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A First: Organs Tailor-Made With Body’s Own Cells (nytimes.com)
61 points by mhb on Sept 16, 2012 | hide | past | web | favorite | 17 comments



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.


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.


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


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.


If globalized, the social effects might be even more interesting. No more incentive to buy 'stolen' organs, some classes of crimes will be rendered useless.


It is cheaper, in time and money, to take a fully formed organ than grow one. I hope that kind of crime would disappear, but I doubt it will.


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.


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.


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.


It has to do with http://en.wikipedia.org/wiki/Cell_potency#Totipotency

There are a few good intro lectures about how stem cells work at http://www.youtube.com/results?search_query=stem+cell+lectur... (please ignore the Samsung Galaxy S® III ads -- they are not totipotent in the least).


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.


They have no immune system. Infection can get started anywhere on/within them, fester. They fuse imperfectly with your body tissue, can shift and tear connections. They perform only the single pumping function of your heart, which has several other functions.


Human heart itself is a machine built by evolution. So of course there is nothing wrong with the idea of using machine as a replacement for the human heart. The author is trying to imply 'artificial mechanical machines' compare to 'biological machines'.

There are certain disadvantages to artificial mechanical machines.

1. Body's rejection to metals/plastic made objects. Patients who use those devices must take medicines to suppress their immune system to keep those machines functioning inside their bodies.

2. Mechanical machines are also very expensive because they are built rather than 'grown'.

3. They have moving parts which make them less reliable.

4. Many of those devices need external source of power instead of using body's energy (unlike biological machines that are highly 'plug and play') which makes them harder to maintain. It also increases costs because patients have to routinely visit hospitals to replace the batteries or fix them.

5. Even if you build highly advanced mechanical heart with non-biologial materials, it could have magnetic interferences and software level problems which are non-existent with biological machines.


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...


Dick Cheney has one.


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.


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.




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