Where Are the Lab-Grown Replacement Organs?

A futuristic rendering of a scientist holding a pair of lungs in a glass dish.
The headline blared from newspapers all the way back in 2006: "First Lab-Grown Organs Implanted in Humans!" A team from Wake Forest University had biopsied cells from the bladders of patients with spina bifida and used them to create brand new full-size bladders, which they then implanted. Although the bladders had to be emptied via catheter, they were still functioning a few years after implantation, and the public grew confident that doctors had climbed an intermediary step on the way to the medicine of science fiction. Ten years later, though, more than 20 people a day are still dying while waiting for an organ transplant, which leads to a simple question: Where are our fake organs?
"We can make small organs and tissues but we can't make larger ones."
Not coming anytime soon, unfortunately. The company that was created to transition Wake Forest's bladders to the market failed. And while there are a few simple bioengineered skins and cartilages already on the market, they are hardly identical to the real thing. Something like a liver could take another 20 to 25 years, says Shay Soker, professor at Wake Forest's Institute for Regenerative Medicine. "The first barrier is the technology: We can make small organs and tissues but we can't make larger ones," he says. "Also there are several cell types or functions that you can reliably make from stem cells, but not all of them, so the technology of stem cells has to catch up with what the body can do." Finally, he says, you have support the new organ inside the body, providing it with a circulatory and nervous system and integrating it with the immune system.
While these are all challenging problems, circulation appears to be the most intractable. "Tissue's not able to survive if the cells don't have oxygen, and the bigger it gets, the more complex vasculature you need to keep that alive," says Chiara Ghezzi, research professor in the Tufts University Department of Biomedical Engineering. "Vasculature is highly organized in the body. It has a hierarchical structure, with different branches that have different roles depending on where they are." So far, she says, researchers have had trouble scaling up from capillaries to larger vessels that could be grafted onto blood vessels in a patient's body.
"The FDA is still getting its hands and minds around the field of tissue engineering."
Last, but hardly least, is the question of FDA approval. Lab-grown organs are neither drugs nor medical devices, and the agency is not set up to quickly or easily approve new technologies that don't fit into current categories. "The FDA is still getting its hands and minds around the field of tissue engineering," says Soker. "They were not used to that… so it requires the regulatory and financial federal agencies to really help and support these initiatives."
A pencil eraser-size model of the human brain is now being used for drug development and research.
If all of this sounds discouraging, it's worth mentioning some of the incredible progress the field has made since the first strides toward lab-grown organs began nearly 30 years ago: Though full-size replacement organs are still decades away, many labs have diverted their resources into what they consider an intermediate step, developing miniature organs and systems that can be used for drug development and research. This platform will yield more relevant results (Imagine! Testing cardiovascular drugs on an actual human heart!) and require the deaths of far fewer animals. And it's already here: Two years ago, scientists at Ohio State University developed a pencil eraser-size model of the human brain they intend to use for this exact purpose.
Perhaps the most exciting line of research these days is one that at first doesn't seem to have anything to do with bioengineered organs at all. Along with his colleagues, Chandan Sen, Director of the Center for Regenerative Medicine and Cell-based Therapies at Ohio State University, has developed a nanoscale chip that can turn any cell in the body into any other kind of cell—reverting fully differentiated adult cells into, essentially, stem cells, which can then grow into any tissue you want. Sen has used his chip to reprogram skin cells in the bodies of mice into neurons to help them recover from strokes, and blood vessels to save severe leg injuries. "There's this concept of a bioreactor, where you convince an organ to grow outside the body. They're getting more and more sophisticated over time. But to my mind it will never match the sophistication or complexity of the human body," Sen says. "I believe that in order to have an organ that behaves the way you want it to in the live body, you must use the body itself as a bioreactor, not a bunch of electronic gadgetry." There you have it, the next step in artificial organ manufacture is as crazy as it is intuitive: Grow it back where it was in the first place.
Tech-related injuries are becoming more common as many people depend on - and often develop addictions for - smart phones and computers.
In the 1990s, a mysterious virus spread throughout the Massachusetts Institute of Technology Artificial Intelligence Lab—or that’s what the scientists who worked there thought. More of them rubbed their aching forearms and massaged their cricked necks as new computers were introduced to the AI Lab on a floor-by-floor basis. They realized their musculoskeletal issues coincided with the arrival of these new computers—some of which were mounted high up on lab benches in awkward positions—and the hours spent typing on them.
Today, these injuries have become more common in a society awash with smart devices, sleek computers, and other gadgets. And we don’t just get hurt from typing on desktop computers; we’re massaging our sore wrists from hours of texting and Facetiming on phones, especially as they get bigger in size.
In 2007, the first iPhone measured 3.5-inches diagonally, a measurement known as the display size. That’s been nearly doubled by the newest iPhone 13 Pro, which has a 6.7-inch display. Other phones, too, like the Google Pixel 6 and the Samsung Galaxy S22, have bigger screens than their predecessors. Physical therapists and orthopedic surgeons have had to come up with names for a variety of new conditions: selfie elbow, tech neck, texting thumb. Orthopedic surgeon Sonya Sloan says she sees selfie elbow in younger kids and in women more often than men. She hears complaints related to technology once or twice a day.
The addictive quality of smartphones and social media means that people spend more time on their devices, which exacerbates injuries. According to Statista, 68 percent of those surveyed spent over three hours a day on their phone, and almost half spent five to six hours a day. Another report showed that people dedicate a third of their day to checking their phones, while the Media Effects Research Laboratory at Pennsylvania State University has found that bigger screens, ideal for entertainment purposes, immerse their users more than smaller screens. Oversized screens also provide easier navigation and more space for those with bigger hands or trouble seeing.
But others with conditions like arthritis can benefit from smaller phones. In March of 2016, Apple released the iPhone SE with a display size of 4.7 inches—an inch smaller than the iPhone 7, released that September. Apple has since come out with two more versions of the diminutive iPhone SE, one in 2020 and another in 2022.
These devices are now an inextricable part of our lives. So where does the burden of responsibility lie? Is it with consumers to adjust body positioning, get ergonomic workstations, and change habits to abate tech-related pain? Or should tech companies be held accountable?
Kavin Senapathy, a freelance science journalist, has the Google Pixel 6. She was drawn to the phone because Google marketed the Pixel 6’s camera as better at capturing different skin tones. But this phone boasts one of the largest display sizes on the market: 6.4 inches.
Senapathy was diagnosed with carpal and cubital tunnel syndromes in 2017 and fibromyalgia in 2019. She has had to create a curated ergonomic workplace setup, otherwise her wrists and hands get weak and tingly, and she’s had to adjust how she holds her phone to prevent pain flares.
Recently, Senapathy underwent an electromyography, or an EMG, in which doctors insert electrodes into muscles to measure their electrical activity. The electrical response of the muscles tells doctors whether the nerve cells and muscles are successfully communicating. Depending on her results, steroid shots and even surgery might be required. Senapathy wants to stick with her Pixel 6, but the pain she’s experiencing may push her to buy a smaller phone. Unfortunately, options for these modestly sized phones are more limited.
These devices are now an inextricable part of our lives. So where does the burden of responsibility lie? Is it with consumers like Senapathy to adjust body positioning, get ergonomic workstations, and change habits to abate tech-related pain? Or should tech companies be held accountable for creating addictive devices that lead to musculoskeletal injury?
Kavin Senapathy, a freelance journalist, bought the Google Pixel 6 because of its high-quality camera, but she’s had to adjust how she holds the oversized phone to prevent pain flares.
Kavin Senapathy
A one-size-fits-all mentality for smartphones will continue to lead to injuries because every user has different wants and needs. S. Shyam Sundar, the founder of Penn State’s lab on media effects and a communications professor, says the needs for mobility and portability conflict with the desire for greater visibility. “The best thing a company can do is offer different sizes,” he says.
Joanna Bryson, an AI ethics expert and professor at The Hertie School of Governance in Berlin, Germany, echoed these sentiments. “A lot of the lack of choice we see comes from the fact that the markets have consolidated so much,” she says. “We want to make sure there’s sufficient diversity [of products].”
Consumers can still maintain some control despite the ubiquity of tech. Sloan, the orthopedic surgeon, has to pester her son to change his body positioning when using his tablet. Our heads get heavier as they bend forward: at rest, they weigh 12 pounds, but bent 60 degrees, they weigh 60. “I have to tell him, ‘Raise your head, son!’” she says. It’s important, Sloan explains, to consider that growth and development will affect ligaments and bones in the neck, potentially making kids even more vulnerable to injuries from misusing gadgets. She recommends that parents limit their kids’ tech time to alleviate strain. She also suggested that tech companies implement a timer to remind us to change our body positioning.
In 2017, Nan-Wei Gong, a former contractor for Google, founded Figur8, which uses wearable trackers to measure muscle function and joint movement. It’s like physical therapy with biofeedback. “Each unique injury has a different biomarker,” says Gong. “With Figur8, you are comparing yourself to yourself.” This allows an individual to self-monitor for wear and tear and strengthen an injury in a way that’s efficient and designed for their body. Gong noticed that the work-from-home model during the COVID-19 pandemic created a new set of ergonomic problems that resulted in injuries. Figur8 provides real-time data for these injuries because “behavioral change requires feedback.”
Gong worked on a project called Jacquard while at Google. Textile experts weave conductive thread into their fabric, and the result is a patch of the fabric—like the cuff of a Levi’s jacket—that responds to commands on your smartphone. One swipe can call your partner or check the weather. It was designed with cyclists in mind who can’t easily check their phones, and it’s part of a growing movement in the tech industry to deliver creative, hands-free design. Gong thinks that engineers at large corporations like Google have accessibility in mind; it’s part of what drives their decisions for new products.
Display sizes of iPhones have become larger over time.
Sourced from Screenrant https://screenrant.com/iphone-apple-release-chronological-order-smartphone/ and Apple Tech Specs: https://www.apple.com/iphone-se/specs/
Back in Germany, Joanna Bryson reminds us that products like smartphones should adhere to best practices. These rules may be especially important for phones and other products with AI that are addictive. Disclosure, accountability, and regulation are important for AI, she says. “The correct balance will keep changing. But we have responsibilities and obligations to each other.” She was on an AI Ethics Council at Google, but the committee was disbanded after only one week due to issues with one of their members.
Bryson was upset about the Council’s dissolution but has faith that other regulatory bodies will prevail. OECD.AI, and international nonprofit, has drafted policies to regulate AI, which countries can sign and implement. “As of July 2021, 46 governments have adhered to the AI principles,” their website reads.
Sundar, the media effects professor, also directs Penn State’s Center for Socially Responsible AI. He says that inclusivity is a crucial aspect of social responsibility and how devices using AI are designed. “We have to go beyond first designing technologies and then making them accessible,” he says. “Instead, we should be considering the issues potentially faced by all different kinds of users before even designing them.”
How to Live With and Love Bugs with Jessica Ware
Entomologist Jessica Ware is using new technologies to identify insect species in a changing climate. She shares her suggestions for how we can live harmoniously with creeper crawlers everywhere.
Jessica Ware is obsessed with bugs.
My guest today is a leading researcher on insects, the president of the Entomological Society of America and a curator at the American Museum of Natural History. Learn more about her here.
You may not think that insects and human health go hand-in-hand, but as Jessica makes clear, they’re closely related. A lot of people care about their health, and the health of other creatures on the planet, and the health of the planet itself, but researchers like Jessica are studying another thing we should be focusing on even more: how these seemingly separate areas are deeply entwined. (This is the theme of an upcoming event hosted by Leaps.org and the Aspen Institute.)
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Entomologist Jessica Ware
D. Finnin / AMNH
Maybe it feels like a core human instinct to demonize bugs as gross. We seem to try to eradicate them in every way possible, whether that’s with poison, or getting out our blood thirst by stomping them whenever they creep and crawl into sight.
But where did our fear of bugs really come from? Jessica makes a compelling case that a lot of it is cultural, rather than in-born, and we should be following the lead of other cultures that have learned to live with and appreciate bugs.
The truth is that a healthy planet depends on insects. You may feel stung by that news if you hate bugs. Reality bites.
Jessica and I talk about whether learning to live with insects should include eating them and gene editing them so they don’t transmit viruses. She also tells me about her important research into using genomic tools to track bugs in the wild to figure out why and how we’ve lost 50 percent of the insect population since 1970 according to some estimates – bad news because the ecosystems that make up the planet heavily depend on insects. Jessica is leading the way to better understand what’s causing these declines in order to start reversing these trends to save the insects and to save ourselves.
Matt Fuchs is the editor-in-chief of Leaps.org. He is also a contributing reporter to the Washington Post and has written for the New York Times, Time Magazine, WIRED and the Washington Post Magazine, among other outlets. Follow him on Twitter @fuchswriter.