Transplanted in 2035

Published in

Futures, Entrepreneurship and AI

6 min readOct 1, 2018

Dialysis. It’s an unenjoyable topic that’s often associated with only affecting the elderly and the obese … or at least that’s what I used to think.

In 2011, my husband Max, was unexpectedly hospitalized for high blood pressure, where he was placed on emergency dialysis and admitted to ICU. A sonogram showed that his body had reached end-stage renal failure, or simply put, he had zero kidney function and needed a transplant. He was healthy, active, and easily passed physical fitness tests as a US Navy Petty Officer. His symptoms were minor and were easily associated with sympathy weight from my recent pregnancy and the exhaustion of being a new parent.

October 2011- Two days before being hospitalized for kidney failure.

By the the time Max received a kidney transplant in 2016, I had learned a significant amount about the human body, social and government services, and the overall healthcare industry. He’s celebrating his kidney’s third birthday in a few weeks. He watches what he eats and takes anti-rejection medication twice a day, but otherwise leads a completely normal lifestyle. However, donor kidneys do not last a lifetime and he’ll need another transplant in 10–15 years.

A Growing Problem

In the US, dialysis is an estimated $100 billion business keeping 460,000 people with end-stage renal disease (ESRD) alive. The population of ESRD is increasing at a rate of 5% per year. The number of dialysis centers in the U.S. is nearly three times the number of Target stores.

According to UNOS, the company that allocates organs nationwide, the number of people on the waiting list is exponentially outgrowing the number of transplants each year.

Emerging Trends

The possibility of 3D bioprinted organs and DNA gene-editing opens new opportunities for disruption in the medical field. Biotech companies are popping up across the globe. DNA gene editing gives hope that someday xenotransplantation will be a safe practice.

BIOTECHNOLOGY
The exploitation of biological processes for industrial and other purposes, especially the genetic manipulation of microorganisms for the production of antibiotics, hormones, etc.

3D BIOPRINTING
Precise layering of cells, biologic scaffolds, and biologic factors with the goal of recapitulating a biologic tissue (or bio material called bio-ink).

GENOME EDITING
Making specific changes to the DNA of a cell or organism.

XENOTRANSPLANTATION
Transplantation of living cells, tissues or organs from one species to another.

Current technology supports: supplemental bladders, small arteries, skin grafts, cartilage, and full trachea have been implanted in patients. (The procedures are still experimental and very costly.)
Future technology supports complex working organs: heart, lung, kidney, and liver

DIAGNOSTIC WEARABLES
Devices that can be worn or mated with human skin to continuously and closely monitor an individual’s activities, without interrupting or limiting the user’s motions.

In 2018, University of California San Diego built a stretchable diagnostic wearable that can be worn on the skin like a bandage and can wirelessly monitor a variety of physical and electrical signals, from respiration, to body motion, to temperature, to eye movement, to heart and brain activity.

The Impact

ESRD is covered by Medicare, resulting in the federal government spending nearly $31 billion per year treating kidney disease.Government spending is 50 times higher on private dialysis companies than kidney disease research.

New technologies will increase the lifespan of millions of people around the world each year. In the future, there will be less dialysis technicians and less immuno-suppressant drug companies. There will be more surgeons, tissue engineers, 3D designers, and bioink manufacturers.

Who’s Driving Change?

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING, U.S. Department of Health & Human Services, specifically National Institutes of Health (NIH)

Funding R+D of tissue engineering and biomaterials.
Supports research through grants, collaborations, and training.
NIBIB funds more than 700 grants and the work of approximately 5,000 researchers a round the country and internationally.

EGENESIS

Working to make xenotransplantation a routine medical procedure for human transplantable cells, tissues & organs.
A startup that raised $38 million successfully used the gene-editing tool CRISPR to knock out a key virus in piglets.

ORGANOVO

A U.S. regenerative medicine manufacturer has reached the commercialization stage with bio-printed liver tissue and succeeded in bio-printing of artificial kidney tissue in 2016.
Hopeful to start human trials

TISSUE REGENERATION SYSTEMS

Successfully produced commercially available bioprinted products.

CORPORATIONS

The estimated 2015 global bioprinting market was $263.8 million and is predicted to reach $1.8 billion by 2021.
The global market for 3D bioprinting is forecasted to reach a value of $1.9 billion by the year 2028.

COMPETITORS

CHINA
Researchers from more than 10 institutes in China have asked permission from the government to conduct human clinical trials use pig organs for transplants. These trials are part of a national xenotransplantation project funded by the National High Technology Research and Development Program of China (863 Program).

China is also home to the largest pig cloning factory in the world — BGI — which produces up to 500 cloned piglets annually.

“This is unmatched by any other country. The world will eventually depend on China for organs,” a researcher from BGI stated.

BIOARTIFICIAL KIDNEY
A surgically implantable, self-monitoring, and self-regulating bioartificial kidney.

The bioartificial kidney processes blood continuously for 24 hours per day, which mitigates the inconveniences and morbidities associated with intermittent hemodialysis.

The User Experience of Kidney Transplants

A Future Scenario

An optimistic future scenario for end-stage renal failure includes a drastically different way we monitor health and how we communicate with doctors. New technology and biomedical breakthroughs will redesign the systems we know today.

Current problems:

Kidney transplants are treatments, not cures.
The wait list is long and dozens of people die each day waiting for a transplant.
Patient compliance is difficult to measure.
Patient don’t always have immediate access to healthcare.
Kidney disease often goes undetected.

This future includes:

Diagnostic wearables catch kidney disease before patient reaches the need for dialysis.
3D bioprinted organs erradicated the organ transplant waiting list.
Costly anti-rejection medications are no longer needed.

A Future Scenario for Kidney Transplants in 2035.

More about Kidney Disease

Dialysis is a treatment for chronic kidney disease which affects 25% of the American population. The most common causes of chronic kidney disease are high blood pressure and diabetes; but it’s also caused by genetic disorders, infections, and auto immune diseases. Kidney failure is often undetected until the disease is well advanced, because the symptoms are subtle — like tiredness, lightheadedness, and headaches.

On average, patients wait more than two and a half years for a new organ. Dialysis patients spent between 12–70 hours hooked up to a dialysis machine which filters toxins from our blood. The machine itself is more than a thousand times bigger than a kidney, yet only performs a percentage of healthy kidneys.

Disclaimer: I’m not a health advisor nor bioengineer. This article is part of a Design Futures class for the Texas State University MFA in Communication Design program. I am, however, an advocate for ending ESRD.