Research Studies in Organ Printing: The 3D-Printed Sugar Vascular System

Presently, 3D printing software is available on desktop computers for a relatively low cost, incorporating a variety of functions in different industries. In the past, 3D printing (also known as 3DP) was consistently applied to produce instant industrial prototypes, medical instruments, and in general design divisions. The software was industry-specific, costly, and open to a select few. 

Now, this technology is being widely adopted in the bioengineering industry. Using a step-by-step methodology and research study, a new generation of innovation is facilitating 3DP to construct a 3D version of a vascular system. Researchers at the University of Pennsylvania have used 3D printing to create a vascular system made out of sugar. The scientists have created a functional biomimetic that could decipher fundamental improvements for living tissues and propel bioengineering research into new and uncharted territory. Healthcare and bioengineering were the first two industry-adopters to utilize and leverage 3D printing technologies. Prosthetic medical models, surgical guides, hearing aids, implantable devices, and dental applications have all benefited in various ways from 3DP innovations.
(Link: http://www.upenn.edu/pennnews/news/penn-researchers-improve-living-tissues-3d-printed-vascular-networks-made-sugar)
    
However, one major barrier in utilizing 3DP innovation in bioengineering remains: the process of creating 3D layers composed of engineered living tissues. Researches are having a difficult time finding a way to prevent cells from suffocating. The studies have stalled in progress due to this complication; for example, one study involved substituting organs from the patients’ own cells. The structures of blood vessel networks are too sophisticated to be regenerated and studied in a lab.To get around this obstacle, bioengineering Postdoctoral Students Jordan Miller and Christopher Chen, along with the rest of their research team, have developed a new approach. The research team recreated a 3D filament network in the shape of a blood vessel system. This filament can be positioned inside a template. With the help of a RepRap, a 3D printer, and using the right materials, the students managed to provide a better simulation of vascular system. The team found an ideal combination of sucrose and glucose, with a small amount of dextran to maintain structure. (Link to: http://www.bodyworlds.com/en.html)

The 'Body Worlds' exhibit inspired Jordan Miller through its plethora of displays of plastic molds of organ systems, tendons, and muscular compositions within the human body. Miller decided to change direction and began focusing on printing the vasculature, rather than attempting to print out the actual tissue. This approach allowed the team to develop the shape of the vascular system composed of self-standing 3D filament networks; it also afforded them the opportunity to remove the mold and vascular system pattern after the engineering cells created a solid tissue enclosing the filament structure. (Link: http://www.robaid.com/tech/3d-printed-vascular-network-templates-made-from-sugar.htm)

After persistent trials, the team found a type of sugar to use that was firm enough to build the template. Sugar could be used for 3DP template development because it can be dissolved in water without causing any damage to the living cells and also provided a durable and protected shelter for cell development. The glucose and sucrose sugar formula was coated with a corn-based degradable polymer. The coating served two functions: the first was to stabilize the sugar after the 3DP process concluded, and the second was to allow the sugar to flow out of the water-based gel housing the cells via the channels they’ve forged. The sugar won’t constrain the gel solidification process or damage nearby developing cells.

3dprintingindustry.com

After being printed by the RepRap 3D printer, the cell cultures are placed around the vascular system made of sugar inside the template Once the sugar structure is removed, researchers will push fluid networks to deliver nutrients to the tissue.

A significant barrier to saturation in the vasculature market for this new invention is devising a system to mass-produce it. In an article on Robaid.com, Miller stated: “a RepRap 3D printer is only a tiny fraction of the cost of commercial 3D printers,” as well as offered to hold workshops to teach other researchers how to construct. 3D printing is still not feasible to mass-produce this delicate and complex invention. The RepRap 3D printer uses open-source software, however, the intricate nature of biotechnological inventions and the uniqueness involved with each case requires a large investment of time and energy. The researchers have no way to predict how scaling of their technology will play out in the marketplace. Researchers would have to produce a large amount of tissue, which would be costly and time-consuming for 3D printers to build the vascular channels layer-by-layer. Mass production will require standardization of Millet et al.’s product, an essential step stone towards industrial product certification.

Our team member at 3D/DC II: 3D Printing Comes to Washington, DC

    
    The future trends for 3DP technology in bioengineering research include pursuing higher resolution for various materials used in inventions, lowering costs, and increasing printing speed. In the long-term, organ 3D printing will aid in developing simulations for surgical operations and organ transplants. Using a patient's own cells as proxy, eventually organs could be grown via 3DP in labs, solving organ shortages worldwide.

3D Printing for Implants

     3D printing technology converges low volume and high complexity is becoming more and more conventionally used in both the manufacturing and healthcare industry. One new application of this technology is the creation of artificial body parts. 3D Printing has been used to make jawbones, functioning ears, and even a skull.

     In particular, titanium jaw implants are an interesting example of 3D Printing at work. Titanium jaw implants are a revolutionary biomedical invention for bone replacements. Made of titanium powder, titanium implants use laser beams to print layers, working from virtual models scanned and built using computer software. Last summer, an implant was used on an 83-year-old woman whose lower jawbone was destroyed by an infection. After the operation, she was able to eat and speak again. (Source: dvice.com)
     Another team of scientists from Cornell University has engineered 3D-printed ears for individuals who have lost theirs due to an accident or disease like cancer. Specifically, 3D Printed ears have been printed to fit children born with a congenital deformity. The artificial body tissue is made by combining additive gels from living cells with cartilage taken from cow ears as well as collagen derived from rat-tails. In the future, engineers will find new ways to develop human ear cartilage cells from actual patients instead of using cow cartilage, which will reduce the possibility of the body rejecting the ear.

     Other examples of 3D Printed implants include skull and face replacement Check out more using the links here: http://www.popsci.com/science/article/2013-03/get-brand-new-skull-3-d-printing ; http://www.dailymail.co.uk/health/article-2304637/Surgeon-uses-3D-printing-technology-make-cancer-patient-new-face.html 
     Legal questions have been raised due to rapid advancement of 3D Printing technology for medical implants. For example, issues surrounding who owns IP of codes, models, and products a 3D printer produces have been debated back-and-forth amongst stakeholders. What will happen to patients with implants that fail to perform well? Who is liable? There will also be serious consequences for implant producers and other stakeholders. For example, how will cutting-edge 3D-Printing medical device companies turn a profit if someone with access to 3D-Printing can counterfeit their design? How do they maintain autonomy while diversifying their product enough to stave competition? The answers to these questions remain to be seen by early adopters of 3D Printing implant technology.
     Other issues at stake include security and safety. In the healthcare industry, 3D printing technology can be used to create artificial body parts. Creation of new body parts, while artificial, causes great concern amongst lawyers, doctors, and other scientific and medical safety officials. In the future, the potential for enhancing human abilities through 3D-printed implants will exist. .

     The use for 3D printing in the bio-healthcare business is still a new and niche market; however, it has important impacts for this industry. Related technologies and medical products have the ability to save millions of lives. It is an effective platform for developing bioengineering and life-sustaining products, especially custom-tailored devices for patients.

A Touching Side of 3DP Technology

     Emma Lavelle, a two-year-old girl was born with arthrogryposis multiplex congenita (known as AMC for short) has been fitted with a 3D printed exoskeleton. AMC is a genetic disorder that causes joints and muscles to stiffen over time. Researchers at a Delaware hospital 3D printed a durable, custom exoskeleton using small, lightweight parts.



    3D printing can help more children like Emma if both adoption rates and innovation continue to expand. Ekso Bionics released a 3D printed exoskeleton with the idea to replace wheelchairs. (Source: SmartPlanet.com) There is a significant lack of mobility devices or exoskeletons that are fit for children - a custom, 3D printed product solves that problem.    

     Emma’s mother, frustrated with current options on the market, needed a solution that was lightweight and small enough for her child. Mrs. Lavelle asked the makers of the Wilmington Robotic Exoskeleton, or WREX, to customize a version for Emma. WMEX was fitted for Emma using 3DP plastic. The invention suited her frame and utility well, and the nickname "magic arms" was coined. "Magic arms" is now nominated for London's Design Museum "Design of the Year 2013" award. Hopefully, more AMC sufferers, people without socioeconomic access to a wheelchair, and other disabled children will benefit from this innovative design and increase in accessibility to 3DP. If "magic arms" wins the Design of the Year award, the 3DP movement will hopefully prove to be bigger than a hobbyist's dream. More research into the intersection between 3DP and healthcare is needed, and positive exposure in the form of Emma's story will prompt grant funds to be directed towards this disruptive technology. Stratasys Executive VP of Global Marketing, Jon Cobb, is quoted in the article and shares these sentiments about the technology:
     

     “This is an exciting time for 3D printing, as more people become aware of its potential and its impact. We are honored to have been involved in such a worthwhile project and pleased to see it recognized by the design community.”

3D Printing and Prosthetics

     3D printing has been utilized by various industries, however its functionality in healthcare is literally life changing. Every year in the United States, there are 50,000 new amputates which has increased demand for prosthetics. While there are many high-tech prosthetics available in the market, most of them are expensive, with prices ranging from $3,000 to $50,000.

     How can a healthcare system find ways to deliver cheaper and accessible prosthetics? 3D printing, or 3DP for short, can solve both of these problems. There have been multiple attempts from engineers and enthusiasts to delve into 3DP for prosthetics, specifically by engineers at Carleton University. They have created individual finger control devises for a price tag of under $400.

     The whole process starts with a design, which can be outlined using a second existing limb. Engineers use a camera to take pictures of the limb and transfer them into 3DP design software, such as Autodesk 123D (link to: http://www.123dapp.com/catch), and then parts can be 3D printed as needed. This exactly what Bilal Ghalib, a tech enthusiast, did. Mr. Ghalib scanned his cousin’s amputeed leg while on a visit home to Iraq. With the help of his employer, Autodesk’s, basic software, Mr. Ghalib was able to recreate the leg.

     So far, there are two primary uses of 3D printers in prosthetics: the first is creating parts for prosthetics and then embedding the necessary electronic circuits. Liam, a five-year-old boy living in South Africa, illustrates an interesting example of a 3D-printed prosthetic application developed for a real patient, outside of a lab. Liam suffers from Amniotic Band Syndrome, which created constriction in the bones of his right hand before birth. Two engineers created an invention called Robohand, which basically custom fits mechanical fingers and hands using 3DP technology. The team helped Liam by creating motorized fingers for him at a reasonable price; Liam now uses the 3DP fingers to write, play, and brush his teeth.

     The second main application of 3DP technology to the prosthetics industry is using a 3D printer to customize designs for fairings, which are custom panels to encase prosthetic limbs. Fairings help create symmetry between prosthetic limbs and are unique for each individual.

     A company called Bespoke is creating customized fairings using 3DP. The President of the group, Scott Summit, spoke about his 3DP fairings in a TED Talk. Mr. Summit mentions “…that with creating symmetry between the limbs, the memory of the cells is created.” Simply said, the body remembers its former shape and thus has more control over its movements.

While prosthetic technology is improving, currently, prosthetic are not 100% 3D-printable. For example, they still require electronic circuits to be installed. Recently, news of a fully operational, printed 3DP gun is increasing the probability of prosthetics being fully printable soon.

An interesting trend for 3D printing prosthetics is the use of ICT, or information and communications technology. Designs are now circulated online for free by open-source and resource-sharing websites.

     For example, the design pictured here on the right can print two prosthetics hands, one right and one left. This enables 3DP technology to reach more people as well as other designers that have the ability to enhance or alter the primary model.

     3DP increases and promotes access to remote areas. As long as you have a 3D printer and an internet connection, you can download the prosthetic part you need. This will be extremely beneficial in the future when access to adequate doctors may become increasingly limited. It will be a part of the telemedicine industry, where consultations can be sent virtually to doctors, who can assess the situation, make recommendations, and finally, design the best treatment.

     Additionally, 3DP makes creating complex designs easier to accomplish for engineers and designers, especially when the core of the device is challenging to manufacture. 3DP will open doors for designer creativity to solve problems such as the challenges involved with prosthetics in a much easier way. 

     A team of engineers who wanted to raise money to start a 3DP prosthetics business held a Kickstarter campaign recently. Kickstarter is a website used to raise funds for innovative creations, designs, or inventions as start-up businesses. Previously, the engineers created solid prototypes for their ideas but are now focused on making designs more functional.

     3D printing for prosthetics is a promising market that will serve a niche of untapped users and markets. The combination of medicine, technology, and communication will enhance the livelihood for a lot of people. One day, an amputee living in a remote area, with the assistance of his phone camera, will be able to send pictures to doctors halfway around the globe and doctors and prosthetasists will design the best fit for their patients.
 
     A patient with access to a 3D printer will be able to receive a custom-made prosthetic in a short time at reasonable cost.