Luke Massella was born with spina bifida, a condition that left a gap in his spine. By the age of 10, he had undergone a dozen surgeries and, contrary to doctors’ expectations, was able to walk. But then his bladder malfunctioned, causing his kidneys to fail.
Dr. Anthony Atala of Boston Children’s Hospital had a better idea. He took a small piece of Massella’s bladder and, over the course of two months, grew a new organ in the lab. The new bladder was transplanted into the patient in a 14-hour surgery and, according to Massella, he has been able to live a normal life since then. Now 27, Massella underwent 17 surgeries before he was 13, but has not had to have a single operation since then.
“I was kind of facing the possibility I might have to do dialysis for the rest of my life,” he says. “I wouldn’t be able to play sports, and have the normal kid life with my brother.”
Dr. Atala is an expert in bioprinting, and he and his team have developed eight cell-based tissues that they have transplanted into patients. These include skin, urethras and cartilage grown in the lab. The organs are currently going through clinical trials for approval by the US Food and Drug Administration.
“You need to know how to make these organs by hand, then the bioprinter is really a scale-up tool,” said Dr. Atala, now Director of the Wake Forest Institute for Regenerative Medicine in North Carolina.
According to Dr. Atala, the easiest structures to 3D print are flat structures like skin, followed by tubular structures like blood vessels and urethras. Hollow, non-tubular structures like bladders are more difficult – Massella is one of 10 people who currently has a bladder grown from his own cells. The most difficult of all are solid organs like hearts, lungs and kidneys, which have “so many more cells per centimeter,” Dr. Atala said.For a patient like Massella, technology like that Dr. Atala is working with allows a safer transplant, with much less risk of rejection. Massella, who feared he would never be able to have a normal life, went on to become a wrestling coach and now runs events in the jewelry industry.
Massella’s case was an early example of what tissue engineering can accomplish, but advances in bioprinting are making such cases more common.
“A lot has happened in the last couple of years,” said Steven Morris, Chief Executive of bioprinting startup BIOLIFE4D.
BIOLIFE4D has become known as the startup that plans to be the first to 3D print a functioning human heart – and it is getting closer to its goal. Initially, the company will be printing smaller versions of hearts to be used for pharmaceutical testing purposes, but its ultimate goal is to be able to print organs that can be transplanted into patients. That is the dream of most bioprinting companies and research institutions, and while some still doubt that it can be done, the technology is getting closer every day.
Patients like Massella are evidence that functioning organs are possible to create in the lab, and one day – perhaps sooner than anyone expects – cases like his may become much more commonplace. Will we ever be able to eliminate organ donor waiting lists thanks to bioprinting? It’s not nearly as impossible as it once seemed. Generally most practicioners in the field see true 3D printing of organs as something that will happen some 20 to 25 years from now. Approvals, developing all of the tools and assessing long term risk will all take time. We’re still very far from this becoming a day to day procedure for many people. The signs are encouraging however that bioprinting will lead to improvements in patient’s lives.
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