Meet the man who will print you a new organ

Anthony Atala is the director of the Wake Forest Institute for Regenerative Medicine, where his work focuses on growing and regenerating tissues and organs. His team engineered the first lab-grown organ to be implanted into a human and is developing experimental fabrication technology that can "print" human tissue and organs on demand.  Foreign Policy has named Dr. Anthony Atala as a 2017 Global Thinker. 

I talked to him about the potential of 3D organ printing and when we could engineer new heart, kidney and lungs.

What is the potential of 3D organ printing?

The potential of 3D organ printing is to improve people’s lives for the better. It is estimated that every 30 seconds, a patient dies from a disease that could be treated with tissue replacement. There are simply not enough donor tissues and organs to meet demand. Regenerative medicine offers the hope of engineering replacement organs in the lab to solve this shortage. Because these organs would be made with a patient’s own cells, there would be no issues with rejection as there are with organs from donors.

What are the current challenges?

We have now implanted several tissues and organs in patients using engineering strategies, but these have been created in the lab by hand. We know that to make these treatments more widely available we must scale up the manufacturing process. We have turned to 3D printing as one way to accomplish this and over many years our scientists have developed the Integrated Tissue and Organ Printing System.

Our research with ITOP has proven that it is feasible to print human scale living tissue structures. We have optimized the water-based “ink” that holds the cells so that it promotes cell health and growth and we printed a lattice of micro-channels throughout the structures which allow nutrients and oxygen from the body to diffuse into the structures and keep them alive while they develop a system of blood vessels.

What’s your aim?

Our Institute’s mission is to develop regenerative medicine therapies to improve patients’ lives. Our ultimate goal is to help solve the shortage of donor organs and tissues that are available for transplantation.

What organs and tissues are you able to 3-D print currently?

Our team is working on a variety of tissues and organs, including trachea, bone, cartilage, muscle, kidney and ear. Our research has shown that 3D printed bone, muscle and cartilage structures, when implanted in animals, developed a system of nerves and blood vessels and integrated with the body. These are all in the research stage and not yet ready for patients.

When do you think the lab-engineered tissues and organs could be used in patients?

Some of our lab-engineered tissues and organs have been used clinically in patients, but as part of small studies to prove feasibility. Much of our work is still in the pre-clinical research phase and making progress.

When do you think we could have heart, kidney, and lungs as replacement organs?

We have not yet been able to engineer the most complex organs which are solid organs such as the kidney, liver and heart. These are the most challenging because they are dense with cells and have high oxygen requirements. We do not make predictions about how soon a new treatment might be available because science itself can be unpredictable.

When do you think we could have heart, kidney, and lungs as replacement organs?

We have not yet been able to engineer the most complex organs which are solid organs such as the kidney, liver, and heart. These are the most challenging because they are dense with cells and have high oxygen requirements. We do not make predictions about how soon a new treatment might be available because science itself can be unpredictable.

When do you think lab-grown penises will be available to men?

Our team is working on a procedure to replace damaged erectile tissue. Currently, there are reconstructive procedures available for men with congenital abnormalities or damaged or diseased penile tissue. However, with these surgeries, the natural erectile function is not possible. With the treatment being developed at the Institute, donor erectile tissue is being used as a “scaffold.” Cells are removed from this tissue and replaced with a patient’s own cells. This engineered erectile tissue would be used as part of the reconstructive surgery to fashion a new penis. As you can imagine, this is a fairly complex surgery.

What about the 3-D printed ovaries? This year we have seen that they helped mice to get pregnant. When would this technology be available for women?

Scientists at the Institute recently announced that new research in rats suggests the possibility of bioengineering artificial ovaries in the lab to provide a safer, more natural hormone replacement therapy for women. Reporting in Nature Communications, the research team suggests that the cell-based system of hormone replacement, because of its ability to match dose with the body’s needs, is an attractive alternative to drugs and is consistent with current guidelines in the U.S. and Europe recommending the lowest possible doses of hormone replacement therapy.

A future step will be to determine if the treatment is effective in women and if donor cells are a safe option.

What does the “body on a chip” project include?

The body on a chip is basically a miniaturized system of human organs to model the body’s response to harmful agents and develop potential therapies. Human cells are used to create tiny organ-like structures that mimic the function of the heart, liver, lung, blood vessels, etc. Placed on a 2-inch chip, these structures are connected to a system of fluid channels and sensors to provide online monitoring of individual organs and the overall organ system.

This research is supported by the Defense Threat Reduction Agency with the intent to test the body’s response to chemical and biological warfare, but it can also be used to test the effects of new drugs.

How could it benefit people with diseases like cancer?

In addition to working on systems with additional organs, we are also working on “tumors on a chip.” By using a patient’s own cancer cells to grow micro-tumors in the lab, we aim to predict how patients would respond to treatment in order to optimize their care. The model can also help predict where a patient’s tumor is likely to spread.

How do you see the future of regenerative medicine?

The future of medicine, especially where it intersects with regenerative medicine, is very exciting. At our Institute, we are working to develop cell therapies and replacement tissues and organs for more than 40 different areas of the body. Projects range from blood vessels to kidneys to cell therapies for lung disease and hemophilia. We are pursuing multiple strategies, including 3D bioprinting to move our projects forward to meet our ultimate goal – making patients’ lives better.

If the human regeneration holds the potential to rejuvenate, heal, or completely replace damaged tissue and organs, what impact do you think it will have on how we think about aging and death?

Our approach to regenerative medicine is to improve people’s lives. The intent is not to prolong lives necessarily, but to ease suffering. For example, someone experiencing kidney failure will someday, hopefully, be able to have a new kidney made from their own cells implanted which means no rejection or the need for anti-rejection medicines for the rest of their lives.