Innovations in Artificial Organs

Artificial organs are often described as the Holy Grail of bioengineering—an important research area that lies at the intersection of medicine, life sciences and engineering. The importance of and urgent need for artificial organs have been long understood: medical texts dating back several centuries contain ideas describing their design, fanciful and impractical as they may have been. The first real breakthrough in artificial organ design came in 1982, with Jarvik-7, the first fully functioning artificial heart to be successfully implanted in a human. The medical researcher, Robert Jarvik, and inventor Willem Kolff are credited with the design of Jarvik-7. Kolff has several other innovations to his credit, including the first artificial kidney (dialysis machine) and the heart-lung machine, and he is known for being an avid proponent of blood transfusion procedures—all of which reflect his enthusiasm and belief in helping the human body continue to function even after its organs stop. For these innovations and ideologies, he is regarded as the father of artificial organs.

Today, despite remarkable advances in transplantation, the importance of artificial organs has not diminished. If anything, the long waiting list and the wait duration necessitate effective and immediate alternatives to organ transplant. The United Network for Organ Sharing, a U.S.-based not-for-profit organization that administers the organ donation network, estimates that more than 120,000 Americans—more than 100,000 of whom require a kidney—are on the waiting list for life-saving organs. The average prospective kidney recipient has a 3.6-year wait, and at least 20 people waiting for an organ die each day.   

Artificial Organs Could Solve Transplant Shortages

The thought of an off-the-shelf heart that could replace a failed one is a tempting proposition, and one that a few companies have cracked. Notable among them is BiVACOR of Houston, Texas. BiVACOR’s eponymously named total artificial heart (TAH) device is an option available to patients with end-stage heart failure who do not qualify for transplants. Another important company, SynCardia Systems (Tucson, Ariz.), has developed a temporary TAH device—an implantable system that can take over heart functions—for patients suffering end-stage biventricular heart failure. The device is intended to be used only as a bridge to donor heart transplantation, and is the only one approved by the U.S. Food and Drug Administration and European Union and Canadian regulatory boards.

With the advent of 3-D printing and tissue engineering, one can think beyond electromechanical pumps that can serve as hearts to visualize an artificial one in, quite literally, flesh and blood. The race is on to develop a functional, tissue-based artificial organ that would mimic organs in physical and physiological functions, such as secretion of hormones, nurturing vasculature, and growth and modeling as the individual grows.

Stephen Badylak, professor and deputy director of the McGowan Institute for Regenerative Medicine at the University of Pittsburgh, is working on a functional liver that is suitable for transplantation. Badylak’s approach involves harvesting a patient’s stem cells and culturing them in specially designed 3-D scaffolds.  The hope is that these cells will develop into a functional organ when supplied with appropriate growth nutrients. Because the cells are retrieved from the patients themselves, the challenges of organ rejection and immune response are bypassed.

Artificial Organs for Medical Research

While the delay in producing a fully functional, dimension-matched organ will disappoint the organ transplant market, it is still news worth cheering. In fact, the entire pharmaceutical industry waits with bated breath for tissues that resemble actual human tissues. Such analogues are of great importance for drug testing.

San Diego-based Organovo has been at the forefront of commercializing 3-D bioprinting of tissues for medical research. The company has successfully printed patches of tissues of the liver, lung, heart and kidneys for use by research partners. The company’s ExVive line of human liver and kidney tissues are used in toxicology studies and other preclinical drug testing. This application of artificial organs has tremendous potential to accelerate the drug development process, lower costs, and reduce the need for animal and clinical testing. In fact, L’Oreal, the global cosmetics company, sources 3-D-printed human skin tissues from Organovo with the aim of reducing much-reviled animal tests. L’Oreal already owns a patent on Episkin, a tissue-engineered skin product that has been developed by incubating skin cells donated by surgery patients. The partnership with Organovo would enable L’Oreal to print them more easily, and to requirements.

Electronic Skin Can Give Robots a “Human” Touch

Skin is the largest organ of the human body, and a highly complex one. Recreating the skin involves imparting the sensations of touch, pressure and temperature to the artificial material. Such an artificial skin would no doubt be of great value to burn victims and patients undergoing extensive surgery. However, an application that is now the fuel for science-fiction movies could soon be a reality: providing robots with sensory inputs.

SmartCore, a project funded by the European Research Council and executed by researchers at the Graz University of Technology in Austria aims to create a material that would respond to varied stimuli. To achieve this, the team has developed a novel material that is lined with an array of nanosensors whose sensitivity far exceeds that of the human skin. Although still in early stages, the team is designing a “smart” core—a polymer that would expand when exposed to humidity and temperature and is encased in a piezoelectric shell that produces an electric current when pressure is applied. These cores receive the stimuli and transmit them to the robotic system. The team aims to display the prototype by 2019, after which specific applications would be explored.

Artificial Womb Raises Hope for Premature Babies

In April 2017, researchers from the Center for Fetal Diagnosis and Treatment at the Children’s Hospital of Philadelphia announced—and published—that they had developed the world’s first artificial womb. Nicknamed BioBag, these “wombs” resemble Ziploc bags with tubes of amniotic fluid, oxygen, nutrients and blood weaving in and out. Inside the bags, though, the researchers managed to nurture fetal lambs.

In August 2017, a similar womb was devised by an unrelated group: researchers from Women and Infants Research Foundation in Australia, the University of Western Australia, and Tohoku University Hospital in Japan. Aptly named ex-vivo uterine environment (EVE) therapy, it has raised expectations of a viable and repeatable womb-like environment.

The Road Ahead

Frost & Sullivan believes that the road ahead for artificial organs is paved by enthusiastic researchers, funding agencies and a collaborative ecosystem. However, there are also roadblocks in the form of ethical concerns, regulatory requirements, device cost, and safety concerns because of a lack of long-term clinical data. The answer would be detours that may still lead to lucrative destinations. The use of artificial skin tissues for medical and cosmetic research is an example. Similarly, an artificial womb to gestate a human embryo would be a tall task, and one that would unearth numerous ethical, moral and legal questions; however, an acceptable route for the time being would be to use the womb to save the lives and improve the health of the millions of pre-term babies that are born every year.

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