In the age of advancing technology, newfound inventions are continuously changing the world as we know it, revolutionising entire industries – and oftentimes saving lives in the process.
Nowhere is this more evident than in the medical fraternity. Biomedical technology is a niche field of innovation that encompasseses elements of information technology, engineering principles and natural sciences, with an emphasis on sustaining human life and health care.
One such invention that’s been adopted – and adapted – in medical use today, is 3D printing. Also known as additive manufacturing, 3D printing is considered as one of the most disruptive technologies of modern society. Sitting at the forefront of the Fourth Industrial Revolution, it has unsurprisingly opened up immense possibilities for future development in all spheres of life.
3D printing is the process of creating a three-dimensional solid object from a digital file, which functions as the 3D model or “blueprint.” The object is created by laying down successive layers of thinly-sliced material until it is fully formed (hence the term “additive manufacturing). Each layer is essentially a horizontal cross-section of the item itself.
But what makes it so revolutionary? 3D printing enables us to produce complex shapes and items using substantially less material. In fact, it has changed the way we manufacture almost everything, while using a variety of materials, including metal, concrete, polymer, plastic – and even substances deemed inconceivable before, such as living organisms and human cells.
With this in mind, 3D printing has enabled humans to produce replicas of natural, living things and, being an early adopter of most technological innovation, the medical field today is one of the most robust arenas when it comes to the use of this invention.
More specifically, the term “bioprinting” refers to 3D printing that uses viable living material to create tissue-like structures that imitate natural human tissue.
Since the mid-1990s, surgical uses for 3D printing have been on the rise. Starting with anatomical modelling for bone reconstructive surgery, it then developed into personalised, patient-specific 3D-printed orthopaedic metal implants. These implants were printed on a porous surface to facilitate osseointegration (the connection between living bone and the artificial implant).
Since then, there have been many notable procedures made possible by the contributions of 3D-printed parts.
Just last year, doctors at the Steve Biko Academic Hospital in Tshwane, South Africa, successfully completed a groundbreaking surgery of the world’s first middle ear transplant, using 3D-printed middle ear bones. The 35-year-old male patient, who severely damaged his ear in a car accident, was able to fully regain his hearing after the procedure. The surgeons reconstructed the broken bones of his middle ear using 3D-printed bones made from titanium. These were then replaced endoscopically.
According to Prof Tshifularo, head of the Department of Otorhinolaryngology at the University of Pretoria Steve Biko Academic Hospital, his search to find the right prosthesis for this type of surgery was a 10-year journey. He believes that this breakthrough can now function as a long-term solution for curing patients, including babies, from loss of hearing caused by damage, disease or infection of the inner ear. In fact, hearing is restored less than two hours after the operation.
In addition to breakthrough procedures and the possibilities for new life-enhancing operations, bioprinting holds a number of other benefits that can transform entire sectors of the surgical and pharmaceutical industries.
One of the most prominent among these is the fact that bioprinting could eliminate the need for organ donors in the near future. On average, there are approximately 4300 people in South Africa in need of organs at any given moment. Unfortunately, the country is facing a massive organ donor shortage and patients in need of livers, kidneys, lungs or hearts have to wait many years to receive the life-saving transplant – if they’re lucky enough to get one at all.
To combat this issue, scientists are now developing techniques to produce living vital organs through bioprinting technology – using the patient’s own cells. The most common way in which this is done is through 3D-printed scaffolds made of biodegradable collagen on polymers. The scaffold is a replica of the organ’s unique dimensions in the patient. Researchers then place cells from the patient on to the scaffold, and a bioreactor creates the optimal environment for the cells to grow into a fully formed organ. Once the organ is finally placed into the patient, the scaffold has usually disintegrated or does so soon after the surgery.
This phenomenal process means patients could receive their organs in a matter of days or weeks instead of years. It drastically reduces the demand for organ donations on a global scale and allows everyone an equal opportunity for a second chance at life. It also leads to another major benefit of bioprinting in the medical field: cell compatibility.
Organ transplants can be tricky in that it is common for a body to reject the organ coming from a donor. Incompatibility can activate the immune system to attack the body if a foreign cell is detected. The body will reject the new addition, leading to complications that cause the patient to require a new transplant (which means another long and painful waiting time), or they may have to live on immunosuppressants for the rest of their lives. It is recorded that approximately 50% of organ transplants are rejected within the first 10 to 12 years.
With 3D bioprinting, the cultured cells are taken from the patient themself, thus ensuring the transplant won’t be rejected after the operation.
This ability to grow human tissue through bioprinting also presents an alternative for cosmetic and pharmaceutical companies when it comes to the practice of animal testing. Every year, millions of animals suffer and eventually end up dying as a result of the testing. However, as tissue production becomes more common and accessible, companies have the option of testing their products on such printed organisms as opposed to live animals, eradicating the suffering that they endure.
In 2015, cosmetics conglomerate L’Oreal became the first company to test its products on bioprinted human-skin instead of animals, setting a precedent for the rest of the industry to follow suit.
While the field of bioprinting still requires a lot more development, particularly when it comes to laboratory testing, there are also aspirations for bioprinting to replace the need for human volunteers in drug testing facilities, reducing the numerous health and safety risks it poses. Thus, 3D bioprinting could be the safest and most practical way to test newly developed drugs before they are made available to the mass market.
Although bioprinting has advanced in leaps and bounds over the past few years of its existence, there is still a long way to go in terms of development. This is especially true for multi-layer organisms or more complicated tissues such as eye tissue.
One of the keys to moving the industry forward is developing technology that is not only capable of constructing delicate living tissue, but is also made accessible and affordable to hospitals on a wide scale. Imagine a world where organs and other body parts can be printed on demand, a liver transplant can be conducted without the need for a donor or a face can be reconstructed without the use of plastic surgery. When bioprinting first emerged on the scene, it’s unlikely that scientists could envision just how far technology would take it.
And while researchers already have their eyes on extraterrestrial uses, such as using it as a tool to colonise other planets, where hospitals and organ donors will not be accessible, only time will tell how far this niche field of 3D printing will evolve. As for now, the benefits and medical advances it provides are nothing short of remarkable.