A few months ago our CTO, Turlif, spoke at the Renato Archer Research Center (CTI) in São Paulo, Brazil at a workshop aimed at showing the state-of-the-art and the complete cycle of the human organs bio-fabrication process utilizing three-dimensional printing. Besides the challenges and the enabling technologies on each bio-fabrication step, the narrow dependency of this area with information technology was also discussed. Check out his talk, part 1 and part 2, as well as some of the other speakers there, such as Evan Malone (co-creator of the Fab@Home and founder of NextFab) and Vladimir Mironov (one of the leading researchers in the areas of cardiovascular development, vascular biology, tissue engineering, and phenomics).

A recent article by Bonnie Berkowitz in the Washington Post discusses bioprinting and touches on its implications for organ replacement.

I occasionally get an uncomfortable feeling when reading news articles about 3D fabrication, particularly in the mainstream press. They can take on a simplistic tone that makes me think of a B movie sci-fi script or that young children are the target audience (“The machine looks like the offspring of an Erector Set and an ink jet printer. The “ink” feels like apple sauce and looks like icing”) but maybe I am imagining it and the writer was simply hungry when she wrote the piece. Or perhaps the concepts are just so large and potentially far-reaching that we are all struggling to find the right words to accurately corral and shape them to our understanding. I don’t know though, I think people are able to get more than we sometimes give them credit for, it just falls upon us to communicate the ideas well and in doing so perhaps giving shape to the concepts.

Despite my issues with the presentation, it is gratifying to see such an interesting field within 3D fabrication being discussed.

Researchers in bioprinting like Tony Atala, (Director of the Wake Forest Institute for Regenerative Medicine) and Lawrence Bonassar, (Cornell University) are using a “pearly material” made up of human cells that resembles "icing" (hmmm...) to experiment with printing human organs and bones.

“The possibilities for this kind of technology are limitless” said Lawrence Bonassar. His lab has already printed vertebral tissue that has been successfully introduced in mice. “Everyone has a mother or brother or uncle, aunt, grandmother who needs a meniscus or a kidney or whatever, and they want it tomorrow ... The promise is exciting.”

The article goes on to say that there are many challenges ahead and this bioprinting technology is many years away from creating the more complex organs. Up to now, even the less complex body parts to fabricate such as skin and vertebral disks have not been put in human bodies yet. However, they are expected to be ready for human trials within two to five years.

“Scientists say the biggest technical challenge is not making the organ itself, but replicating its intricate internal network of blood vessels, which nourishes it and provides it with oxygen.”

Accordingly, it is believed that the best initial option is to create an intermediary environment that encourages the majority of the cells to grow on their own once the major support vessels within the organ have been fabricated.

“The cells, after all, have been functioning within the body already in some capacity, either as part of the tissue that is being replaced or as stem cells in fat or bone marrow. (Donor stem cells could be used, but ideally cells would come directly from the patient.)”

“The cells are actually the tissue engineers, so the people that do the work are just cheerleaders,” said Rocky Tuan, director of the Center for Cellular and Molecular Engineering at the University of Pittsburgh. “When we do tissue engineering, we are accelerating what the cells normally do. I tell people its assisted living, because we help the cells. We build all the houses and everything, and then we say, ‘Cells, come in and do your thing.’ ” If the cells do their thing correctly, the organ lives and grows just as the original once did.”

The technical difficulties are not the only hurdles. Keith Murphy, (co-founder of Organovo) believes that it would take less than ten years to make a kidney if the American government created a ‘human organ project’ and made it a goal to manufacture a human kidney but that would take a massive commitment of resources. And then there is the issue of clearing it with the Food and Drug Administration.

The article concludes looking at the possibility of fabricating an entire human being. Something it describes as science fiction.

“While a complex organ would be the holy grail for most tissue engineers, some like to look even farther ahead, straight into science fiction.”

“If one can bioprint functional human organ constructs, then bioprinting a whole human — or whatever will be the name for such a creature — is just a logical extension,” says Vladimir Mironov, a pioneer in the field.

We are hastily assured that not everyone feels that this is necessary and the more typical way of producing humans works pretty well. Okay.

Whatever the case, a couple of interesting points came up. One is the flexibility in producing what is desired and that fabrication is not locked to any specific location; human organs to go as it were. Regardless of the specific application, the portability and future customizability of production is starting to become evident. There can be no doubt that there will have to be huge shifts in how we deal with a manufacturing process that can undermine manufacturing monopolies and effect how we see personal ownership and trade. What changes will 3D printing cause in transport and the exchange of commodities. Will changes such as these release us from many of the more mundane aspects of daily life that we just accept as a given? “I don’t need to go to the Mall; I’ll just make it here”. Science fiction indeed.

What happens when we don’t have to travel, when we don’t have to line up for daily commodities… when we don’t have to burn vast quantities of fuel to transport those commodities over large distances? What happens to the commodities themselves when they lose monetary value based on rarity ( a rarity that might well have been created simply by limiting access to them)? I find myself thinking back to the music industry before you could share MP3s or produce your own music so easily. It could be argued that we have a more dynamic and varied music scene than we have had for a long time because such accessibility encouraged small, non-mainstream musicians to produce music in the “garage” and get it out there but I don’t know if the major record labels would say that. What happens when that occurs to an ever increasing number of objects? What happens to Wal-Mart? And by extension what on earth (literally) will we do with all the discarded junk when we grow bored of it?

Maybe we will become fat dissocialized lumps that need 3D printers to create our organs as they languish from loneliness and misuse in our decaying unexercised bodies…or maybe we will make super humans…who knows at this point?

As a final note on the article, I also found myself wondering why the writer chose to finish by assuring the reader that not everyone is considering fabricating whole humans and that the more traditional ways of reproduction are still pretty good. Why do that? It's probably my imagination but the future moral and ethical debates at a society wide level are going to be picked up as people realize that issues like the stem cell debate pale when discussing the possibility of producing whole humans. Imagine the letters to the editor when that sort of furore ensues? Will conservatives still be outraged if we don’t have to use the stem cells of a foetus to produce the real meat and gristle of the human form? Will debates regarding the existence of the soul intensify when we create an exact human form in a fabricator? Will such outrage be limited to conservatives only?

What happens to reproduction’s last mysteries when the human form is manufactured exactly as if from a human womb, simply, or rather not that simply ex vivo?