Lab-made organs could soon solve donor shortage: Scientists

Scientists claim to have found a way to turn artificial scaffolds into a fully functional organ using a patient's own stem cells, a technique which they say could offer a potential solution to the organ donor shortage.

The technique, developed by researchers at the Karolinska Institutet in Stockholm, involves creating a three-dimensional biological scaffold made with human or animal tissue then inserting the patient's stem cells to regenerate and transplant organs.

It needs no human donors, has no problems with rejection, and has no need for immunosuppressive drugs, the researchers explained in a paper published in The Lancet.

"Such an approach has already been used successfully for the repair and reconstruction of several complex tissues such as the trachea, oesophagus, and skeletal muscle in animal models and humans," said Paolo Macchiarini who led the study.

"Guided by appropriate scientific and ethical oversight, [this] could serve as a platform for the engineering of whole organs and other tissues, and might become a viable and practical future therapeutic approach to meet demand after organ failure," he added.

There is a bid crisis in whole organ donor supply because of an ageing population. Every year in the US alone, about 1,20,000 people die from lung diseases, 112 000 from kidney failure and 425 000 from heart disease. And those who manage to get a donor organ still face life-long expensive and dangerous immunosuppressive therapy.

In 2008, Prof Macchiarini and his team transplanted a trachea into a 30-year-old woman in Barcelona grown from her own cells. In her case, the trachea was taken from a donor, stripped of all its living cells and reseeded with stem cells taken from her bone marrow before being grown in a "bioreactor", the Independent reported.

In a second operation carried out at Great Ormond Street Hospital in London in 2010, a British team assisted by Prof Macchiarini performed a similar operation on a 10-year-old boy, who had been born with a narrow windpipe.

In his case the donor trachea was transplanted into his chest as soon as it had been reseeded with stem cells taken from his bone marrow.

Prof Macchiarini, however, explained that identifying the best cell sources for different organs, as well as the ideal scaffold material, were among the challenges that would need to be addressed before widespread clinical use could be adopted.

"For clinical trials, due consideration needs to be given to who to recruit: suitable patients should be able to provide competent consent, have some amount of social support, have few comorbidities, and be willing to face loss of privacy," he said.

As well as scientific challenges, more needs to be done to address the numerous ethical issues raised by this new technology, the researchers said and called for policies to tackle issues such as transparency about the techniques used, cell sources, financial costs, informed consent etc.

Commenting on the study, Dusko Ilic from King's College London and Julia Polak from Imperial College London said: "Although several questions are unresolved, the promise of an off-the-shelf scaffold that can be repopulated with autologous stem cells expanded in vitro seems much closer than one could have hoped for even a few years ago."