

A First: Organs Tailor-Made With Body’s Own Cells - mhb
http://www.nytimes.com/2012/09/16/health/research/scientists-make-progress-in-tailor-made-organs.html?pagewanted=all

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ChuckMcM
People seem astonished that you can grow a new organ, and yet they grew them
originally so you have an existence proof :-) The challenge is understanding
literally _everything_ that is going on during that growth and what its role
is. That is an analysis problem which is well suited to the techniques
available to doctors.

Like a program, the rapidity of the improvement gets faster the more you know.
Using stem cells as a proxy for how much we 'know' we went from 'harvesting'
stem cells to 'making' stem cells. Lately I've read a number of interesting
(if opaque :-) papers about various scaffolds for holding cells as they
develop into tissue. The third piece of this puzzle will be the triggers (or
you can think of it as the minimum scaffold) to evoke the organ you're looking
for. This is simply analysis, ongoing, checking the boxes, we have working
systems to compare against. Sure it needs the insights to 'connect the dots'
but if you look at the puzzle long enough you figure it out.

So step back for a minute and think about what that will mean for health care
costs. If we can replace organs at will for people, that is a much more cost
effective treatment of heart disease, or diabetes, or gout. The trick will be
insuring that those cost savings return to you and me and not to someone else.

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jared314
I disagree with your last statement. Most current drug therapies are dirt
cheap compared to the costs of organ implantation (even when you assume no
long term care afterwards). This cost difference also makes me think insurance
companies won't cover replacement organs when there is a normal treatment,
thus keeping the current costs the same.

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ChuckMcM
Would love to hear more about this. There are a couple of things, first we
have to forward predict what an organ transplant will cost when things like
flying a kidney in a helicopter from LA to SF is unnecessary. or the previous
owner's body is maintained on life support. I've heard horror stories (but not
seen the bills) for recipients being charged for that which grossly inflated
the cost. So lets start with say 2 months of space in a tissue reactor to get
the organ grown, and an 8hr surgical procedure, full team with 3 days postop
care. For things like kidneys/spleens/bladders I would think it would be a lot
less than say a heart or heart/lung transplant.

Then the second part is the costs associated with 'regular' care. So 10 years
of dialysis + incidental infection care + machinery + visits is less expensive
than the one day in the OR + 3 days post op?

I don't know, seems like a grown organ transplant should be less expensive,
would love a heath care administrator to step in with some solid numbers.

Then

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jared314
The organ failure scenarios you describe are the ideal case. If you look at
the more common ailments like heart disease, diabetes, gout, or tooth decay.
The equation changes in favor of the current treatments. You would be hard
pressed to convence me that the cost of growing, and implanting, a new tooth
would be lower than a conventional dental crown or implant.

I would love to be wrong. I would love to see the growth of spare parts reach
mainstream use. But, I still believe their use will be artificially
restricted, because of the cost of the skilled professionals involved and
availability of proven alternatives.

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dhughes
This hits a little too close to home.

I have GERD and daily I think about cancer, already I feel like I'm being
strangled all the time. My doctor said it was a one in a million chance but
constant irritation and a daily proton-pump inhibitor drug isn't my idea of
being healthy.

Add to that my dad was diagnosed last January with IPF, an incurable
progressive scarring of lung tissue, a cause of which is GERD; stomach acid
splashes into lungs and over time can cause damage. Lung cancer seems like a
walk in the park compared to IPF.

It would be fantastic if specific organs could be replaced it would solve my
problem and for most diseases people develop other than entire body, systemic
diseases or diseases of the brain.

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SeanDav
Consider me boggled.

How does the body "know" or get "told" to only manufacture wind pipe cells and
not say grow a new toe?

Really impressive stuff.

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agumonkey
In vivo, IIRC, there's a neighboring effect. If you take too lump of cells
separated by a small space, they will grow and fill the gap will functioning
specialized cells similar to the one in the lump. It only works for small
distances. The scaffold might act as a structural guidance.

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kiba
_The work of these new body builders is far different from the efforts that
produced artificial hearts decades ago. Those devices, which are still used
temporarily by some patients awaiting transplants, are sophisticated machines,
but in the end they are only that: machines._

What's wrong with those machines? They're off-the-shelf machines that can be
manufactured in large number as necessary and they're subjects to engineering
improvement over time.

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apendleton
The conventional Jarvis-style artificial heart also tries to imitate the
functioning of a human heart, with distinct pumps making up a heartbeat. They
tend to suffer from mechanical fatigue over time, though, because they have no
mechanism for self-repair. There has, however, been some interesting
artificial heart research that uses continuous-flow pumps that could
conceivably work much better than the current generation of artificial hearts:
[http://www.popsci.com/science/article/2012-02/no-pulse-
how-d...](http://www.popsci.com/science/article/2012-02/no-pulse-how-doctors-
reinvented-human-heart?page=all)

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stephengillie
Dick Cheney has one.

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apendleton
Dick Cheney has half of one. He has a left-ventricular assist device, which
has one pump, but still has a heart that does part of the work. The proposed
devices in the PopSci article are two of those pumps together, replacing the
heart's functions altogether. These have been implanted into cows and work
fine, but haven't worked their way through the FDA yet for non-trial use in
people.

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stephengillie
I remember the NOVA special on flushing pig organs of their cells, then
seeding that scaffold with stem cells. It's good to see progress.

