A New Breath of Life: Artificial Organs
Posted on: June 6, 2021.

Evolution has provided certain animals the natural ability to regenerate body parts that have been cut off. Missing limbs and tails of certain creatures regrow by themselves using regenerative “superpowers”.

Regrowing destroyed or damaged body parts aren’t the abilities of only starfish and salamander—in only three months, a deer can re-sprout as much as 30 kilograms of antlers.

Regrowing hearts is possible by Zebrafish, while regenerating their own heads have been demonstrated by flatworms. What’s lost is lost, though, for us humans—or is it?

The Beginning…

Heart, lung, kidney, liver, pancreas, or neuro-sensory organs—these are the active mechanical or biochemical functions of complex medical devices that comprise an “Artificial Organ” (AO).

A renal dialyzer or a blood transfuser is an example for an “extra corporeal” AO—blood is temporarily processed outside the patient’s body—while most other AOs are ones that are surgically implanted.

There is considerable research and development underway for devices involving active mechanical, biological, or mass-exchange functions, while clinical use of devices in artificial organs is at present limited.

Clinically, cells are either transplanted or induced in the recipient by implantation—this is either known as bio-material science or, often, Tissue Engineering. “Artificial Organs” is a logical extension of this.

An AO for hearts…

There is the only class of heart disease—”Congestive Heart Failure” (CHF)—whose incidence only continues to increase, and which can be mitigated only by providing permanent cardiac assist or replacement.

And the greatest potential to fill this clinical need—effective treatment for CHF—is offered by Total Artificial Hearts (TAHs) and Ventricular Assist Devices (VADs).

Mimicking the natural biological heart had been the focus of TAHs in their initial designs, whose successful application in man required the fulfillment of specific, necessary criteria—

  • Adequate volume of blood pumping necessary to meet the physiological needs of the recipient
  • Proper anatomic alignment in relation to recipient structures that transport blood entering and exiting the TAH
  • Lack of interference with other organs and maintenance of the ability to approximate the chest wall structures
  • Avoidance of any complications caused directly or indirectly by the TAH

Significance and Scope of AOs…

Amputation, osteomyelitis, or death, may result from corrective or secondary surgery required for infections involving artificial organs, synthetic vessels, joint replacements, or internal fixation devices.

In 25–50% of cases, amputation or death is the result of infected cardiac, abdominal, and extremity vascular prostheses—even more vulnerable to infection are the aged or immuno-compromised.

In cases where the total artificial heart is implanted for more than 90 days, rate of infection approaches 100%. Infectious complications are why implanted artificial organs are at a critical pass.

Scope of Research into Bio-Artificial Organs (BOAs)…

End-stage renal disease—a continued challenge for patients—is being addressed by the combined recent advances in the areas of artificial organs, regenerative medicine, organ transplantation, and bio-engineering.

Though clinically effective, challenges in quality of life and susceptibility to infection is posed by dialysis, resulting in an exceeding demand among those needing, and thence waiting for, kidney transplants.

The field of renal replacement therapy offers a significant clinical impact through focus on two remarkable innovations—

  1. Implantable artificial Renal Assist Device (RAD)
  2. Transplantable bio-engineered kidney

Both these innovations are designed to be implantable, long-lasting, and free-standing to allow patients with kidney failure to be autonomous, although stemming from different technological approaches.

Current pursuits in the discipline of bio-medicine…

Achieving the desired clinical response through artificial organs and engineered living tissues requires—

  • The ability to generate novel materials
  • Fabricating or assembling materials into appropriate 2-D or 3-D structures
  • Precise tailoring of material-related properties

Artificial Extra-Cellular Matrices (ECM) is a development of profound importance, whose ideal mechanical and biological performance is based on the fashioning and engineering of structural micro-environments.

Many, if not all, morphological or physiologic features of native tissues will have to be mimicked, as likely required by this design, as decades of research have indeed demonstrated.

Consequently, the quality of the tissues thus formed is enhanced, by virtue of our progressively improving ability to control the physical and biological properties of scaffolding materials.

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