PopTech interview: Gabor Forgacs on the reality of 3D organ printing

Dr. Gabor Forgacs has taken three dimensional printing to the next level. We’re not talking printing a chair or an architectural prototype but human organs – printing blood vessels, mini livers and nerve grafts cell by cell. Organ printing is one of the latest technologies within the tissue engineering discipline and Forgacs is at the forefront. PopTech spoke with the theoretical physicist turned biophysicist to get a sense of what’s currently possible in the realm of regenerating human cells and tissue, where he envisions the field is headed, and what the long-term implications could be.

PopTech: At the crux of this innovation and beyond just sounding cool, what is the need for 3D organ printing?
Gabor Forgacs: There are 70,000 people right now just in the U.S. waiting for a replacement kidney. There are 5,000 people waiting for a heart. There are people waiting for a liver transplant. And before a suitable donor is found, many of them will be dead. So there is a critical shortage of replacement organs and this interdisciplinary science, this discipline – tissue engineering – works with physicists, medical doctors, biologists, engineers to produce replacement tissue and eventually organs that will help to regenerate the body or to recover body functions that have been lost.

What are the basic elements needed to get the printer to produce blood vessels and tissue?
For ordinary printing [using a desktop printer], you need some ink, a cartridge, paper and a printer. For this, you need the bio-ink, the bio-paper and the bio-printer. The bio-ink, or cell aggregates with composition appropriate for a particular organ, is delivered using a bio-printer in a bio-friendly environment appropriate for the organ and within bio-compatible scaffolding gels that serve as the paper to form 3D tissue constructs.

Your research and development of 3D organ printing has its roots at the University of Missouri, where you’re a professor. Since then you’ve founded a company called Organovo, which sells “the world’s only commercial bioprinter proven to create tissue.” Is Organovo concentrating its research on something specific right now?
Organovo is trying to come up with two products. One of them is focused on blood vessels, which I call vascular grafts and the other focus is on nerve grafts. You need vascular grafts, or substitute blood vessels, when you have a clogged artery or symbiosis where you need to replace blood vessels. We are building blood vessels using the 3D printing technology but we’re not yet at the point where our vessels can be safely introduced into a living organism. We’re very close but we’re not yet there.

Even if we’re never able to print an organ, which I don’t believe, because there are already good results, our ability to print expanded 3D structures will have serious and very far-reaching implications and applicability in many other places.

The nerve graft is another important graft. Imagine that someone’s nerve is ruptured, typically in a traffic accident or on a battlefield, which is a serious injury. Unfortunately a nerve will not regenerate spontaneously if the gap between the two ruptured ends is bigger than 3 centimeters in a human being so we’re building grafts that can breach this gap that’s made of the patient’s own cells. The buzzword here is autologous tissue engineering. Autologous means we’re using the patient’s own cells. That’s where this science is leading to avoid immunological reactions.

It sounds like the printer has immense potential. You’re still in the prototype phase but at this point, how have you used it thus far to make an impact?
We have worked with pharmaceutical companies, most of which spend $1 billion to develop and market a drug, if it is successful. When they go from animal trials to human clinical trials there is a good chance that they will lose the drug. In fact, 65% of the drugs that are developed in the labs that go through successful animal trials are thrown away once human clinical trials commence because what is good for the animal is not good for the human.

We tell them, we’re going to print you a truly 3D little organoid – let’s say a liver from human cells. We take human liver cells and we build a 3D little teeny tiny liver that still can be maintained in culture and we tell them, OK, why don’t you try the drug on the 3D human structure and if the drug does not work and the little liver dies, well then don’t go any further because chances are that when you put it into a human, it’s not going to work. We are already working with some pharmaceutical companies and they realize the value of this.

Even if we’re never able to print an organ, which I don’t believe, because there are already good results, our ability to print expanded 3D structures will have serious and very far-reaching implications and applicability in many other places.

I see no reason why we would not be able to build from the patient’s own cells a structure that can perform the same function.

The idea of developing a mini liver to test drugs sounds fascinating but as you mentioned, I’m sure there’s significant value in those advances besides saving pharmaceutical companies money. What else has it been used for thus far?
It is being used for baby science. If someone wants to study early development, we can print a 3D structure, which in some ways would mimic an early embryo. The scientist can do a lot of hocus pocus and look at how cells behave under various conditions that may be there in early development.

Just say someone needs a heart replacement. Will this 3D organ printer one day be able to print an entire organ?
We will not be able to reproduce the heart that you have in your body one hundred percent. That is a structure that evolved over millions of years. The biggest challenge to tissue engineering or organ engineering is that we don’t know yet how to construct the vascular tree, which we have in our body [and which is integral in keeping organs alive]. However, this is probably not necessary.

We don’t have to reproduce exactly the same kidney that you have in your body, which again is the result of many millions of years of evolution. The kidney is a complex organ but one of its major functions is to rid the body of toxins. If we just concentrate on that function, I see no reason why we would not be able to build from the patient’s own cells a structure that can perform the same function. This structure will not look like a kidney and it will not mimic or resemble 100% that kidney that we carry in our body because I don’t think we’ll be able to do that ever.

So it’s about replicating the functionality of the kidney from one’s own cells as opposed to creating an identical copy of the actual organ?
If I can come up with a structure from your own cells – so I put it in your body and there is no immunological reaction and that structure performs the same function as far as ridding the body of toxins – then I accomplished my goal. It’s a very important realization that that’s what we’ll be able to do in the future. Maybe not in the too distant future. Don’t ask me when exactly because I don’t know. But this is my vision of regenerative medicine.

This interview has been edited and condensed.

Images: Gabor Forgacs and Organovo

For more on regenerative science, check out the PopTech talk that regenerative medicine expert Dr. Stephen Badylak gave in 2008.

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