Printing a human kidney Anthony Atala
[Music]
there’s actually a major health crisis
today in terms of the shortage of organs
the fact is that we’re living longer
Medicine has done a much better job
making us live longer and the problem is
as we age our organs tend to fail more
and so currently there not enough organs
to go around in fact in the last ten
years a number of patients require an
organ has doubled well in the same time
the actual number of transplants has
barely gone up this is now a public
health crisis so that’s where this field
comes in that we call the field of
regenerative medicine it really involves
many different areas you can use
actually scaffolds biomaterials they’re
like the piece of your blouse or your
shirt but specific materials you can
actually implanted patients and they
will do well and help you regenerate or
we can use cells alone either your very
own cells or different stem cell
populations or we can use both we can
use actually biomaterials and the cells
together and that’s where the field is
today but it’s actually not a new field
interestingly this is a book that was
published back in 1938 titled a culture
of organs the first author Alexis Carrel
and Nobel Prize winner he actually
devised some of the same technologies
used today for suturing blood vessels
and some of the blood vessel grafts were
used today were actually designed by
Alexis but I want you to note his
co-author Charles Lindbergh that’s the
same Charles Lindbergh who actually
spent the rest of his life working with
Alexis at the Rockefeller Institute in
New York in the area of the culture of
organs so the fields been around for so
long why so field clinical advances and
that really has to do to many different
challenges but if I were to point to
three challenges the first one is
actually the design of materials that
could go in your body and do well over
time and many advances now we can do
that fairly readily the second challenge
with cells we could not get enough of
your cells to grow outside of your body
over the last 20 years
years we’ve basically tackled that many
scientists can now grow many different
types of cells plus we have stem cells
but even now 2011 there’s still certain
cells that we just can grow from the
patient liver cells nerve cells
pancreatic cells still can grow them
even today and the third challenge is
vascularity the actual supply of blood
to allow those organs or tissues to
survive once we regenerate them so we
can actually use biomaterials now this
is actually biomaterial we can weave
them knit them or we can make them like
you see here this is actually like a
cotton candy machine you saw this spray
going in that was like the fibers of the
cotton candy creating this structure
this tubular eye structure which is a
biomaterial that we can then use to help
your body regenerate using your very own
cells to do so and that’s exactly what
we did here because it’s actually a
patient who presented with a deceased
organ and we then created one of these
smart biomaterials and we then use that
smart bomb material to replace and
repair that patients structure what we
did was we actually use the biomaterial
as a bridge so that the cells in the
organ could walk on that bridge if you
will and help to bridge the gap to
regenerate that tissue and you see that
patient now six months after with an
x-ray showing you the regenerated tissue
which is fully regenerated when you
analyze it under the microscope we can
also use cells alone these are actually
cells that we obtained these are stem
cells that we create from specific
sources and these are we can drive them
to chem heart cells and they start
beating in culture so they know what to
do the cells genetically know what to
then they start beating together now
today many clinical trials using
different kinds of stem cells for heart
disease so that’s actually now in
patients or if we’re going to use larger
structures to replace larger structures
we can then use the patient’s own cells
or some cell population and the
biomaterials the scaffolds together
so the concept here is if you do have a
or injured organ we take a very small
piece of that tissue listen half the
size of a postage stamp
we then tease the cells apart we grow
the cells outside the body we then take
a scaffold a biomaterial
again looks very much like a piece of
your blouse or your shirt
we then shape that material and we then
use those cells to code that material
one layer at a time very much like
baking a layer cake if you will we then
place that in an oven-like device and
we’re able to create that structure and
bring it out this is actually a hard
valve that we have engineered and you
can see here we have the structure of
the heart valve and we’ve seated that
with cells and then we exercise that you
so you see the leaflets opening and
closing of this heart valve that’s
currently being used experimentally to
try to get it to to further studies
another technology we have used in
patients actually involves bladders we
actually take a very small piece of a
bladder from the patient less than half
the size of a postage stamp
we then grow the cells outside the body
take the scaffold coat the scaffold with
the cells the patient’s own cells two
different cell types we then put it in
this oven like device has the same
conditions as a human body 37 degrees
centigrade 95% oxygen a few weeks later
you have your engineered organ that
we’re then able to implant back into the
patient for these specific patients we
actually just suture these materials we
use three-dimensional imaging analysis
but we actually created these
biomaterials by hand but we now have
better ways to create these structures
with the cells we use now some type of
technologies where first solid organs
for example like the liver what we do is
we take discard livers as you know a lot
of organs are actually discarded not
used so we can take these liver
structures which are not going to be
used and we then put them in a washing
machine like structure that will allow
the cells to be washed away two weeks
later you have something that looks like
a liver you can hold it like a liver
but it has no cells it’s just a skeleton
of the liver and we then can Reaper fuse
the liver with cells preserving the
blood vessel tree so we actually profuse
first a blood vessel tree with the
patient’s own blood vessel cells and we
then infiltrate the parenchyma with the
liver cells and we not been able just to
show the creation of human liver tissue
just this past month using this
technology another technology that we’ve
used is actually that of printing this
is actually a desktop inkjet printer but
instead of using ink we’re using cells
and you can actually see here the
printhead going through and printing
this structure and it takes about 40
minutes to print this structure and
there’s a 3d elevator that then actually
goes down one layer at a time each time
the printhead goes through then finally
you’re able to get that structure out
you can pop that structure out of the
printer and implant it and this is
actually a piece of bone that I’m going
to show you in this slide that was
actually created with this desktop
printer and implant it as you see here
that’s all new bone that was implanted
using these techniques another more
advanced technology we’re looking at
right now our next generation of
technologies are more sophisticated
printers this particular printer with
worthy signing now is actually 1 we
print right on the patient so what you
see here is I know it sounds funny but
that’s the way it works because in
reality what you want to do is you
actually want to have the patient on the
bed with the wound and you have a
scanner basically a cliff like a flatbed
scanner that’s what you see here on the
right side you see a scanner technology
that first scans the wound on the
patient and then it comes back with the
print hits actually printing the layers
that you require on the patient’s
themselves this is how it actually works
here’s a scanner going through scanning
the wound
once it’s scanned sends information in
layers the correct layers of cells where
they need to be and now you’re going to
see here a demo of is this actually
being done
in a representative wound and we
actually do this with a gel so you can
lift the gel material so once those
cells are on the patient they will stick
where they need to be and this is
actually new technology still under
development we’re also working on more
sophisticated printers because in
reality our biggest challenge are the
solid organs I don’t know if you realize
this but ninety percent of the patients
and the transplant list are actually
waiting for a kidney patients are dying
every day because we don’t have enough
of those organs to go around so this is
more challenging large organ vascular a
lot of blood vessels supply a lot of
cells present so the strategy here is
this is actually a CT scan an x-ray and
we go layer by layer using computerized
morphometric imaging analysis and 3d
reconstruction to get right down to
those patient’s own kidneys we then are
able to actually image those do
360-degree rotation to actually analyze
the kidney in its full volumetric
characteristics and we then are able to
actually take this information and then
scan this in a printing computerized
form so we go layer by layer through the
organ analyzing each layer as we go
through the organ and we then are able
to send that information as you see here
through the computer and actually design
the organ for the patient this actually
shows the actual printer and this
actually shows that printing in fact we
actually have the printer right here so
I’m in while we’ve been talking today
we’ve actually you can actually see the
printer back here in the backstage
that’s actually the actual printer right
now and that’s been printing this kidney
structure that you see here it takes
about seven hours to print the kidneys
this is about three hours into it now
and dr. Kang’s going to walk onstage
right now and we’re actually going to
show you one of these kidneys that we
print a little bit earlier today
put a pair of gloves here
thank you
you’re backwards
so these clothes are a little bit small
on me but here it is you can actually
see that kidney as it was printed
earlier today
that’s a little bit of consistency to it
this is dr. Connie who’s been working
with us in this project and we went a
part of our team Thank You dr. Kahn
appreciate it so this is actually a new
generation this is actually the printer
that you see here on stage and this is
actually a new technologies we’re
working on now in reality you know we
now have a long history of doing this
I’m going to share with you a clip in
terms of technology that we have had in
patients now for a while and this is
actually a very brief clip only about 30
seconds of a patient who actually
received an organ I was really sick I
could barely get out of bed I was
missing school it was just pretty much
miserable I couldn’t you know go out in
play you know basketball at recess
without feeling like I was going to pass
out when I got back inside it was I felt
so sick I was facing basically a
lifetime of dialysis and I don’t even
like to think about what my life would
be like if I was on that so after the
surgery life got a lot better for me I
was able to do more things I was able to
wrestle in high school I became the
captain the team and that was great I
was able to be you know the normal kid
with my friends and because they use my
own cells to you know build this bladder
it’s gonna be with me I got it for life
so I’m all set
these experiments sometimes work and
it’s very cool when they do Luke
come up please
so look before last night when’s the
last time you saw Tony ten years ago
when I had my surgery and it’s really
great to see him
I’m tell us a little about what you’re
doing well right now I’m in college at
the University of Connecticut I’m a
sophomore and studying communications TV
and mass media and basically trying to
live life like a normal kid which I
always wanted growing up but it was hard
to do that when I was born with spina
bifida and my kidneys and bladder
weren’t working I went through about 16
surgeries and it seemed impossible to do
that when I was in kidney failure when I
was ten and this surgery came along and
basically made me who I am - and saved
my life
I’m Tony Dunne hundreds of these what I
know from he’s he’s working really hard
in his lab and coming up with crazy
stuff I know I was one of first ten
people to have this surgery and when I
was ten I didn’t realize how amazing it
was I was a little kid and I was like
yet I’ll have that I’ll have that
surgery I all I wanted to do is to get
better and I didn’t realize how amazing
it really was until now that I’m older
and I see the amazing things that he’s
doing um when you know you got this call
out of the blue I mean
Tony’s really shy and it took a lot of
convincing to get somebody as modest as
Tony to allow us to bring Luke so look
you go to your communications professors
your majoring communications and you ask
them for permission to come to Ted which
might have a little bit to do with
communications and what was their
reaction most of my professors were all
for it and they said bring pictures and
and you know show me the clips online
and I’m happy for you there are a couple
that were a little stubborn but I had to
talk to I pulled him aside well it’s an
honor of privilege to meet you thank you
so much
you