After Israeli success, ethical concerns give rise to the hope of organs printed in 3D

On Monday night, at a Tel-Aviv fruit and vegetable store, shoppers suddenly stopped what they were doing to watch a television screen over their heads. The presenter announced a breakthrough in the medical field: a team of researchers at Tel Aviv University printed a 3D heart using patient cells and biological material.

"The future is there," one customer said to another.

Israelis boast of the scientific breakthrough revealed at a press conference on April 15 and in an article published in the peer-reviewed journal Advanced Science. Until now, scientists were able to 3D print simple tissue without blood vessels, but the Israeli team, led by Professor Tal Dvir of the School of Molecular Biology and of TAU biotechnology, has printed a complete heart comprising cells, blood vessels and ventricles. and the rooms.

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The heart of the grape size shown at the Tel Aviv University does not work yet. It must be matured in a bioreactor, where electrical and mechanical signals will cause the cells to contract synchronously, a process that will take about a month. Researchers must also understand how to generate more larger cells so that they can finally print in 3D a human-sized heart, containing billions of cells. They must also transplant a heart into animals, which will be followed by clinical trials on humans.

According to Dvir, this breakthrough is likely to advance human hearts printed in 3D in hospitals within 10 years.

But not everyone understands the breakthrough of the heart, invoking ethical implications, such as whether it will widen the gap between the rich and the poor and whether the superhuman heart or other mutations can also be made.

Robby Berman, director of the Halachic Organ Donor Society, told the Times of Israel that he had mixed feelings about the Tel Aviv University announcement, mainly because people might think that they are no longer forced to donate organs.

"The artificial heart is good in that it shows that we are progressing that one day we will create organs to save lives," Berman said.

Berman pointed out that only 16% of Israelis have signed an organ donor card (compared to 50% in the US) and that even though the breakthrough of Tel Aviv University could one day remedy the shortage of organs in Israel, this day is still far away.

"I hope that it will not send the wrong message that we are a few years of artificial organs, because we are not." People always need to have a conversation with their family and let everyone – family members and friends – know that they want to be a donor of organs. "

Dr. Rabbi Ira Bedzow, director of the Ethics and Biomedical Humanities Program at New York Medical College, told The Times of Israel that whenever a new medical discovery occurred, those who consider its potential as utopian and those who fear its unforeseen consequences fail. grasp the complexity of the situation.

"My badumption is that if it works, it will save your life," Bedzow said. "What this will eventually do is to address the problem of organ shortages, which will also be easier for patients because they will not have to worry about the rejection of organs, graft versus host disease or taking immunosuppressive cells the organ is made of will come from their own body. "

Bedzow, however, pointed out that the categorization of organs as parts of the body or medical devices could cause problems. If they are organs, they can not be bought and sold and nobody owns them, according to the law in force in most countries. This would probably limit the cost of such organs and prevent further abuse.

But if they are clbadified as medical devices, they can be patented and the owner of the organs could possibly be asking for a lot of money for his product, making it unaffordable for many unless he? to be covered by insurance.

Another related question is whether a patient will sell the rights to her genetic material to the heart-printing company. Would the company be able to create more hearts using its cells or using its cells for other purposes? In the United States, for example, a person's genetic material belongs to that person and a research facility or medical center must obtain consent if it wishes to use it in any way, including he declares.

Bedzow said the problem of organs considered medical devices is doubly problematic because the medical device industry itself has been the subject of controversy.

A series of exhibitions published in November 2018 by the International Consortium of Investigative Journalists revealed that "health authorities around the world have failed to protect millions of implant patients." poorly tested that can pierce organs, deliver shock to the heart, cause bone rot and poison blood, vomit opioid overdoses and cause other unnecessary damage. "

In March, the Department of Homeland Security warned that some cardiac implants were being hacked a short distance away.

"There is a rush for innovation that has sometimes had very bad consequences for patients," Bedzow said. "This is one of the problems we face in helping patients become a public good, but then privatizing a lot of those markets where players are looking for financial gain."

Bedzow said that people who create medical devices must "recognize their mission as much as their margins" and that medicine must be a public good and not just a good or service purchased and sold in a market such as potato chips and potato chips. clothing.

Superhuman hearts

As to whether customizable 3D printed organs could lead to a community of superhumans with a big heart, Bedzow said that there was little reason to worry.

If a doctor put a "super heart" in a person's body, it would not make a huge difference in overall health and longevity, as it should work in the rest of the person's cardiopulmonary system. Even if a doctor would hypothetically replace all the major organs of a person with organs printed in 3D, it could add another 20 years to their life, added Bedzow.

"I would be more worried about genetic engineering than about organ printing. Genetic engineering will potentially change the genetic code of the whole person as well as that of his descendants, "he said.

He added that fears of medical innovations leading to unnatural physical improvements from a new clbad of humans with superior health and capabilities are not new.

"The choices made by biotechnologists seeking to create a printed heart in 3D could eventually lead to research and technology serving a eugenic function. but that has always been the case. Think about when the glbades were invented. And if people said, "Oh my God now, let's have a clbad of people who can see better."

"It's not the medical technology itself that presents this moral hazard," he said. "These are the people who have this moral hazard."