NARRATION
This is Luke Masella. He shouldn't
be this healthy.
Luke Masella
I was born with spina bifida, which is a birth defect. It's
basically a hole in the spine, where all the nerves don't develop. When I was
ten, I got really sick, and they were trying to figure out what was going on.
And I was in and out of the hospital every week, and they finally figured out
that I was actually in kidney failure.
NARRATION
A faulty bladder was Luke's problem, caused by the spina
bifida.
Luke Masella
The bladder was sending fluid back up into my kidneys, which
was making them not work correctly.
NARRATION
But Luke was given a remarkable treatment. At Wake Forest
School of Medicine, in America's North Carolina, researchers are growing
artificial body parts. Luke was one of the first in the world to benefit.
Luke Masella
They take a piece of your bladder out. They grow it in a lab
for two months into a new bladder that's your own. And they put it back in.
NARRATION
Grow your own organs in the lab means no rejection problems
and no waiting around for organ donors. It's called 'regenerative medicine',
and it's an exciting future that awaits us all.
Dr Sharon Presnell
I see us getting to a point of having options available that
actually stop disease processes, reverse disease processes or offer people
cures.
NARRATION
Simple organs, like bladders, are the easiest to grow. Cells
were taken from Luke's original bladder, multiplied up, nutrients added, and
that produced this pink solution.
Prof Anthony Atala
And we then created a three-dimensional mould. And we placed
the cells on top of the mould.
NARRATION
The mould is in the shape of a bladder, and is made from
material that breaks down in the body.
Prof Anthony Atala
We placed the mould with the cells in an oven-like device.
We cooked it, if you will - very much like baking a layer cake. And we then
were able to take that organ out, and we were able to place it into patients.
NARRATION
And the team has cooked up more than bladders.
Prof Anthony Atala
Another of the organs that we have targeted is the urethra,
which is the channel that connects the bladder to the outside of the body. It
is a very important organ, as you can imagine.
NARRATION
Some of Anthony's patients had had car accidents, damaging
their urethras. So he decided to grow them new ones. They were like bladders,
really, with a different geometry. Scaffolding was seeded with the patient's
cells and nutrients, and then sewn into the shape of a urethra.
Prof Anthony Atala
We then were able to place those engineered urethras back
into those patients.
NARRATION
To automate organ-making, the researchers came up with an
incredible method - print them. They even started out with modified computer
printers.
Prof Anthony Atala
But instead of using ink, we use cells. And we print the
cells with a gel-like material one layer at a time. And we then allow the gel
to get harder over time.
NARRATION
Nowadays these bioprinters are
purpose-built and much more sophisticated. Indeed, on the other side of the
country, in San Diego, we visited start-up company Organovo.
They're planning to take bioprinting to market.
Dr Graham Phillips
Very impressive-looking labs. Brand-new.
Dr Sharon Presnell
Yes. Brand-new. Been here for about three weeks. This is
where the action happens. These are our tissue culture heads. It keeps
everything sterile. And we take the cells and build the 3-D tissues within this
space.
Dr Graham Phillips
So it's kind of an organ-growing lab, in a way.
Dr Sharon Presnell
It is, absolutely.
NARRATION
This sophisticated robot is the bioprinter.
It squeezes out half-a-millimetre-wide cylinders of bioink.
The ink is just clusters of human cells - remarkably, holding themselves
together in the correct shape just with natural adhesion. Six cylinders of
cells are laid on each other to make a tubular blood vessel. In this
cross-sectional diagram, the red circles represent the walls of the vessel.
Dr Sharon Presnell
This is a fully human blood vessel that we've created with
the bioprinter here on the plate. And so, you can see
its three-dimensionality just as you turn the plate a slight angle.
Dr Graham Phillips
Yeah, yeah, yeah.
NARRATION
Again, the cells have assumed their correct positions in the
vessel by themselves. There's no scaffolding holding this together.
Dr Graham Phillips
So how do the cells know where to go?
Dr Sharon Presnell
They're smarter than we are in a lot of ways. It's their
inherent properties. I think it's... You know, it's leveraging the qualities
that cells naturally have, which is to stick to each other. We are able to
control the shape in which they do that, and then the printer builds the
ultimate structure.
NARRATION
The next step is to give the cells nutrients and then put
them in the incubator over night. There they'll
continue to self-arrange and form a vessel.
Dr Graham Phillips
After a night in the incubator, and with a bit of cleaning,
this is what you get - a replacement blood vessel made out of your cells.
NARRATION
This blood vessel is the width of a few human hairs. Back in
North Carolina, they're developing another application for bioprinting
- for wounds.
Prof Anthony Atala
One strategy is to have a printing machine that not only
prints but also scans. So, basically, the patient is first scanned, so the
wound area gets a scan of the wound, and then we're able to go back with a
printer and print the right layers of tissues right where they belong.
NARRATION
Now, for most organs, there's still a long way to go before
they'll be ready for patients. But research IS progressing - on artificial
kidneys, heart valves, large blood vessels and skin. Here it's being slowly
stretched out. They're even working on artificial ears and fingers.
Prof Anthony Atala
Of course, fingers is still a long
time away of us actually getting that into a patient. But the ear is simpler
than a digit, and we're creating ears in a project we're doing right now with
the military to provide these kinds of structures to our injured warriors.
NARRATION
Even muscles are up for replacement.
Prof Anthony Atala
To create artificial muscle, we use the same strategies as
we have used with other tissues, but we also exercise them. We put them in
these mobile reactors, these exercise machines, that actually stretch and
compress the muscle structures, so they build up strength over time before we
implant them.
NARRATION
But the organs most in demand are kidneys and livers. And
Anthony's team recently had a breakthrough. They developed miniature livers
that functioned like human ones - in the lab at least. But artificial liver and
kidney transplants are some way off because they're so complicated.
Prof Anthony Atala
The kidney's a very complex structure, because it's a solid
organ. And so, unlike other structures - like flat structures, such as skin,
which are the simplest, tubular structures, like blood vessels or urethras,
which are a second level of complexity, or even the bladders, which are a third
level of complexity - the kidneys are a solid organ and have a fourth level of
complexity. And, therefore, you'd have a lot more cell types. It requires much
more sophisticated methods for engineering.
NARRATION
Still, fixing up livers and kidneys may be closer than you
think. We may be able to patch them.
Dr Sharon Presnell
If you take chronic kidney disease, for example, by the time
a patient shows up at the doctor to say that I don't feel well, they are
usually down to less than 10% of the function of that organ.
NARRATION
That says you don't need the whole organ to be replaced to
feel well.
Dr Sharon Presnell
The tissue that is required to replace is actually only 10%-20%
- to change the way that patient feels, change their quality of life and really
be effectively a cure for them.
NARRATION
Predicting the timing for any research is always difficult.
But it's clear that some pretty exciting developments are on their way. There
will be so many people, like Luke, who will benefit.
Topics: Health, Technology
Reporter: Dr Graham Phillips
Producer: Dr Graham Phillips
Researcher: Wendy Zukerman
Camera: Kevin May
Sound: Steve Ravich
Editor: Toby Trappel
STORY CONTACTS
Dr Sharon Presnell
Chief Technology Officer
Organovo, San Diego
Professor Anthony Atala
Director
Wake Forest Institute for Regenerative Medicine
North Carolina