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Growing Human Organs
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If there was ever a point in your career to unleash your inner magician, it’s at a TED conference, hands down. TED has emerged as the premier global event for satiating the intelligentsia’s appetite for the cutting edge and has made overnight rock stars out of numerous speakers. This year has turned out to be no different and may very well be Dr. Anthony Atala’s coming out event as he brashly demonstrated the tissue regeneration technology he has been working on for 20 years by using a 3D printer to generate a kidney on stage. Dr. Atala is THE man in regenerative medicine and a favorite at Singularity Hub, where we’ve profiled his work previously, but this year he went all out. We just had to provide an update on what he pulled out of his hat at TED.

In case you haven’t heard of him, Dr. Atala is the director of the Wake Forest Institute for Regenerative Medicine, the Chair and Professor of Urology, and a surgeon. He has spent 20 years working in the area of regenerative medicine – in other words, he is growing human organs. Reiterating some of his points from the TEDMED talk he gave in January of 2010 but under a time constraint, Dr. Atala can only give a zoo-tour treatment of years of research in his TED talk. He first shows an artificial heart valve that beats, followed by an engineered human bladder that was generated from a scaffold sutured together to match a 3D image of the organ. The scaffold was coated with patient cells and incubated for a few weeks in an oven at physiological conditions to generate a new bladder. Next, he shows the underlying vasculature of a liver that was produced by the washing away of cells from a salvaged liver, which can later serve as a template for patient liver cells to grow on. Finally, he turns to desktop ink-jet printers in which cells replace the ink and layer by layer, a 3D object can be printed in 40 minutes, such as a piece of bone implanted in a real patient. He then casts the vision of the future in which new 3D printers can be designed where a scanner would first create a relief-like map of a patient’s wound and then printing would be done directly on the atient to build up the layers of the regenerated tissue. Check out Atala’s TED talk below:

[youtube]http://www.youtube.com/watch?v=9RMx31GnNXY[/youtube]

At the two-thirds mark in his talk, Dr. Atala definitely had the audience’s interest, so it was time to build up the show stopper. He starts by saying, “90% of the patients on the transplant list are actually waiting for a kidney. Patients are dying every day because we don’t have enough of those organs to go around.”

He describes how they reconstruct the entire volume of a kidney from CT scans of patients, something that is becoming increasingly popular when engineering replacements for the body, and this information is processed to create scans of single layers, much like the slices from an MRI. These scans become the instructions for how the layers of cells are to be printed to generate a patient-specific kidney. Dr. Atala then reveals that there happens to be a printer on the stage and is about halfway through the 7-hour task of printing the kidney prototype. To show the audience what a bioengineered kidney looks like, the finished product is brought out that has the appearance of a raw chicken breast, but then again, it is made out of real human cells. When he shows the kidney to the audience, it gets its own applause. And showing it off is important because ratcheting up public attention about both the supply-demand problems of organs and efforts toward novel solutions not only justifies the funding of scientific research, but offers hope for many who are facing the prospect of joining the transplant list, even if this kidney is experimental and a clinical version is in the distance.

Now the search for new technologies to restore functional tissue has been possible because of three developments in the field, which Dr. Atala mentioned earlier in his talk. First, he highlighted that the challenge of designing suitable biomaterials for organ engineering. Biomaterials are important because they are shaped into a 3D scaffold which is then coated with actual patient cells one layer at a time to rebuild the organ. Second, he pointed out that it used to be difficult to grow human cells outside of the body, but numerous advances have made this trivial for most cells, with a few notable exceptions, including liver, pancreatic, and nerve cells. Finally, Dr. Atala stated that one of the greatest challenges in bioengineering has been recreating the vasculature of organs, but new fabrication techniques with biomaterials allows for vessels to be constructed. He even showed a slide from work in 1996 of a diseased and regenerated vessel in an actual patient using the biomaterial technology they developed.

While much of the media is focusing on the printed kidney in Dr. Atala’s hands, and erroneously reporting that it was a functional kidney, this was not his finale.

The wow moment came after a short video about Luke Massella, now a communications major at the University of Connecticut. As a child, he was born with spina bifida. At 10 years old and after a dozen surgeries, he agreed to an experimental surgery to receive a regenerated bladder from his own cells. He explains how after the surgery he became a wrestler and has been able to have a normal life. The video ends, the audience gives a standing ovation, and humbly Dr. Atala thanks the audience. That’s when the big reveal happened. Luke walks out on stage and talks about the experience in more detail, even getting choked up at one point reflecting on what the surgery meant for him. And this is why Dr. Atala is the man. He has spent a career developing tissue-fabricating technologies and his work is gaining more traction as the advances blow people away. But in the end, it’s about changing the course of a single individual’s life. While we’re in an era that is shaped by emergent technologies and the next big things, researchers like Dr. Atala that fuel innovation out of a tenacious desire to help people are the kind of minds we need at the helm.

Dr. Atala began his presentation saying, “There’s actually a major health crisis today in terms of the shortage of organs,” and laid out the scope of the crisis: “In the last ten years, the number of patients requiring an organ has doubled, while in the same time, the actual number of transplants has barely gone up.” With an aging population, this divergent trend is bound to continue so work in bioengineered organs is not just a cool demonstration of futuristic technology — it is desperately needed.
There's no stoppin' what can't be stopped, no killin' what can't be killed. You can't see the eyes of the demon, until him come callin'...
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