Artificial Organs: The Organs of The Future
By Yash Laddha
What are Artificial Organs?
Artificial organs, also called synthetic or bioengineered organs, are laboratory-grown replicas of natural organs designed to replicate their structure and functionality, utilizing biomedical technologies such as tissue engineering, regenerative medicine, and 3D bioprinting. Artificial organs serve as replacements or supplements for malfunctioning or absent organs in the human body, aiming to restore, duplicate, or augment specific functions upon implantation.
According to the materials used, artificial organs can be divided into three main classes: (1) mechanical, made of polymers (i.e., plastics) and/or metals (2) biomechanical, made of partially living cells and inanimate polymers and/or metals; and (3) biological (i.e., bioartificial), made of living cells, biodegradable polymers and/or metal elements. Normally, the former two classes can only partially and temporarily replace and repair the failed organs in the human body, while the biological class can totally and permanently restore defective/failed organs.
Examples of artificial organs include the artificial heart, pacemakers, prosthetic limbs, artificial pancreas, and cochlear implants.
Need for Synthetic Organs
Synthetic organs enable patients to resume normal lives as soon as possible as they offer life support to patients awaiting a transplant (e.g. artificial heart); improve a patient’s ability for self-care (e.g., artificial limb), social interaction (e.g., cochlear implant), or quality of life post-accidents.
Organ failure is the leading cause of mortality all over the world. According to the United Nations, around 15% of the global population lives with disabilities. The World Bank has reported mortality rates of up to 80% among disabled children in multiple nations. Additionally, data from the National Organ and Tissue Transplant Organization (NOTTO) in India shows that the number of patients awaiting organ transplants (over 300,000) far exceeds the number of available organs (16,041 donations were recorded in 2022). This highlights the critical need for synthetic organs, which offer significant benefits to these populations and can pose a solution to organ donor shortages.
How are Synthetic Organs Grown or Manufactured?
Organ manufacturing involves designing, preparing materials and tools, seeding cells or integrating them, and maturing the tissue. To produce a scaffold for tissue regeneration, researchers use techniques such as 3D printing and decellularizing tissue. With 3D printing, scientists can create scaffolds that mimic the extracellular matrix and incubate them for cell proliferation and maturation. Decellularized tissue techniques involve removing cells from pre-existing organs while maintaining the extracellular matrix. After this stage, the scaffolds are prepared for surgical implantation to replace the faulty organ.
Examples of Artificial Organs
Synthetic organs have been a topic of research and development for many years. As a result, several biotech products and services have been developed in this field. Three such products are:
Artificial Heart: An artificial heart serves as a device to replace a malfunctioning or failing natural heart. Typically, it is employed as a temporary measure to support patients while they await heart transplantation surgery. However, ongoing research aims to develop permanent artificial heart devices for situations where a suitable human heart transplant is unavailable or not feasible. As of December 2023, two commercially available full artificial heart devices exist, both intended for temporary use, typically less than a year (Soft Artificial Heart and BiVACOR Artificial Heart), for patients with total heart failure awaiting a suitable human heart transplant. The first successful implantation of an artificial heart in a human occurred in 1982 with the Jarvik-7, designed by a team including Willem Johan Kolff, William DeVries, and Robert Jarvik.
Artificial Lung: An artificial lung (AL) mimics natural lungs, providing oxygenation and CO2 removal. Unlike temporary heart-lung machines, ALs are for long-term use. Initially inspired by the heart-lung machine, Extracorporeal Membrane Oxygenation (ECMO) bridges to lung transplant. Mechanical Ventilation (MV) can harm the lungs over time. Advancements include simplified ECMO systems and devices with hollow fibres mimicking alveoli. Research teams at institutions like the University of Pittsburgh, University of Michigan, University of Maryland, and Boston are developing AL devices for lung transplants.
Cochlear Implants: In cases of profound deafness or severe hearing impairment, cochlear implants are surgically implanted to provide a sense of sound by avoiding the peripheral auditory system. These implants consist of external components, including a microphone and electronics, which transmit signals to electrodes placed in the cochlea, stimulating the cochlear nerve. Recently, researchers at Massachusetts General Hospital, led by Thomas Cervantes, developed an artificial ear from sheep cartilage using 3D printing technology.
Ethical, Legal and Social Issues
The adoption of artificial organs raises ethical, legal, and social concerns including safety, efficacy, accessibility, and affordability. Regulatory agencies like the FDA evaluate their safety before clinical use.
Ethical Issues: The use of artificial organs poses ethical dilemmas regarding their role in prolonging life and enhancing quality of life, and whether their use aligns with patient values. Allocation concerns arise regarding who should receive these devices and how decisions are made. Furthermore, issues of informed consent, privacy, and patient autonomy regarding healthcare decisions are important.
Legal Issues: Legal considerations include determining liability in case of device malfunctions or harm to patients. Regulation and oversight are essential to ensure the safety and efficacy of artificial organs, raising questions about the appropriate regulatory framework and oversight bodies. Intellectual property rights are also relevant, determining ownership of the technology and fair compensation for creators.
Social Issues: Access to artificial organs raises concerns about equity and fairness, questioning whether these devices will be available to all or restricted based on affordability. Artificial organs could change how society views humanity and life, affecting social norms. The impact of technological advancements on employment in the healthcare industry and the broader economy requires careful consideration.
Conclusion
In conclusion, artificial organs are organs designed to replace or support the function of a natural organ in the body. They hold great potential in addressing the critical need for organ replacement in patients suffering from organ failure. They not only offer life support to patients while they await organ transplantation but also improve the quality of life for patients with disabilities. However, their adoption raises important ethical, legal, and social concerns that need to be addressed. With ongoing research and development in this field, it is hoped that synthetic organs will continue to evolve, offering more effective and permanent solutions for organ replacement and repair.
