Society of Bioethics and Medicine
Fighting Ailments with Custom-Made Living Organs
Written by Jonathan Gao
Edited by Raheem Sheikh
If you ever baked cookies or cakes, you’re familiar with the process: a simple batter is made from flour, egg yolks, milk, and sugar. If you’re a chocolate lover, you’re likely to mix chocolate chips or Nutella into the batter. If you prefer some fragrant spices, you’d probably be inclined to throw cinnamon or ginger snaps in. Or if you like things more refreshing, you may add strawberries or blueberries to the finished product.
While naturally more appetizing, this dessert analogy helps explain the process that scientists and technicians at 3DBio Therapeutics have used in their design of a 3D-printed ear implant.
In June 2022, the New York Times reported that Dr. Arturo Bonilla, a pediatric ear reconstructive surgeon from Texas, surgically removed cartilage from Alexa, a 20-year old woman born with microtia - a rare birth defect that causes ear malformation in 1 in every 2,000-10,000 babies within the United States. Along with a 3D scan of her healthy left ear, the cartilage was then sent from San Antonio, TX to Queens, NY. The cells responsible for the production of collagen, known as chondrocytes, were isolated from the sample and grown in nutrients that would promote chondrocyte proliferation.
A specialized bioprinter, loaded with a mixture of both the chondrocytes and the company’s “batter”, a collagen bioink, then extrudes the material layer by layer. Eventually, the product begins to take form, possessing the unique features, or ingredients, that make Alexa's ear uniquely hers. After ten minutes, the ear is finished. Dr. Bonilla receives the ear and implants it to the side of Alexa’s face, revealing a healthy right ear.
This clinical trial from 3DBio, whose primary aim is to gather preliminary data from living-tissue implants on participants born with microtia, is the very first of its kind. AuriNovo, the trademarked name of the patient-matched and patient-tissue-derived transplant that was implanted on Alexa, still requires several evaluations before more patients with microtia and receive an ear that works and feels like a genuine Fighting Ailments with Custom-Made Living Organs ear.
Such evaluations include standard safety assessments and ratings on treatment efficacy that are measured by surgical outcome satisfaction and questionnaires on how participants feel about certain facial features.
A recipient’s response to their personalized bioprinted transplant is equally as important as the research that goes into developing such a solution. That is why new bioprinting methods, like the Digital Assembly of Spherical Viscoelastic Bioink particles (DASP), are capable of offering enhanced versatility and biocompatibility with the recipient’s body - even in ways that surpass the bioink method used to develop Alexa’s right ear.
Drawing inspiration from Minecraft, Dr. Liheng Cai and his team, at the University of Virginia School of Medicine and School of Engineering and Applied Science, developed DASP as a way to mimic what biological tissues do best: pack cells and proteins of varying types together.
Like the world of Minecraft itself, DASP involves the use of voxels – small 3D cubes that make up a larger whole, consisting of various textures, colors, and flavors. Similar to how a cave in Minecraft consists of stone, gravel, and ores, biosynthetic tissues developed with DASP involve the precise placement of individual cells within a water-soluble environment.
Combined, the successful ear transplant and pioneering bioprinting research signifies yet another great advance towards implementing replacement limbs and eventually, vital organs into the arsenal of effective, life-saving medical treatments. These novel findings prove that bioprinting is no longer a question of “what if?”, but rather, a matter of “how soon” we’ll see this enhance self-esteem and improve outcomes in transplant patients.
https://www.nytimes.com/2022/06/02/health/ear-transplant-3d-printer.html https://www.theverge.com/2022/6/2/23151690/3d-printed-ear-transplant https://clinicaltrials.gov/ct2/show/NCT04399239 https://www.cdc.gov/ncbddd/birthdefects/anotia-microtia.html
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