Engineering whole organs: Closing in on a potential solution to the organ donor shortage?
A new technique involving the use of an artificial scaffold into which a patient's own stem cells are inserted, turning it into a fully functional organ, could offer a potential solution to the donor shortage crisis, according to the second paper in this week's Lancet Series on stem cells. This pioneering approach to regenerating and transplanting organs requires no human donors, has no problems with rejection, and has no need for immunosuppressive drugs.
"Such an approach has already been used successfully for the repair and reconstruction of several complex tissues such as the trachea, oesophagus, and skeletal muscle in animal models and human beings, and guided by appropriate scientific and ethical oversight, could serve as a platform for the engineering of whole organs and other tissues, and might become a viable and practical future therapeutic approach to meet demand after organ failure", explains Paolo Macchiarini from the Karolinska Institutet, Stockholm, Sweden, lead author of the paper.
Because of an ageing population there is a growing crisis in whole-organ donor supply. Every year in the USA alone, about 120 000 people die from chronic lung disease, 112 000 from kidney failure, and 425 000 from coronary heart disease. Patients who are fortunate enough to receive a donor organ still face life-long expensive and potentially dangerous immunosuppressive therapy.
In this paper, Macchiarini and colleagues discuss the use of a new regenerative technique based on the use of naturally occurring extracellular matrix as a biological scaffold, outline the key scientific and ethical challenges that remain before wider clinical use of this approach is possible, and review progress made in the reconstruction of individual organs.
Identification of the optimum cell sources for different organs, the ideal scaffold material, and the appropriate population of patients are some of the key challenges that will need to be addressed before widespread clinical use.
"For clinical trials, due consideration needs to be given to who to recruit: suitable patients should be able to provide competent consent, have some amount of social support, have few comorbidities, and be willing to face loss of privacy", say the authors.
As well as scientific challenges, more needs to be done to address the numerous ethical issues raised by this new technology. "The pressure to advance this technique, driven by demand, the race for prestige, and the potential for huge profits, mandates an early commitment be made to establish the safety of various strategies particularly when there are so many potential patients and doctors who are desperate for any remedy that offers hope", warn Macchiarini and colleagues.
They conclude by calling for policies to address issues including: transparency about the techniques involved, cell sources, financial costs to patients, informed consent, strategies for dealing with experimental failure, and assisting patients after initial treatment, adding that: "Perhaps the strongest ethical duty the bioengineering community faces is the identification of criteria that constitute sufficient evidence of the evolution of an intervention from research to therapy Establishment of adequate safety and functional success will need input from investigators and key professional societies and organisations."
In an accompanying Comment, Dusko Ilic from King's College London, UK, and Julia Polak from Imperial College, London remark: "Although several questions are unresolved, the promise of an off-the-shelf scaffold that can be repopulated with autologous stem cells expanded in vitro seems much closer than one could have hoped for even a few years ago."
Provided by Lancet
- Sweden hospital in lab-made windpipe transplant Jul 07, 2011 | not rated yet | 0
- Recipient doing well after first artificial windpipe graft Nov 24, 2011 | not rated yet | 0
- Doctors: Transplant advance in windpipe cancer Aug 01, 2010 | not rated yet | 0
- Europe needs to tackle legal, ethical and cultural barriers to child organ donation Sep 08, 2011 | not rated yet | 0
- Step towards creating intestine transplant using patient's own cells Feb 09, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
6 hours ago Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
Professor Michael Jennings, Deputy Director of the Institute for Glycomics at Griffith University, was part of an international team that discovered the previously unknown pathway of how the bacterium colonizes people.
Medical research 44 minutes ago | 5 / 5 (1) | 0 |
(Medical Xpress)—Scientists from the Joint Center for Structural Genomics (JCSG) at SLAC National Accelerator Laboratory have determined the 3-D structure of the chemically active part of an enzyme involved ...
Medical research 1 hour ago | not rated yet | 0 |
(Medical Xpress)—According to the World Health Organization, approximately 70 million couples experience infertility worldwide. Current data suggests that nearly one third of infertility disorders are due ...
Medical research 2 hours ago | 5 / 5 (1) | 0
Every day, their baby stopped breathing, his collapsed bronchus blocking the crucial flow of air to his lungs. April and Bryan Gionfriddo watched helplessly, just praying that somehow the dire predictions ...
Medical research 17 hours ago | 5 / 5 (3) | 0
The human gut is loaded with commensal bacteria – "good" microbes that, among other functions, help the body digest food. The gastrointestinal tract contains literally trillions of such cells, and yet the ...
Medical research 21 hours ago | 5 / 5 (3) | 0 |
(Medical Xpress)—Research by U of T Mississauga psychology professor Glenn Schellenberg reveals that two key personality traits – openness-to-experience and conscientiousness—predict better than IQ ...
1 hour ago | not rated yet | 0 |
Scientists at Newcastle University have shed new light on how the brain tunes in to relevant information.
41 minutes ago | 5 / 5 (1) | 0 |
New techniques in imaging of brain activity developed by Jean Gotman, from McGill University's Montreal Neurological Institute, and his colleagues lead to improved treatment of patients suffering from epilepsy. The combination ...
42 minutes ago | not rated yet | 0
Studying the networks of connections in the brains of people affected by schizophrenia, bipolar disease or depression has allowed Dr. Peter Williamson, from Western University, to gain a better understanding of the biological ...
41 minutes ago | not rated yet | 0
For the first time, physicists from the Max Planck Institute for Extraterrestrial Physics (MPE), biologists and physicians demonstrated the synergistic effect of cold atmospheric plasma - a partly ionized ...
1 hour ago | 5 / 5 (1) | 0 |