Printing a human kidney - Anthony Atala

Summary

The transcript discusses the critical shortage of organs and the field of regenerative medicine as a solution. Due to advancements in medicine, people are living longer, but aging organs often fail. Regenerative medicine combines biomaterials, cells, and scaffolds to regenerate or replace damaged tissues. It has made progress in clinical applications, such as creating new organs like bladders, heart valves, and livers. The video highlights ongoing challenges, innovations like 3D printing organs, and patient success stories, showcasing the potential of this revolutionary field to save lives.

Takeaways

• 💉 There's a major health crisis due to a shortage of organs, exacerbated by longer lifespans and an increasing need for transplants.
• 👨‍⚕️ The field of regenerative medicine focuses on creating new ways to regenerate organs and tissues using biomaterials and cells.
• 🧬 Scientists can use scaffolds (biomaterials), cells, or a combination of both to promote tissue regeneration and repair damaged organs.
• 📚 Regenerative medicine is not a new field; it dates back to work from the 1930s by Alexis Carrel and Charles Lindbergh on organ culture.
• ⚗️ Significant advances have been made in growing different types of cells, though some cell types like liver, nerve, and pancreatic cells remain challenging.
• 🩸 Vascularity, or the blood supply to regenerated tissues, is one of the biggest challenges in organ regeneration.
• 🧵 Biomaterials can be woven or sprayed into specific structures to support the body's cells in regenerating tissue.
• 🫀 Regenerative technologies have already been applied in patients, with examples including engineered bladders, heart valves, and liver structures.
• 🖨️ 3D printing techniques are used to create organ structures, with advancements allowing for on-demand printing directly onto patients' wounds.
• 🔬 The ultimate challenge lies in creating solid organs like kidneys, requiring complex layers of cells and vascularization.

Q & A

What is the major health crisis discussed in the script?

The major health crisis discussed is the shortage of organs for transplant. As people live longer, their organs tend to fail, but the number of organ transplants has not increased significantly, leading to a shortage.

What is regenerative medicine, and how does it relate to the organ shortage crisis?

Regenerative medicine is a field that aims to regenerate or replace damaged tissues and organs using biomaterials, cells, or a combination of both. It addresses the organ shortage crisis by developing alternatives to organ transplantation.

What are some of the key challenges in regenerative medicine?

The key challenges include designing biomaterials that can function well in the body over time, growing sufficient amounts of specific cells (like liver or pancreatic cells), and ensuring proper vascularization (blood supply) for newly generated tissues and organs.

What role do biomaterials play in regenerative medicine?

Biomaterials serve as scaffolds or structures that can support the regeneration of tissues by allowing cells to grow on them. These materials can be implanted in the body to help regenerate tissues or organs using the patient’s own cells.

How are stem cells used in regenerative medicine?

Stem cells, which have the ability to develop into different types of cells, are used to regenerate tissues and organs. In heart disease treatments, for example, stem cells can be transformed into heart cells, which begin to beat and form heart tissue.

What process is used to create larger organ structures for patients in regenerative medicine?

To create larger organ structures, scientists take a small piece of the patient’s tissue, grow the cells outside the body, and then layer those cells onto a biomaterial scaffold. The scaffold helps form the shape of the organ, and the cells grow around it, eventually creating the desired organ.

How is 3D printing being used in the field of regenerative medicine?

3D printing is used to print tissues and even entire organs layer by layer using cells as 'ink.' These printed structures can then be implanted into patients. More advanced 3D printing techniques are being developed, including printing directly onto the patient.

What specific example of an organ created using regenerative medicine is mentioned in the script?

One example mentioned is the bladder. A small piece of the patient’s bladder tissue is taken, cells are grown outside the body, and these cells are then used to coat a scaffold, eventually forming a new bladder, which is then implanted into the patient.

How are discarded organs being used in regenerative medicine?

Discarded organs, such as livers that are not used for transplantation, are placed in a washing machine-like device that removes the cells, leaving behind the organ's structure. This structure can then be repopulated with the patient’s cells, creating a functional organ.

What advancements are being made toward creating solid organs like kidneys using regenerative medicine?

Scientists are using 3D imaging and reconstruction techniques to map the layers of the kidney. They then use this information to print the organ layer by layer. Though this process is still under development, kidneys have already been printed using this technology.

Outlines

00:00

🚨 Organ Shortage: A Growing Health Crisis

The video opens by discussing the global shortage of organs, noting that while medical advancements allow people to live longer, this results in more organ failures as they age. The demand for organ transplants has doubled in the last decade, but the number of transplants hasn't increased proportionally. This situation has become a public health crisis. Regenerative medicine is introduced as a potential solution, using biomaterials, cells, or both to repair or regenerate tissues. The speaker references early pioneers like Alexis Carrel and Charles Lindbergh, who contributed to the field of organ culture as early as 1938.

05:02

🧬 Regenerative Medicine: Challenges and Solutions

This section outlines the three main challenges faced in regenerative medicine: creating durable materials for the body, growing sufficient cells outside the body, and ensuring proper blood supply (vascularity) to regenerated tissues. Advances in biomaterials allow scientists to weave and shape structures to help organs regenerate. The video highlights a successful case where biomaterials were used to regenerate a patient’s organ. The use of stem cells to grow specific tissues like heart cells is also discussed, showing how cells can be guided to perform their natural functions. Ongoing clinical trials focus on heart disease treatments.

10:03

🧪 Organ Engineering: Building Organs Layer by Layer

The process of bioengineering organs is described in detail, comparing it to baking a layered cake. Starting with a small tissue sample, scientists grow cells and coat biomaterial scaffolds to create organs like heart valves and bladders. These bioengineered organs are grown in controlled environments, simulating human body conditions. The section also discusses creating organs from discarded donor organs, where the cellular material is washed away, leaving a scaffold. This scaffold is then seeded with the patient’s own cells, allowing for the potential creation of human liver tissue. The video explains how these technologies are currently being used.

15:04

🖨️ 3D Printing of Organs: A Breakthrough in Medicine

The speaker introduces 3D printing technology as a revolutionary method to create tissue structures. Using a modified desktop inkjet printer, researchers can print layers of cells to form bone and other tissues. More advanced printers are being developed, including a model that can print directly onto a patient’s body. This printer scans the wound and prints layers of cells precisely where needed. While still in development, this method has potential for healing injuries. The speaker also discusses the challenges of creating solid organs like kidneys, which require extensive vascular networks to function.

🔬 Imaging and Printing Complex Organs: The Kidney

This section focuses on the complexities of bioengineering large organs, particularly the kidney. A combination of 3D imaging and printing technology allows researchers to scan a patient’s kidney, layer by layer, and recreate it. The video demonstrates a kidney being printed in real-time, taking around seven hours to complete. The speaker shows an actual bio-printed kidney, highlighting the progress made in organ printing. The technology represents a new frontier in regenerative medicine, aiming to address the critical shortage of organs, especially kidneys, which are in high demand among transplant patients.

😊 Patient Testimony: A Life Transformed by Organ Engineering

The video shifts to a personal testimony from Luke, a young man who received a bioengineered bladder after being born with spina bifida. Before the surgery, Luke faced a lifetime of dialysis and numerous health complications. After receiving the bladder created from his own cells, his health improved dramatically, allowing him to lead a normal life. Luke shares how he’s now studying communications in college, reflecting on the life-changing impact of the surgery. The speaker introduces Luke’s surgeon, highlighting the innovative work that has helped patients like Luke live healthier, fuller lives.

🎓 A Reunion: Reflections on the Power of Innovation

The final section features a heartwarming reunion between Luke and his surgeon, Tony, ten years after the life-saving surgery. Luke reflects on how the surgery allowed him to have a normal childhood and pursue his dreams. He expresses his amazement at the groundbreaking work done in regenerative medicine, acknowledging that as a child, he didn't fully grasp the significance of the surgery. Luke shares his gratitude, while the speaker highlights the importance of continuing this innovative work to benefit more patients in the future. The interaction underscores the profound impact of regenerative medicine on patients' lives.

Keywords

💡Regenerative Medicine

Regenerative medicine is a field that focuses on repairing or replacing damaged or failing organs using biological materials like cells and scaffolds. In the video, this concept is central to addressing the shortage of donor organs by regenerating tissues or entire organs, helping patients who would otherwise require transplants. It represents the future of medical treatment for organ failure.

💡Scaffolds

Scaffolds are biomaterials that provide a structure for cells to grow on and regenerate tissues. The video explains how these materials can be used to help cells repair damaged organs by acting as a bridge that supports cell growth. These scaffolds can be made from various materials and are essential for the engineering of organs and tissues.

💡Stem Cells

Stem cells are undifferentiated cells that have the potential to develop into various types of cells. In the video, stem cells are highlighted as a critical resource in regenerative medicine because they can be used to generate heart, liver, and other specialized cells to repair or replace damaged tissues. They play a key role in ongoing clinical trials for heart disease and organ regeneration.

💡Vascularity

Vascularity refers to the supply of blood to tissues or organs, which is vital for their survival. In regenerative medicine, ensuring vascularity is one of the major challenges, as newly created tissues or organs need a blood supply to function properly. The video emphasizes how important it is to create blood vessel networks to sustain regenerated organs.

💡Biomaterials

Biomaterials are synthetic or natural materials used to replace or support the function of biological tissues. In the video, biomaterials like scaffolds are mentioned as essential components for creating tissue structures that can be implanted into patients to facilitate the regeneration of damaged organs. These materials are often used in conjunction with cells to create functional tissue.

💡Organ Shortage

Organ shortage refers to the global crisis where the number of people in need of organ transplants far exceeds the number of available donor organs. The video addresses this issue as a major public health crisis, with the number of patients requiring organs doubling in the last decade while the number of transplants has not kept pace. Regenerative medicine is presented as a potential solution.

💡3D Printing

3D printing in regenerative medicine involves creating three-dimensional tissue structures layer by layer using a printer. In the video, the speaker explains how organs like kidneys are printed using this technique, and how it can be customized to replicate a patient’s specific anatomy. This technology is critical for creating complex structures like bones and organs.

💡Cell Expansion

Cell expansion is the process of growing a patient's cells outside the body to produce enough cells for tissue regeneration. The video highlights how advances in this area over the past 20 years have made it possible to grow many types of cells, although challenges remain for certain cell types like liver and nerve cells. This process is fundamental to creating tissues for regenerative therapies.

💡Bladder Regeneration

Bladder regeneration refers to the process of growing a new bladder for patients using their own cells. The video gives an example of how regenerative medicine was used to grow a bladder by taking a small tissue sample, expanding the cells, and using a scaffold to form a new bladder. This example demonstrates the practical application of regenerative techniques in medicine.

💡Solid Organs

Solid organs refer to organs like the liver, kidney, and heart, which are more complex to regenerate due to their dense structure and extensive vascular requirements. The video explains the challenges of regenerating solid organs, especially with the need to recreate the blood vessel networks that support them. Advances in imaging and 3D printing are helping to overcome these challenges.

Highlights

There is a major health crisis due to a shortage of organs, driven by people living longer and more organs failing as they age.

In the last 10 years, the number of patients needing an organ transplant has doubled, but the number of available transplants has barely increased.

Regenerative medicine is emerging as a solution to organ shortages, using biomaterials and scaffolds to help the body regenerate tissue.

Alexis Carrel, a Nobel Prize winner, pioneered some of the same technologies used today in regenerative medicine back in the 1930s.

One of the key challenges in regenerative medicine is designing materials that can work well inside the body over time.

Another challenge is growing enough cells from patients outside of the body, and while there has been progress, certain cell types like liver, nerve, and pancreatic cells still can't be grown reliably.

A major obstacle is vascularity, the ability to supply blood to regenerated tissues and organs.

Biomaterials are being used to create scaffolds that mimic structures like blood vessels, helping the body regenerate tissue using its own cells.

Stem cells are being used in clinical trials to treat heart disease, with promising results showing heart cells that start beating on their own in culture.

Biomaterials can be used in conjunction with a patient's own cells to grow organs, such as bladder tissue, which can then be implanted back into the patient.

An inkjet printer has been adapted to print structures using cells instead of ink, allowing for the creation of tissue-like bone, which can be implanted.

Sophisticated printing technologies are being developed to print directly onto a patient’s wound, scanning the wound first and then printing the necessary layers of cells.

One of the biggest challenges in regenerative medicine is the development of solid organs, particularly kidneys, which 90% of patients on the transplant list are waiting for.

A 3D printer has been developed to print a kidney layer by layer, taking approximately seven hours to complete the process.

A patient named Luke, who was born with spina bifida, received a bladder transplant as a child using regenerative medicine and has since gone on to live a normal life, even becoming a high school wrestling team captain.

Transcripts

[Music]

there's actually a major health crisis

today in terms of the shortage of organs

the fact is that we're living longer

Medicine has done a much better job

making us live longer and the problem is

as we age our organs tend to fail more

and so currently there not enough organs

to go around in fact in the last ten

years a number of patients require an

organ has doubled well in the same time

the actual number of transplants has

barely gone up this is now a public

health crisis so that's where this field

comes in that we call the field of

regenerative medicine it really involves

many different areas you can use

actually scaffolds biomaterials they're

like the piece of your blouse or your

shirt but specific materials you can

actually implanted patients and they

will do well and help you regenerate or

we can use cells alone either your very

own cells or different stem cell

populations or we can use both we can

use actually biomaterials and the cells

together and that's where the field is

today but it's actually not a new field

interestingly this is a book that was

published back in 1938 titled a culture

of organs the first author Alexis Carrel

and Nobel Prize winner he actually

devised some of the same technologies

used today for suturing blood vessels

and some of the blood vessel grafts were

used today were actually designed by

Alexis but I want you to note his

co-author Charles Lindbergh that's the

same Charles Lindbergh who actually

spent the rest of his life working with

Alexis at the Rockefeller Institute in

New York in the area of the culture of

organs so the fields been around for so

long why so field clinical advances and

that really has to do to many different

challenges but if I were to point to

three challenges the first one is

actually the design of materials that

could go in your body and do well over

time and many advances now we can do

that fairly readily the second challenge

with cells we could not get enough of

your cells to grow outside of your body

over the last 20 years

years we've basically tackled that many

scientists can now grow many different

types of cells plus we have stem cells

but even now 2011 there's still certain

cells that we just can grow from the

patient liver cells nerve cells

pancreatic cells still can grow them

even today and the third challenge is

vascularity the actual supply of blood

to allow those organs or tissues to

survive once we regenerate them so we

can actually use biomaterials now this

is actually biomaterial we can weave

them knit them or we can make them like

you see here this is actually like a

cotton candy machine you saw this spray

going in that was like the fibers of the

cotton candy creating this structure

this tubular eye structure which is a

biomaterial that we can then use to help

your body regenerate using your very own

cells to do so and that's exactly what

we did here because it's actually a

patient who presented with a deceased

organ and we then created one of these

smart biomaterials and we then use that

smart bomb material to replace and

repair that patients structure what we

did was we actually use the biomaterial

as a bridge so that the cells in the

organ could walk on that bridge if you

will and help to bridge the gap to

regenerate that tissue and you see that

patient now six months after with an

x-ray showing you the regenerated tissue

which is fully regenerated when you

analyze it under the microscope we can

also use cells alone these are actually

cells that we obtained these are stem

cells that we create from specific

sources and these are we can drive them

to chem heart cells and they start

beating in culture so they know what to

do the cells genetically know what to

then they start beating together now

today many clinical trials using

different kinds of stem cells for heart

disease so that's actually now in

patients or if we're going to use larger

structures to replace larger structures

we can then use the patient's own cells

or some cell population and the

biomaterials the scaffolds together

so the concept here is if you do have a

or injured organ we take a very small

piece of that tissue listen half the

size of a postage stamp

we then tease the cells apart we grow

the cells outside the body we then take

a scaffold a biomaterial

again looks very much like a piece of

your blouse or your shirt

we then shape that material and we then

use those cells to code that material

one layer at a time very much like

baking a layer cake if you will we then

place that in an oven-like device and

we're able to create that structure and

bring it out this is actually a hard

valve that we have engineered and you

can see here we have the structure of

the heart valve and we've seated that

with cells and then we exercise that you

so you see the leaflets opening and

closing of this heart valve that's

currently being used experimentally to

try to get it to to further studies

another technology we have used in

patients actually involves bladders we

actually take a very small piece of a

bladder from the patient less than half

the size of a postage stamp

we then grow the cells outside the body

take the scaffold coat the scaffold with

the cells the patient's own cells two

different cell types we then put it in

this oven like device has the same

conditions as a human body 37 degrees

centigrade 95% oxygen a few weeks later

you have your engineered organ that

we're then able to implant back into the

patient for these specific patients we

actually just suture these materials we

use three-dimensional imaging analysis

but we actually created these

biomaterials by hand but we now have

better ways to create these structures

with the cells we use now some type of

technologies where first solid organs

for example like the liver what we do is

we take discard livers as you know a lot

of organs are actually discarded not

used so we can take these liver

structures which are not going to be

used and we then put them in a washing

machine like structure that will allow

the cells to be washed away two weeks

later you have something that looks like

a liver you can hold it like a liver

but it has no cells it's just a skeleton

of the liver and we then can Reaper fuse

the liver with cells preserving the

blood vessel tree so we actually profuse

first a blood vessel tree with the

patient's own blood vessel cells and we

then infiltrate the parenchyma with the

liver cells and we not been able just to

show the creation of human liver tissue

just this past month using this

technology another technology that we've

used is actually that of printing this

is actually a desktop inkjet printer but

instead of using ink we're using cells

and you can actually see here the

printhead going through and printing

this structure and it takes about 40

minutes to print this structure and

there's a 3d elevator that then actually

goes down one layer at a time each time

the printhead goes through then finally

you're able to get that structure out

you can pop that structure out of the

printer and implant it and this is

actually a piece of bone that I'm going

to show you in this slide that was

actually created with this desktop

printer and implant it as you see here

that's all new bone that was implanted

using these techniques another more

advanced technology we're looking at

right now our next generation of

technologies are more sophisticated

printers this particular printer with

worthy signing now is actually 1 we

print right on the patient so what you

see here is I know it sounds funny but

that's the way it works because in

reality what you want to do is you

actually want to have the patient on the

bed with the wound and you have a

scanner basically a cliff like a flatbed

scanner that's what you see here on the

right side you see a scanner technology

that first scans the wound on the

patient and then it comes back with the

print hits actually printing the layers

that you require on the patient's

themselves this is how it actually works

here's a scanner going through scanning

the wound

once it's scanned sends information in

layers the correct layers of cells where

they need to be and now you're going to

see here a demo of is this actually

being done

in a representative wound and we

actually do this with a gel so you can

lift the gel material so once those

cells are on the patient they will stick

where they need to be and this is

actually new technology still under

development we're also working on more

sophisticated printers because in

reality our biggest challenge are the

solid organs I don't know if you realize

this but ninety percent of the patients

and the transplant list are actually

waiting for a kidney patients are dying

every day because we don't have enough

of those organs to go around so this is

more challenging large organ vascular a

lot of blood vessels supply a lot of

cells present so the strategy here is

this is actually a CT scan an x-ray and

we go layer by layer using computerized

morphometric imaging analysis and 3d

reconstruction to get right down to

those patient's own kidneys we then are

able to actually image those do

360-degree rotation to actually analyze

the kidney in its full volumetric

characteristics and we then are able to

actually take this information and then

scan this in a printing computerized

form so we go layer by layer through the

organ analyzing each layer as we go

through the organ and we then are able

to send that information as you see here

through the computer and actually design

the organ for the patient this actually

shows the actual printer and this

actually shows that printing in fact we

actually have the printer right here so

I'm in while we've been talking today

we've actually you can actually see the

printer back here in the backstage

that's actually the actual printer right

now and that's been printing this kidney

structure that you see here it takes

about seven hours to print the kidneys

this is about three hours into it now

and dr. Kang's going to walk onstage

right now and we're actually going to

show you one of these kidneys that we

print a little bit earlier today

put a pair of gloves here

thank you

you're backwards

so these clothes are a little bit small

on me but here it is you can actually

see that kidney as it was printed

earlier today

that's a little bit of consistency to it

this is dr. Connie who's been working

with us in this project and we went a

part of our team Thank You dr. Kahn

appreciate it so this is actually a new

generation this is actually the printer

that you see here on stage and this is

actually a new technologies we're

working on now in reality you know we

now have a long history of doing this

I'm going to share with you a clip in

terms of technology that we have had in

patients now for a while and this is

actually a very brief clip only about 30

seconds of a patient who actually

received an organ I was really sick I

could barely get out of bed I was

missing school it was just pretty much

miserable I couldn't you know go out in

play you know basketball at recess

without feeling like I was going to pass

out when I got back inside it was I felt

so sick I was facing basically a

lifetime of dialysis and I don't even

like to think about what my life would

be like if I was on that so after the

surgery life got a lot better for me I

was able to do more things I was able to

wrestle in high school I became the

captain the team and that was great I

was able to be you know the normal kid

with my friends and because they use my

own cells to you know build this bladder

it's gonna be with me I got it for life

so I'm all set

these experiments sometimes work and

it's very cool when they do Luke

come up please

so look before last night when's the

last time you saw Tony ten years ago

when I had my surgery and it's really

great to see him

I'm tell us a little about what you're

doing well right now I'm in college at

the University of Connecticut I'm a

sophomore and studying communications TV

and mass media and basically trying to

live life like a normal kid which I

always wanted growing up but it was hard

to do that when I was born with spina

bifida and my kidneys and bladder

weren't working I went through about 16

surgeries and it seemed impossible to do

that when I was in kidney failure when I

was ten and this surgery came along and

basically made me who I am - and saved

my life

I'm Tony Dunne hundreds of these what I

know from he's he's working really hard

in his lab and coming up with crazy

stuff I know I was one of first ten

people to have this surgery and when I

was ten I didn't realize how amazing it

was I was a little kid and I was like

yet I'll have that I'll have that

surgery I all I wanted to do is to get

better and I didn't realize how amazing

it really was until now that I'm older

and I see the amazing things that he's

doing um when you know you got this call

out of the blue I mean

Tony's really shy and it took a lot of

convincing to get somebody as modest as

Tony to allow us to bring Luke so look

you go to your communications professors

your majoring communications and you ask

them for permission to come to Ted which

might have a little bit to do with

communications and what was their

reaction most of my professors were all

for it and they said bring pictures and

and you know show me the clips online

and I'm happy for you there are a couple

that were a little stubborn but I had to

talk to I pulled him aside well it's an

honor of privilege to meet you thank you

so much

you