3D Printing of Organs: State of the Art and Prognosis (1)

3D printing of organs is a regular guest on almost every list of technologies  influencing the healthcare of the future. At the same time, this technology seems almost old again, we have been talking about it for so long. Would we still call it a future technology? Without compromise, yes. 3D printing of organs has the potential to fundamentally change healthcare. The image of our body is changing. yesterday, medicine was working on restoring an original state given by God or nature, tomorrow the improvement and expansion of physical functionalities will become the central task. Here is a brief overview of the main players and their roadmap.

Probably the most important actor is Anthony Atala, surgeon, urologist and director of the Wake Forest Institute for Regenerative Medicine in Winston-Salem, North Carolina. During my most recent visit in spring 2018 I could not only hold a printed kidney in my hand, I could observe machines printing blood vessels, bones, livers, heart cells. His initiative to industrialize the processes for the production of any organs is even more promising. Only half of his total of 500 employees in the laboratory are physicians. At the same time, mechanical engineers, among other things, are working on reliably standardizing the processes in order to be able to offer them at many locations in this way.

The principle “3D printing of organs” is always the same and simple in logic: Whoever is able to grow organs from human stem cells can a) produce organs whenever he needs them and b) will prevent the organ from being rejected by the body. Risks are reduced and lifelong therapies are eliminated. The acute shortage of donor kidneys in particular is eliminated; the transport of transplants is no longer necessary. So far the consensus.

100% or more?

Among the researchers developing this technology, opinions differ at c): Will we also be able to improve the organs? Will my printed heart, my kidney, my liver be more efficient than the original one? And will my organs receive additional functions that were not yet provided for in the original configuration of my body? We see how the image of our body changes in the face of this possibility alone: The functional scope of the institutions, the coordination among each other – all this becomes a configuration. The body becomes a configurable machine. The only difference is whether the ideal is to restore the initial 100% as accurately as possible – or an individual and targeted deviation.

Dr Atala is the most important representative of those who rely on the 100% model. At the same time, he is the one whose laboratory is closest to formal approval by the FDA. His perspective: At the beginning of the 2020s, the first procedures for 3D printing of organs will be approved. First for rather simple structures, later step by step also more complex ones. Until the mid-2040s, it will be normal in many parts of the world to talk to your physician of trust about an exchange of almost any organ as a matter of course. In this way, he expects to be able to increase normal life expectancy to around 120 years.

3D Printing of Organs
Dr. Atala showing a printed kidney

Read about the work of 3D printing pioneer Gabor Forgacs in part 2.

Healthcare-Tech: Apple strengthens commitment

Healthcare-Tech in focus: around Apple, the sensors for potential developments are particularly finely adjusted. And even if Apple traditionally communicates very sparingly: The company’s job advertisements are a reliable source of news and trends. The US media company CNBC is just pointing out that Apple is looking for developers to expand the range of its own processors. One focus is on healthcare. CNBC quotes an Apple posting: The new employees should “help develop health, wellness, and fitness sensors”.

One possible field of application is Apple Watch. It already has functions to measure heart rate and activity data. Relevant blogs from Silicon Valley such as Venturebeat have already included the news. What is interesting is that Apple is obviously in the process of bringing the development of healthcare technology in-house. This would be a clear indication of the priority this issue has for the most valuable company in the world.

Healthcare-Tech-Apple-Fotolia

Demographic change and healthcare: Good News

Demographic change and healthcare: The core business of health insurance in the future will no longer just be healing the sick. Health insurers will support healthy people – from the prevention of diseases to increasing well-being and life expectancy. This is the result of a current trend study by 2b AHEAD ThinkTank. Demographic change has a direct impact here.

Trend study health insurance

The healthcare sector will undergo unprecedented change by 2030. With digitalization, the possibilities of medical research, diagnostics, therapy, rehabilitation and prevention are growing at exponential speed. These effects are nowhere more evident than among the fastest-growing groups in our society:

  • The old who don’t feel old even when they retire,
  • the still older, who in many cases can still lead an active and active life, and
  • the very old, still rare today, soon an everyday occurrence.
The good news

The majority of today’s forecasts and future studies address demographic change as a problem and a threat. Of course, it will present us with social and economic challenges of an unprecedented scale. But for both individuals and our communities, demographic change represents the greatest conceivable progress: the considerable extension of one’s own life in activity and self-determination. Demographic change may be expensive news, but above all it is good news.

People born in this decade realistically reach an age of over 100 years. It is the interaction of four influential drivers that brings the dream of longer life within reach. The first condition is the freely available gene analysis. The second development concerns the breeding of individual copies of internal organs, which may be optimised compared to the previous version. The third prerequisite is a comprehensive understanding of the aging processes of humans. The fourth element is the synchronization of the human psyche with the virtual world. A breakthrough in research in all four fields is likely in the coming years.

For the sake of completeness: There is a well-founded opposite position to this, especially taken up here in the blog. It is represented among others by the medical ethicist Ezekiel J. Emanuel. He fears extension as a phase of helplessness and diminishing dignity.

The increase of well-being

A decisive change in dealing with human health is the disappearance of the binary assumption that a patient is either healthy or ill. This categorical distinction has always been a fiction anyway. Nobody’s just sick or just healthy. Instead – assuming the corresponding amount of data and its continuous collection – the individual well-being can be measured and located on a scale. This is changing the goal of medical action. While yesterday the focus was on repair and damage prevention, tomorrow it will be on gradually improving one’s own well-being. What can I do to feel a little better tomorrow – and who will support me? The enlightened healthcare customers of the future are very consciously and with the support of digital assistance systems selecting the most competent physician for their situation, the appropriate insurance and the trustworthy data manager from their individual healthcare network. At the same time, they will no longer accept that the interaction of several service providers is associated with increased effort for them.

In the near future, evidence-based, personalised recommendations for targeted prevention will replace the always identical bonus booklets of health insurance companies and lump-sum and overall undirected health-promoting measures.

Test Case Robotics in Nursing

This can be clearly seen in the emergence of robotics in care. Robotics became a widely accepted matter of course in the course of the 1920s. This has long been the case in the field of dementia care. The fact that a robot has the patience to listen to the same question, the same story, the same excitement over and over again as it did the first time makes this development even easier.

However, the development will not be limited to animated stuffed animals. This is shown in the example of medication. Where nursing staff still have to work by hand today, the procedure is time-consuming and prone to errors. The next step is automated dispensing of medication to the patient at home: individual implementation of the medication plan by a pill robot. In the next step, robots learn to analyse the state of health of humans. By blood sample, air analysis, nutrition tracking, later by observing the skin temperature, the movement patterns and by voice analysis. The dosage of the active ingredient is calculated in real time.

In the next expansion stage, the medication robot is able to print the individually appropriate active ingredients onto a carrier directly before ingestion. Is this a relief for the nursing service? With great certainty. Does this development, and thus indirectly the demographic change, have the potential to improve the well-being of the individual patient? With a very high probability. These are the simple questions. But whose knowledge is the robot`s work based on? As soon as he has access to networked medical knowledge, his professional competence will always be higher than that of the individual doctor. For the time being, the family doctor is still needed to issue prescriptions, which also makes up for a reason to exist professionally. His profession will change permanently, a thesis that Markus Bönig of Vitabook has just confirmed here. The medicines or active ingredients do not have to be purchased in the pharmacy around the corner anyway. This opens up completely new business areas for new players.

Smart Home

An additional driver of this development is the currently exponentially growing networking of buildings, starting with Ambient Assistant Living. The smart home of the person in need of care is the first and most competent care robot. This means that completely new players are suddenly active in the health industry: Network operators, property managers, building contractors, manufacturers of electronics and sensor technology. This, too, is an indirect consequence of demographic change.

Health insurers as the health promoters of the future must start much earlier in the process, which means that they will occupy a much more active and positive position in the perception of health customers. The one-size-fits-it-all-principle has had its day. In future, health promoters will not react only when health customers are ill, but will continuously monitor their current state of health and act before the onset of a foreseeable illness. This too: That’s good news.