Have you ever wondered what it really means when you agree to become an organ donor?
Becoming an organ donor means you can give up to 8 people a second chance of living by donating your heart, liver, lungs, kidneys, pancreas, and intestines. You also volunteer non-organ biomaterial like tissue, bones, skin, heart valves, and corneas that raise your impact to up to 50 bettered lives! Here’s a few recent organ statistics from the Health Resources and Services Administration to get us warmed up:
- There are 106,795 men, women, and children on the national transplant waiting list
- 17 people die each day waiting for an organ transplant
- Every 9 minutes another person is added to the transplant wait list
- Over 80% of transplanted organs come from the deceased
*Data last viewed May 2021
As of 2019, there are 165 million people in the US alone registered as donors. While valiant, registering to be a donor does not mean you qualify. A big eliminator is the way someone dies; only 3 in 1,000 people die in a way that allows for organ donation. Vital organs quickly become unusable when the heart stops beating, and oxygen stops circulating to the brain. Another large problem with the lack of organs available is the population is simply getting too old. In other words, medicine (as well as overall health awareness) is keeping us alive longer.
Organs are formed in a step process much like how computers work. Think of your organs as unique webs with roadways, bridges, and avenues going in several directions. Within the web layers, there is continuous movement of blood and air. For the most part, we have learned much of what it takes to create an organ; it’s a matter of learning the blueprint, then asking a bioengineer to replicate it in a Petri dish.
Queue tissue engineering
Tissue engineering started in the late 1980s when Dr. Joseph Vacanti of the Children’s Hospital approached Dr. Robert Langer of MIT with the idea to design scaffolding for cell diversity. Tissue engineering bridges biological components (cells and growth factors) with engineering principles and synthetic material. Not long after, tissue engineering quickly grew to become its own disciplinary field in the United States and Europe, with a major hub in the Boston area.
Organs are very complex, requiring even the smallest adjustments to cells, tissues, and layers to make it work properly. They need to come together in exactly the right way to work. To add another layer of complexity, while our respective organs are all similar, they are also quite unique. An organ may fit and work optimally for patient A, but be completely rejected by patient B. Many experts believe the solution is to farm individual organs with help from the candidate’s cells in hopes that the body will be less likely to reject familiar cells.
Given the vast amount of R&D and hype, why can’t we order organs yet?
Experts in the field underestimated how long it would take to grow full-functioning organs given the advancement in plastic and metal prosthetics. Jordan Miller, a PH.D. Associate Professor in Bioengineering at Rice University, said it best: “You can grow billions of cells in a lab. You can grow hundreds of billions of cells, all flat at the bottom of a petri dish, but put them in 3D, in a scaffold with factors, they will die if they’re any bigger than about half a millimeter.” If you manage to keep the cells alive, your next challenge is to mimic activities your body does naturally like feeding soft tissues with oxygen and nutrients as well as removing cells’ waste products as it grows. Then, hope that all your work and proper implantation is accepted by the body. You see how complex the situation is? It’s like having all the puzzle pieces in front of you but not knowing how to do the puzzle.
Where are we today?
The first lab grown organ to be implanted into a human was a bladder in 2006. Since then, considerable R&D has been invested into stem cell growth and organoid (small artificial cells that mimic organs) malleability to farm more complex organs like lungs.
3D printing is being worked on as a second solution to organ shortages. Instead of plastic or metals, Volumetric is using water-based materials to make parts that are biocompatible with the body. In theory, the water-based material should mimic the stiffness of human organs and natural bodily fluids.
Organ farmers that use human-animal stem cells, often pigs, have received a lot of negative attention regarding animal welfare and the spread of infectious diseases. Organ farmers are often associated with the illegal sale of organs and tissues.
Vanderbilt University Medical Center and the University of California at San Francisco created a working prototype of artificial kidneys in 2021.
There’s also been great success in lab-grown epidermis with pluripotent stem cells, with the long-term goal of using organoids for skin reconstructive surgery.
Despite significant advancements, experts still struggle to overcome the challenges of scaling cells and keeping them alive. Scientists are following a variety of theories in hopes that organ donation will become a thing of the past. And if it works, what opportunities does that open for cosmetic changes? In theory, it would be as simple as creating a drawing and 3D printing a new nose or ears. What ethical and legal questions does that Pandora box open? Share your thoughts below.