The Future of Regenerative Medicine: Integrating 3D Bioprinting into Tissue Engineering to Save Lives
By Ansh Mathur
Do you remember the replicants (the bioengineered beings) who had artificial organs? In the 1982 film Blade Runner, featuring Harrison Ford, how there are artificial organs that are nearly indistinguishable from those of humans!
Well, what if I told you that you could learn about a world where such science fiction can turn into a reality? Get ready to explore the potential of 3D bioprinting in tissue engineering as it is transforming the future of medicine and redefining the possibilities of human health.
The field of regenerative medicine has been rapidly growing over the past few years; it can be looked at as an umbrella term, encompassing several concepts and approaches, including many up-and-coming technologies which have either already started or are on track to revolutionize healthcare as we know it!
One very promising technology in this area is 3D Bioprinting, a technology that includes layering of living cells (Bioinks), growth factors and biological scaffolds to create bioidentical structures of tissue. 3D bioprinting has already proven to be a very promising technology. This article will explore 3D bioprinting’s application to the concept of tissue engineering (creating functional tissue substitutes to help treat or replace tissue and organs), as a major breakthrough that is giving hope to those on lists for organ transplants and taking regenerative medicine to whole new heights!
What’s the Issue?
The term organ transplant refers to the “surgical procedure in which organs, tissue, or cells are surgically transplanted from a donor to a recipient” to replace someone’s failed organ (potentially saving their life). The majority of organ donors are either recently deceased people who had volunteered before their death/had family donate them on their behalf, or a healthy person is able to donate certain organs/tissues while also ensuring their own health. Now, the recipients are primarily patients who are critically ill in the end stages of organ failure; the beauty of this process is how a transplant is able to save the patient and completely change someone’s quality of life.
Over the past decade, there has been a very high increase in the demand for organ transplants as the occurrence of organ failure-related conditions has grown exponentially. However, there has been an unavailability to get an adequate amount of organs to meet the demand for these essential transplants, resulting in a major Organ shortage (organ scarcity) across the globe. This is an issue affecting countless people across the globe, with thousands on incredibly long waiting lists for such crucial transplants. “ In the United States, for example, the number of patients on the waiting list in the year 2006 had risen to over 95,000, while the number of patient deaths was over 6,300” (National Library of Medicine).
This shortage of available organs for transplantation is a major global crisis as it is then depriving thousands of patients of the ability to get better and have a better quality of life. Despite the constant advancements in the healthcare industry as well as growing research in the understanding if human biology, the supply of organs to treat patients is still a major issue. As a result, numerous patients face extended waiting times (see graphs below), resulting in prolonged suffering and, sadly, loss of life (as they are not able to receive the necessary care on time).
What’s the Solution?
Tissue Engineering:
In regenerative medicine, tissue engineering is the field that studies creating tissue and organ replacements. At its essence, it involves understanding areas of human biology to design bioengineered structures that could replace the structure and function of natural tissues.
3D Bioprinting
Now, 3D bioprinting is the specific solution for replacing the need for traditional transplant surgeries. This technology creates living tissues and organs by depositing layers of living cells (biomaterials) to build a complex structure one piece at a time—to save lives!
Finally, integrating 3D bioprinting into tissue engineering provides a solution that can potentially overcome not only organ shortages but also major issues such as organ compatibility (as 3D bioprinting ensures the ability to tailor the structure to fit the patient's needs by using the patient's own cells as biomaterial); this customization also assists in ensuring higher success rates in organ transplants.
How Does it Work?
Understanding the concept of 3D printers:
The first thing to do is to understand the concept of 3D printers. Relative to traditional 2D printers that many of us use on a day-to-day basis, 3D printers implement another dimension, which is depth (z), so that they can move up/down (y—vertical) and sideways(x—horizontal). This gives them the ability to “print” 3D figures layer by layer using different materials (plastics, metals, ceramics, etc.) for a process known as “additive manufacturing.”
The process to print an item is as follows:
- You first need a digital blueprint (created using a designing software)
- That digital model would then be sent to the printer, from where you would specify the material (which would have to be loaded into the printer).
- Lastly, the printer would then move the head vertically, horizontally, forward, and back while reading the detailed blueprint as it layers the material (that will cool to stay in a solid form) to build the product.
- This (very simplified) process is quite common and is known to be implemented to create many things (e.g., jewelry, toys, etc.).
Bioprinting
Now, the essence of bioprinters is very similar to regular 3D printers, with the main difference being that rather than using materials like plastics, metals, etc, bioprinters “print” layers of biomaterial (“synthetic or natural material suitable for use in constructing artificial organs or to replace bone or tissue.”); such as real tissue or living cells to build these complex structures that can be used as alternatives or replacements for potentially functional body parts.
The bioprinting process:
- Bioink Preparation (synthesis):
- Bioink is a key term to understand. The term refers to a material consisting of living cells, which are biomaterials and growth factors; the creation of the Bioink is the initial step in the process.
2. Digital Design
- Similar to traditional 3D printing, a digital model is designed using digital design software. The model (which includes specific detailed information related to the shape and structure of the tissue or organ) will then serve as a blueprint for the bioprinter to follow.
3. The bioprinting process
The printer would use one of these printing methods:
- Extrusion-based bioprinters (where they remove artificial live tissue “Bioink” to create a 3D structure).
- Droplet-based bioprinters (use something called” inkjet technology” to deposit Bioink, “the artificial tissue,” onto an organism.
- Laser-based bioprinters (a laser simply solidifies Bioink from liquid form into a 3D structure.
4. Layer-by-layer Deposition
- the initial process where the 3D bioprinter prints the Bioink layer-by-layer, creating the structure
- This step is creating the architectural framework for the organ being printed to ensure that each part is correctly positioned
5. Cross-Linking
- the process of using UV lights and heat to solidify the printed biomaterials.
6. Maturation
- this phase is where the structure (that was printed), referred to as the “bioengineered scaffold,” further develops to form functional tissue.
7. Customization
- A very exciting advantage of this technology is the ability to change and customize printed material (organs) to meet specific situations or patients' needs.
- Also, by using the patient's cells (as biomaterial), the printed structure can be customized to fit the needs of the patient.
Is anyone in Particular Working on Solutions Now?
As there are many current challenges (such as scaling to create larger and more complex organs)
Many companies are currently working to tackle this issue. In particular, Aspect Biosystems (https://www.aspectbiosystems.com/ )
A biotech company is developing a “tissue therapeutic platform” to create printed tissue that will help repair and replace parts of the body; implantable tissue. Another company leading the space is CELLINK, which develops bioprinters and bioprinting materials to provide ready models for researchers and healthcare providers. The technology is currently being used to print tissues such as skin and cartilage.
Conclusion
In conclusion, the integration of 3D bioprinting offers a solution to the organ shortage crisis as a beacon for development in the regenerative medicine space. Fixing the current obstacles will hopefully help create a world where we don’t have to worry about organ shortages and ensure people get the care they need for a healthier and happier life!
References
Sauer, Mary. “The Long Haul: Engineering High-Tech Solutions to the Organ
Shortage.” Harvard Advanced Leadership Initiative,
www.sir.advancedleadership.harvard.edu/articles/
engineering-high-tech-solutions-organ-shortage. Accessed 20 Oct. 2023.
Sauer, Mary. “Annual Number of Patients on Waiting List, Transplants Received,
and Living and Deceased Donors in the United States, 1988–2018.” Harvard
Advanced Leadership Initiative, www.sir.advancedleadership.harvard.edu/
articles/engineering-high-tech-solutions-organ-shortage. Accessed 20 Oct.
2023. Chart.
Sauer, Mary. “Number of US candidates waiting for selected organ transplants as of November 2022.” Harvard
Advanced Leadership Initiative, www.sir.advancedleadership.harvard.edu/
articles/engineering-high-tech-solutions-organ-shortage. Accessed 20 Oct.
2023. Chart.
Abouna, G M. “Organ shortage crisis: problems and possible solutions.” Transplantation proceedings vol. 40,1 (2008): 34–8. doi:10.1016/j.transproceed.2007.11.067
Papaioannou, Theodore G et al. “3D Bioprinting Methods and Techniques: Applications on Artificial Blood Vessel Fabrication.” Acta Cardiologica Sinica vol. 35,3 (2019): 284–289. doi:10.6515/ACS.201905_35(3).20181115A
