioning of cells. By 2001, there was a 3D bioprinter with us, but it was in 2004 that we could print a tissue but that too had only cells and no scaffolding. In 2009 we had scaffold free vascular models and in 2016 cartilage models were obtained. It was finally in 2019 a cardioid structure was bioprinted. Scientists had also worked on in situ bioprinting on animals.
The whole process of bioprinting can be divided into 4 steps- Data acquisition, material selection, bioprinting and functionalization. During the data acquisition phase, information regarding the design required is gathered. X rays , CT scans, MRI scans and other 3D models can be used. Once we have the data we work on selecting the material appropriate for the structure. These are known as bioinks, it is a mixture of biomaterials. It is a crucial step in deciding biocompatibility, printing and mechanical property. Then bioprinting is done, making sure all configurations are right. Finally functionalization occurs, which means making connections between the cells so that it functions as a tissue or organ respectively. The general bioprinters we use prints droplets, but another kind of bioprinter is available, known as extrusion based bioprinters. These bioprinters make filaments by using continuous extrusion forces. This makes it versatile and affordable as compared to other bioprinters.
Now what are the uses of bioprinters? The initial use can be generating cells to study basic characters like growth, mutations, functions and intercellular relationships. This use can be further extended to tissues and organs. It can also be used to study tumorigenesis from mechanism to life cycle of a tumor. It is also a great development in helping to find the functioning of drugs, its pharmacokinetics and pharmacodynamics. The cells it targets and the reactions it creates can all be studied in detail. Finally, the most important use of bioprinters is printing tissues and organs for transplant. We have received success in printing, skin, bones and cartilage, nerves, blood vessels, muscle and tendon, adipose tissues and organoids in the lab.
Bioprinted organs aren’t still completely approved for use in humans but we have two cases that give hope for a bright future for these bioprinted organs. First is the bioprinted bladder that has been transplanted in a patient of spina bifida with defective bladder. The bladder was made by Dr Anthony Atala, in Boston Children Hospital using the patient’s bladder tissue. The printer was used to build a kind of scaffold for the cells. The bladder grew in 2 months, it was transplanted in 2004 and is still functioning properly. Another latest development in the field was an ear transplant surgery in a 20 years old woman with a small and misshapen ear. It took place in 2022. There haven’t been many successes in the field because printing organs is a difficult job, especially solid organs but there is scope for a lot of development in the field.
What are the advantages of these printed organs? If we are able to print fully functioning and sustainable organs, it will reduce a lot of problems of organ transplantation. First of all, we will be able to get organs without long waitlists and survival rates can be improved. As per a survey in the USA, roughly 17 people die daily because of not receiving an organ on time. This rate can be reduced exponentially with bioprinted organs. As the organs are generated using the patient’s own cells, there won’t be any problem of organ rejection. Along with this it will also solve the problem of lifelong immunosuppressive drug use, which is required in normal organ transplant. It reduces the ethical conflicts related to organ donation and will reduce organ trafficking considerably.
Whatever comes with advantages also has some or the other disadvantages attached to it. Firstly, it is a very complicated and intricate process. It is very difficult to plan a design for these organs along with the vasculature required to keep this organ functioning. This problem leads to another and that is, if making these organs is difficult then it will also be very expensive. So even if it becomes a reality, it will only be affordable by the rich people. We also don’t know how efficient these organs are and how many years of survival it can provide. Along with all this, ethical doubts like use of bioprinting in cloning are also raised, making its introduction controversial.
In conclusion, bioprinting of organs holds a lot of possibilities but only if it is discovered with care. It has a long way to go from resolving technical problems to resolving ethical issues. But as healthcare professionals we can only hope that it turns into a great success, because it can change the life of many. We hope for a bioprinting revolution for the medical sector.
REFERENCES
https://www.nytimes.com/2022/06/02/health/ear-transplant-3d-printer.html
https://www.sciencedirect.com/science/article/pii/S1818087619311869