March 7, 2016 at 9:38 AM
When four-month-old Lucy Boucher needed a kidney transplant, her 35-year-old father donated her a kidney. The transplant surgeons' challenge was figuring out how to fit an adult kidney in an infant, connecting it with Lucy's tiny blood vessels, making a complex procedure even more complicated and risky. It was recently revealed that Lucy was the first to have an adult-to-child kidney transplant aided by 3D printing. Realistic models of Lucy's anatomy and her father's kidney were essential to the procedure's success.
Lucy Boucher's big story is only a tiny part of a revolution in the making. While the nascent industry is struggling — "the 3D emperor has no clothes and is unable to print his own," sniffed The Motley Fool — the medical uses of 3D technology could be the killer app that, ironically, saves lives and saves the industry.
There are three ways in which 3D printing can be life-saving:
1. Re-imagining medical imaging
Images are central to practicing medicine; 3D printers can take imaging to a whole new level. Using data from CT and MRI scans to produce liquid plastic models, such printers can replicate the size and density of organs and anatomical parts for surgeons to rehearse on 3D models, as they did in Lucy's case. Moreover, printing cells could lead to better ways of studying diseases in the lab and developing therapies. For example, researchers have printed ovarian cancer cells onto a gel in a lab dish and tested the effectiveness of drugs on them before administering on real cancer patients.
3D models can also be powerful diagnostic tools. 3D mammography, or digital breast tomosynthesis, for example, provides radiologists a clearer view of overlapping layers of breast tissue, leading to life-saving earlier cancer detection, according to studies by a University of Pennsylvania research team.
2. Replacing tissues and organs
The next step in 3D modeling of the human anatomy is in producing body parts that can go inside the body. Much like familiar desktop inkjet printers, specialized 3D printers can be used to jet living cells, along with support material, called scaffolding. Such "bioprinters" are being used for printing skin, bones, and joints. Recently, a surgeon used the technology to create a new pelvis for a man, while soldiers could have their bones scanned prior to going into combat so that 3D replicas could be created in case they are injured.
Reliable organ-printing systems would be nothing short of revolutionary. Over 121,000 people are on the waiting list for an organ transplant, with a new person added to the list every 12 minutes, with 21 who die each day waiting for a transplant. Anthony Atala, a Wake Forest surgeon, spoke of printing organs instead of having to wait years for donors, in a 2010 TED talk that went viral. Atala had already grown and transplanted a new bladder from stem cells and has been at work on printing a transplantable kidney. In the last month, his team reported printing ear, bone and muscle structures to replace missing tissue for the injured and the sick.
Other pioneers, such as Gabor Forgacs from the University of Missouri in Columbia and colleagues have printed blood vessels and sheets of cardiac tissue that "beat" like a real heart and have a company, Organovo, bringing such products to market. University of Edinburgh researchers have configured a valve-based cell printer that spits out living human embryonic stem cells.
3D body parts can be created even with non-biological materials. The medical device company Anatomics, made history by 3D printing a new titanium sternum and ribs for a cancer patient. The techniques were taken a step further for a face transplant: 3D prints of surgical guides, plates and titanium implants, were used to reconstruct a patient's entire face.
3. Designing human-centered medicines
Despite advances in new medicines, more than 50 percent do not take their medications as prescribed. There are many reasons for such non-compliance; for example, the products of the bio-pharmaceutical industry are often, as the saying goes, "bitter pills to swallow." The first 3D printed pill, an anti-epilepsy drug, Spritam, was recently approved by the FDA and takes a step in addressing the problem. Created by Aprecia Pharmaceuticals, Spritam uses a 3D printing technology that allows pills to instantly dissolve on the tongue with a sip of liquid, a boon for those with trouble swallowing pills.
The 3D technology allows printing of high dose medication layer-by-layer without using traditional production, based on compression forces or molding techniques, which limits dose ranges. The 3D technique is the only platform to date that can achieve high doses while maintaining rapid medication disintegration.
More generally, 3D printing, through alteration of a pill's surface area and printing of complex shapes, can allow more reliable and customized control over dosing, size, flavors, and colors, which can be especially useful for the elderly, young children or the physically impaired — usually the largest medicine consumers.
3D printing of medicine could also allow manufacturers to shift production and distribution processes closer to consumers, say at hospitals or pharmacies, which also increases compliance. This can also be a boon for the developing world: AIDS patients in Sub-Saharan Africa, for example, could print their own antiretroviral drugs at a low cost.
With breakthroughs in 3D printing the medical community is gearing up. There are idea exchange initiatives, such as 3D Print For Health, while the NIH's print exchange, offer free downloadable models.
I expect adoption will be slow-paced. Whenever a new product goes inside the human body, there will be concerns. Second, change is hard in health care, where a large ecosystem must coordinate. Third, disparate groups will have to team up — bio-pharmaceutical producers, doctors, technologists and engineers. Like, Vice President Biden's "cancer moonshot," the 3D killer app that saves lives could be the moonshot opportunity for the next administration.