Video of a cardiac construct made with heart cells that are spontaneously beating on a biodegradable material.
Over the past 50 years, engineers, scientists and clinicians have made amazing, almost magical, advances in the design and implementation of artificial organs. Doctors now routinely implant mechanical devices to replace worn out biological components. Artificial knees and hips have become almost commonplace. Cochlear implants have restored hearing to hundreds of thousands of people and teams have promised designs for retinal implants to restore vision. Hospitals are testing fully robotic arms and hands. Patients now have wearable devices that can take over the function of the pancreas, sensing glucose and releasing insulin, dialysis machines that take over kidney function and devices that stimulate specific nerves and can control bladder function. Clinicians and researchers in the Texas Medical Center were heavily involved with the design and implantation of mechanical artificial hearts and smaller ventricular assist devices, which can take over the function of one chamber of a heart.
Despite the availability of artificial mechanical organs, the gap between the number of patients waiting for an organ transplant and the number of available organs is widening. Additionally, the potential of purely mechanical devices is limited. Parts wear out much more rapidly than the original biological organs, devices rely on bulky batteries and controllers, mechanical systems do not fight off infections the way a biological organ does, and, in pediatrics, a mechanical organ will not grow as a child grows, and could require frequent revisions to enlarge the size.
Therefore, I feel the next breakthrough in medical technology will come from the relatively new and rising field of tissue engineering, where organs are grown in a laboratory, in some cases with the patient’s own cells, and then implanted. These organs would contain living cells and, in the case of pediatric patients, could grow as the child grows. Researchers working on tissue engineered organs have had several recent successes, including skin, trachea, blood vessels and bladder. Unfortunately, pediatric applications have been largely ignored. A search in PubMed shows that less than 2% of all articles about tissue engineering since 2006 (only 260 papers out of more than 14,000!) describe applications for use in pediatric/congenital cases. There is clearly a need for motivating a focus of these tissue engineering research technologies on pediatric applications.
Starting December 11, 2011, Houston will host the Tissue Engineering and Regenerative Medicine International Society annual North America conference, attracting the top tissue engineering researchers from across the country for four days of scientific presentations and meetings. I, along with Dr. Jane Grande-Allen of Rice University, have developed a Tissue Engineering for Pediatric applications workshop to be held on December 11, prior to the opening addresses of the main conference. By bringing together scientists and engineers who are developing tissue engineered solutions with pediatric-focused clinicians who can motivate a clinical need for solutions to pediatric problems, we feel we can spur more of this pediatric-focused research.
Texas Children’s Hospital is an official sponsor of this workshop, and the opening remarks will be given by Dr. Charles D. Fraser, Jr., surgeon-in-chief. Keynote speakers will include Dr. Hesham Sadek of UT Southwestern, Dr. Dario Fauza of Children’s Hospital in Boston, and Dr. Alan Flake of the University of Pennsylvania, with other talks throughout the day. We encourage clinicians and researchers to attend. More details and registration information can be found on the termis.org website.