I have a friend—let’s call him Nicholas—who told me he has kidney disease, and not much hope of getting a kidney transplant, partly due to his age. Desperation drives some sick patients to grasp at anything, even if it might not be ethical. Fortunately, Nicholas is well aware of the ethical challenges, such as whether to go to India for a transplant, or to get an organ from a paid “donor” who is likely being exploited because of his poverty.
Instead of focusing on the current bleak situation, I’d like to point toward some hopeful signs for the future. What if we could bypass organ donors altogether? Researchers are taking early steps in developing organs in the lab. They have already succeeded in developing flat tissue, such as skin, and hollow organs, such as a bladder. But solid organs like the kidney are much more complex.
You’ve probably heard of 3D printing, for everything from furniture to clothing to hand guns. It’s also being used to develop liver tissue. A tech startup created slices of liver tissue, using 3D printing technology. The tissue survived for 40 days, doing what livers are supposed to do, filtering nutrients, toxins and drugs.
But, the liver tissue slices are not an organ with blood vessels. Connecting the artificial organ to the body’s circulatory system is essential to research success, a step that so far has proved to be elusive. The first step in resolving this technical challenge is proving the concept in animal models.
Using stem cells that can be made from the patient’s own body, a research team created liver buds and implanted them in mice. The buds started connecting to the mouse’s circulatory system by growing new blood vessels.
The liver buds also metabolized drugs in ways that suggest their cells are functional. This is a very early step, and there are many technical challenges, such as having an adequate oxygen supply while the new liver is forming blood vessels. And, success in a mouse does not necessarily mean liver buds would work in a human body. But, still, it is a hopeful step.
What about a kidney for Nicholas? A kidney is more complex than a liver, and living tissue research is slow. Meanwhile, scientists are working on two kidney replacement technologies: an external wearable pack, and an implantable device. The external pack cleans blood-waste products, untethering the patient from time-consuming dialysis machines. The implantable device shrinks the dialysis machine to the size of a coffee cup, small enough to put inside the body.
The bonus is the cost savings. Kidney disease costs Medicare alone about $33 billion per year. Research on one of the devices will cost just $20 million, with a $30,000 or less price tag for each unit.
Maybe you have a loved one with kidney disease. I hope one of these technologies is ready in time to help them . . . and Nicholas.
 “Advances in Bio-Artificial and 3D-Printed Organs,” European Commission Futurium. https://ec.europa.eu/digital-agenda/futurium/en/content/advances-bio-artificial-and-3d-printed-organs.
 Jeremy Hsu, “Tiny 3D-Printed Liver Slices Pave Way for Growing Organs,” LiveScience, November 6, 2013. http://www.livescience.com/40974-3d-printed-liver-slices-created.html.
 Chris Palmer, “Livers Created from Stem Cells,” The Scientist, July 3, 2013. http://www.the-scientist.com/?articles.view/articleNo/36321/title/Livers-Created-from-Stem-Cells/.
 “Wearable Artificial Kidney Trial to Begin Next Year,” UW Medicine Consult, Summer 2013. http://uwconsult.netreturns.biz/LocalStories/Story.aspx?StoryId=4934afdc-b27a-4c2f-9bdf-447ea2cc67f8#.UwZfYkJdWm0.
 Sandy Kleffman, “Artificial Kidney Offers Hope to Patients Tethered to a Dialysis Machine,” San Jose Mercury-News, April 25, 2013. http://www.mercurynews.com/ci_23098487/artificial-kidney-offers-hope-patients-tethered-dialysis-machine.