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Cardiovascular disease is the leading cause of death in the world. Heart transplants are often the only option available to patients in the most severe cases. But the number of heart donors is limited and too many patients die while waiting.
What if hospitals could just print a new heart?
This is the enticing promise Tel Aviv University researchers made this week by announcing that they had successfully used a 3D bio-printer to create a heart with human tissue and blood vessels.
While the university described this as a "major medical breakthrough" that advances transplant opportunities, this 3D printed heart still has some limitations.
First, it's just the size of a rabbit heart. Journalists who attended the press conference in Tel Aviv saw a 3D imprint of a heart that looked more like a cherry, dipped in a liquid.
View of the first vascularized artificial heart printed in 3D, at a press conference in a laboratory of Tel Aviv University, April 15, 2019. Photo by FLASH90
Secondly, 3D heart cells can contract, but do not yet have the ability to pump. Researchers must now understand how to teach printed hearts to behave like real ones.
This is not the first heart to be printed in 3D, but never before has it resulted in the creation of a "cell or blood vessel" organ, said Tal Dvir, who led the project to the School of Cell Biology and Biotechnology at Tel Aviv University.
Previously, scientists in the emerging field of regenerative medicine were able to print cartilage tissue and aortic valve, but not the capillaries without which organs could not survive without even functioning properly.
Dvir said the researchers' next steps would be to transplant a 3D printed heart into an animal model. Their goal is for this to happen in the next year.
"Maybe, in 10 years, there will be organ printers in the best hospitals in the world, and these procedures will be performed routinely," added Dvir, although he expected what hospitals start with simpler organs than hearts.
Could solve the rejection problem
A 3D printed heart may be able to bypass one of the most serious graft problems: rejection of the new organ by the patient.
Researchers at Tel Aviv University are proposing to use a biopsy of a patient's adipose tissue to develop a "custom hydrogel" that will serve as the "ink" needed to print the heart.
"The biocompatibility of engineering materials is crucial to eliminate the risk of rejection of implants, which compromises the success of such treatments," said Dvir.
In this way, hearts printed in 3D – and ultimately many other types of human organs – would be essentially personalized to the patient.
Conceptual diagram of "3D printing of patches and heart hearts thick and perfect for infusion". Image courtesy of Advanced Science / Wiley Online Library
Dvir added that he hoped that the printing of organs will make the organ donation obsolete.
That said, there are other challenges ahead. Current 3D printers are limited by their resolution; it is therefore difficult to print all the many small blood vessels. And researchers must determine how to develop the cells so that they have enough tissue to print a human-sized heart.
This week's announcement was a big step forward because "bigger human hearts [will] require the same technology, "explained Dvir.
In addition to Dvir, the team included Dr. Assaf Shapira from the Faculty of Life Sciences at Tel Aviv University and PhD student Nadav Noor.
The tale of Tel Aviv on this witness heart was published on April 15 in the peer reviewed journal Advanced Science.
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