How 3D-printing organs could revolutionize medicine

Researchers and biotech companies working to revolutionize the field of tissue and organ engineering are making major medical breakthroughs thanks to 3D printing. 

Surgeons in San Antonio successfully transplanted a 3D-printed ear implant made from human stem cells onto a 20-year-old woman who was born with microtia, a rare birth defect in which the outer ear is deformed. 

3DBio Therapeutics, a regenerative medicine company, announced the landmark procedure last week as part of a first-of-its-kind clinical trial that includes 11 microtia patients. 

The process utilizes conventional 3D-printing techniques, where a computer model of the ear is fed into a printer. But instead of laying down materials such as plastic, metal or resin, a biocompatible material, or “bioink,” is used to build a scaffold that acts like a skeleton for the tissue being printed. The scaffold is then seeded with cells from the patient and cultured so cells can multiply. From there, the implant is transplanted onto a patient. Researchers say since the cells came from the patient’s own tissue the new ear is unlikely to be rejected by the body. 

While laboratory-grown ears and other tissues have been implanted in patients before, the recent announcement from 3DBio Therapeutics marks the first time a 3D-printed implant made from living tissue was used to replace a body part in a patient. 

“Up to this point in the field, there have been a number of tissues that have been engineered and implanted in patients. But these have been actually created by hand, one at a time,” Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine who is not involved in the study, said. Atala and his team successfully implanted the world’s first laboratory grown bladder in a patient in 1999. 

“What the printer does is it gives you several advantages. It gives you more precision and reliability because you can create the structures in the same manner every time. It gives you scalability because you’re able to produce more of them in an automated manner. And by doing so, it also gives you a decreased cost of the products,” he said. 

The microtia procedure is among several recent advances in organ and tissue engineering and could pave the way for more ambitious projects, such as the eventual 3D printing of more functional tissues or organs such as livers and kidneys for transplants, although researchers emphasize successfully doing so is still far out in the future. 

But earlier this month, a separate company called United Therapeutics revealed it produced a 3D-printed human lung scaffold that could be seeded with a patient’s own stem cells to create tolerable, transplantable human lungs that would not require immunosuppression to stop the body from rejecting the organ. The ultimate goal is to create an unlimited supply of transplantable lungs in the future. The company called it the “world’s most complex 3D-printed object” and expects human clinical trials in the next five years, a goal Atala says is achievable. 

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The technology in the coming decades could be a gamechanger for the roughly 10,000 organ transplants that occur annually and the more than 100,000 people standing by on waiting lists.

“There’s millions and millions of people who just can’t get on the waiting list because they don’t qualify. So there’s really a need for organs,” Adam Feinberg, co-founder of regenerative medicine company FluidForm and professor of biomedical engineering and materials science and engineering at Carnegie Mellon University, said.

Feinberg said his lab at Carnegie Mellon in 2010 started adapting 3D printers for bioprinting as patents for plastic printers were expiring and companies began making cheap, open source desktop printers. 

“Suddenly there was all this innovation. And the question I asked my students was, can we use this to build a bioprinter because existing bioprinters at the time were like a quarter million dollars, which is not realistic,” he said. 

Feinberg helped develop a form of 3D bioprinting called FRESH, which involves engineering tissue in a support gel to keep the structure secure during printing. FluidForm has since used the process to build parts of the human heart, including ventricles, valves and blood vessels. 

FluidForm is working on building functional parts of the human heart to help the biopharma industry develop better drugs to treat different kinds of cardiomyopathy, heart failure, arrhythmias and other heart conditions. Feinberg said the work is important as there’s currently no good model for developing new heart drugs. 

“Heart disease is still the leading global cause of death, so developing better drugs is pretty critical,” he said. 

The company is also developing 3D-printing technology to build scaffolds to heal wounds that are too large to heal on their own. 

Over at Stanford University, Mark Skylar-Scott’s team is using 3D-bioprinting processes to manufacture heart and vascular tissue. Researchers are hoping to help treat congenital heart defects in children. 

“I think while the dream of tissue engineering has lived on, its ability to really create tissue is only really starting to look like a real possibility,” Skyler-Scott said. 

“And thanks to decades of work by pioneers in the field, we’re starting to see these therapies entering clinical trials, which is very exciting,” he said. 

Skylar-Scott, assistant professor of bioengineering in the schools of engineering and medicine at Stanford, noted that while progress has been made on easier targets and clinical trials of simpler tissues, such as the outside of an ear, are moving forward, it will still likely be decades until there is whole solid organ printing. 

“But that doesn’t mean we shouldn’t be laying the groundwork now. There is real reason for excitement in the field. These technologies are changing the game.”

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