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Running head: 3D HUMAN HEART PRINTING TECHNOLOGY 3D Human Heart Printing Technology Dorette Smith New York City College of Technology SOC 2401 Instructor Dr. Diana Mincyte May 15, 2016 1 3D HUMAN HEART PRINTING TECHNOLOGY 2 Introduction and overview of the 3D printing of human heart The 3D human heart printing is significant medical development owing to the possibility of personalization and customization of the heart generated. This means that there is a possibility of manufacturing medical equipment and products that are customized for explicit medical applications such as customized implants. Besides, the 3D printing technology ensures increased efficiency of the cost in the generation of the hearts. The surgical elements and prosthetics, simulations, and implants that are necessary for various body parts such as craniofacial disorders are very cost-effective when done using the 3D printing technology. This paper examines the development of 3D printing in the medical world today, its future implications, how it is different from the other similar procedures, and the criticisms put forward by most researchers. Difference between 3D human heart printing and other similar developments The 3D human heart-printing technology involves intensive research on stem cell therapy, genomics, and this advantageous in situations where standardized medication does not offer perfect benefits. The current research is different from the other studies because it focuses specifically on the use of 3D printing technology in the development of the human heart. Most studies conducted revolve around orthopedic medication that seeks to develop artificial bones for human body due to cancerous infections. For a long time, the doctors have been skeptical about the application of laser-sintering techniques and other forms of 3D printing in the development of the human heart. However, with the rising cases of heart infections, there has been increased the need for extensive research in this particular area. 3D HUMAN HEART PRINTING TECHNOLOGY 3 Importance of 3D printing of human heart to the future generation Once the research on 3D human heart printing is complete, there will be decreased fatalities that rise from the common heart infections and other cardiovascular complications. Today, most patients suffering from cardiovascular conditions cannot meet the financial burden that comes with the surgical procedures due to economic hardships. The implication, therefore, is that only the rich members of the society can afford a heart transplant quicker. On the other hand, a heart transplant is a very risky medical procedure even though it is a life-saving remedy. The likelihood of the transplanted heart functioning properly is less than 30 percent. What it means is that there are limited chances of surviving the procedure due to grafting dysfunction. Another challenge is that the heart donated by a person who has died may be rejected. Additionally, getting a donor might be a difficult task and a long wait period. However, with the development of 3D heart printing technology, these problems will be alleviated and many patients will benefit. The criticisms towards the 3D technology Other than the benefits that accrue due to the implementation of 3D human heart printing technology in the medical world today, there are certain criticisms raised. To start with, there are criticisms concerning the advancement of personalized medicine with regard to affordability. The argument is that such development in personalized medicine result to health disparities between the poor and rich. The implication of introducing such form of treatment implies additional costs incurred to access better health care and are thus discriminative. The research carried out about personalized medicine is quite expensive since it revolves around stem cell therapies and genomics. The time and cost necessary to generate a succession of different sizes of customized prostheses for children are expressly prohibitive. The challenge of replacing a 3D HUMAN HEART PRINTING TECHNOLOGY 4 damaged heart is common in cases where the patients are young and still undergoing growth and development. With the evolution of 3D printing, heart problems correction will not be expensive and time-consuming as has been seen in the past. Another criticism is concerning the safety of the treatment using 3D printing. Safety is an ethical concern, and the critics express concern over the safety of the treatment approaches using the 3D printing in corrective clinical medicine. The only area where the 3D human organ printing application that has been tested and proven is the orthopedic surgery using titanium to model the human bones. One of the challenges facing the application of 3D human heart printing is the idea of synchronizing the heart valves with the heartbeat even though the researchers worked on the ways of correcting the structure of the aortic valve. The explanation for the challenge is that the whole heart is missing, and consequently, the aortic valve cannot execute the routine operation of closing and opening on its own. In order to subdue this barrier, the researchers came up with a simulation of a heart that can carry on with the process of beating. The simulated heart was then used to test the valve of the aortic heart to access whether it can close and open like a normal heart. However, by combining the derived and stem cell lines, a functioning heart organ can be developed to replace a damaged human heart. Discussion In the present times, a number of research exercises have been dedicated to the process of developing soft organ body tissues by employing 3D bioprinting technology. More specifically, there is a tremendous progress going on in coming up with 3D bioprinting human heart. The rationale for such intensive research is that human beings continue to face varying cardiovascular challenges that are expensive and difficult to correct. Besides, human heart transplanting is one of the most expensive medical procedures in the world and requires high skills to execute. 3D HUMAN HEART PRINTING TECHNOLOGY 5 According to Brown (2016), the scientists at Wake Forest Institute for Regenerative Medicine succeeded in generating a cartilage tissue of the ear for a mouse in their lab. This is indeed a big stride in the 3D printing journey and marks the beginning of a tremendous innovation. This development follows that of a Missouri professor who succeeded in printing out 3D chicken hearts back in 2007. Before these inventions, the 3D printed tissues did not live long enough due to lack of strong and big structures to support the printed tissue. According to Gilpin, and Hiner (2016), great strides are being made at the University of Louisville by one of the interns in respect of 3D bioprinting of the human organ tissues. A team of students, technicians, researchers and doctors at the Cardiovascular Innovation Institute (CII) are in the process of generating biomaterials using a BioAssembly Tool (BAT) in Kentucky, located at the Muhammad Ali Boulevard in Louisville. Mironov, Boland, Trusk, Forgacs, and Markwald (2003) explain that the technology of tissue engineering is capable of solving the crisis of organ transplantation. The authors, however, note that the biggest challenge facing the technology is the process of involved in assembling the soft vascularized body organs in the 3D form. There are three steps involved in soft organ 3D printing. The first one is the development or pre-processing of the soft human organs commonly called blueprints. The second step involves the actual printing of the organ through processing. The last step is organ conditioning or post-processing where the printed organ undergoes maturation through an accelerated process. Hockaday et al. (2012) argue that the aortic valve displays a complicated 3D heterogeneity and anatomy necessary for a long-lasting and efficient biomechanical operation. The authors, however, express that some challenges face the prototyping of a human living tissue that executes reliable and effective valve operation. In the conclusion, the authors cite that a 3D printing that involves a regulated photocrosslinking is 3D HUMAN HEART PRINTING TECHNOLOGY 6 capable of swiftly fabricating the human heart heterogeneous valve that can aid the process of cell engraftment. Another challenge identified is the idea of synchronizing the valve with the heartbeat even though the structure reason being that the entire heart is removed therefore the aortic valve has difficulty performing the routine task of opening and closing in an attempt to overcome this a simulation of a heart that is beating is constructed and it is used to test the aortic valve. Duan, Hockaday, Kang, and Butcher (2012) argue that heart disease continues to be a growing and severe health problem since it requires the replacement of prostheses. Children and younger adults face a common challenge of inadequate prosthetic devices today. The good news is that through tissue engineering, there is the possibility of growth, regeneration, and remodeling of the living aortic valves.According to the authors, the challenge, however, is the fabrication of the natural anatomical intricacy by the use of cellular heterogeneity. The authors further cite that it is possible to bioprint the aortic valve conduits using direct encapsulation of the leaflet interstitial cells in the leaflets and smooth muscle cells in the valve roots using a culture within gelatin/alginate hydrogel discs. Rengier et al. (2010) say that rapid prototyping can find its way in the medical application in a scenario where there is a need for prosthetics and particularized surgical planning. Rapid prototyping has a great potential for the growth of new medical applications. Lueders, Jastram, Hetzer, and Schwandt (2014) argue that tissue engineering as a method of 3D printing technology can assist in fabricating human heart valve gallows. The valves can be made using polymers of different thermal properties. A selective 3D bioprinting laser-sintering device can be used to fabricate the human heart valve for successive seeding. 3D HUMAN HEART PRINTING TECHNOLOGY 7 Conclusion In summary, the culmination of the ongoing research 3D human heart printing will lead to significant reduction in the fatalities that result from the cardiovascular complications, some of which require complex and expensive surgical procedures such as heart transplant. The technology will make the procedure to be affordable to most people. However, the research being taken on the topic continues to solicit criticism in terms of the ethical considerations such as safety of the patient after the procedure. 3D HUMAN HEART PRINTING TECHNOLOGY 8 References 1. Brown, K. (2016). How Close Are We to a 3D-printed Human Heart? Fusion. Retrieved 17 April 2016, from http://fusion.net/story/269559/3d-printed-organs-can-live-in-animals/ In this article, the author explains the various ways that scientists have succeeded in bioprinting of living tissues such as kidneys, and livers which will help those patients who are on waiting lists for organs. The organs are made with the patient’s own cells so as to reduce the chance of rejection The author also explained that researchers have successfully printed muscle structures , bone and ear cartilage and that bone implants printed with human cells were able to trigger blood vessels. 2. Duan, B., Hockaday, L., Kang, K., & Butcher, J. (2012). 3D Bioprinting of heterogeneous aortic valve conduits with alginate/gelatin hydrogels. Journal of Biomedical Materials Research Part A, 101A (5), 1255-1264. http://dx.doi.org/10.1002/jbm.a.34420 The authors explains that heart disease continues to be a growing and severe health problem and that through tissue engineering, there is the possibility of growth, regeneration, and remodeling of the living aortic valves. The authors are the fabrication of the natural anatomical intricacy by the use of cellular heterogeneity. The authors further cite that it is possible to bioprint the aortic valve conduits using direct encapsulation of the leaflet interstitial cells in the leaflets and smooth muscle cells 3. Gilpin, L., & Hiner, J. (2016). 3D bioprinter to reproduce human organs, change the face of healthcare: The inside story - TechRepublic. TechRepublic. Retrieved 17 April 2016, from http://www.techrepublic.com/article/new-3d-bioprinter-to-reproduce-humanorgans/ The authors of this article cites the development of a BioAssembly Tool (BAT) 3D HUMAN HEART PRINTING TECHNOLOGY which is a glass enclosed machine used for 3D printing of biomaterials the use of the printer and the challenges it presents. The problem with the printer is that it does not handle curves well and printing is a very slow process. One of the benefits is that researchers are able to manipulate 3D organs and tissues which enable them to diagnose and treat patients 4. Hockaday, L., Kang, K., Colangelo, N., Cheung, P., Duan, B., & Malone, E. et al. (2012). Rapid 3D printing of anatomically accurate and mechanically heterogeneous aortic valve hydrogel scaffolds.Biofabrication, 4(3), 035005. http://dx.doi.org/10.1088/17585082/4/3/035005 5. Lueders, C., Jastram, B., Hetzer, R., & Schwandt, H. (2014). Rapid manufacturing techniques for the tissue engineering of human heart valves. European Journal of Cardio-Thoracic Surgery, 46(4), 593-601. http://dx.doi.org/10.1093/ejcts/ezt510 The authors explain that tissue engineering as a method of 3D printing technology can assist in fabricating human heart valve gallows. The valves can be made using polymers of different thermal properties. A selective 3D bioprinting laser-sintering device can be used to fabricate the human heart valve. 6. Mironov, V., Boland, T., Trusk, T., Forgacs, G., & Markwald, R. (2003). Organ printing: computer-aided jet-based 3D tissue engineering. Trends in Biotechnology, 21(4), 157161. http://dx.doi.org/10.1016/s0167-7799 (03)00033-7 The authors explain that the technology of tissue engineering is capable of solving the crisis of organ transplantation and that the biggest challenge facing the technology is the process of involved in assembling the soft vascularized body organs in the 3D form. The 9 3D HUMAN HEART PRINTING TECHNOLOGY 10 three steps explain that the technology of tissue engineering is capable of solving the crisis of organ transplantation and the challenges in assembling the soft vascularized body organs in the 3D form. The three steps of soft organ 3D printing. are explained which involve pre processing, printing and maturation of the organs 7. Potkonjak, A., & Hartman, A. (2015). 3D Printing of Aortic Heart Valve Tissue in Patients Suffering from Cardiovascular Disease. Retrieved from http://136.142.82.187/eng12/Chair/pdf/5192.pdf In this article, the author explains how 3D printing can be used in modeling the Aortic Heart Valves. One of the challenges facing the doctor is the idea of synchronizing the valves with the heartbeat although the doctor got the correct structure of the aortic valve. The reason why this is a challenge is that the entire heart is missing and therefore, the aortic valve cannot perform the routine task of closing and opening on its own. In an attempt to overcome this barrier, a simulation of a heart that is beating is used to test that valve of the aortic heart and a mechanical device that could aid in the closing and opening of the valve. The simulation uses 3D printing technology. 8. Rengier, F., Mehndiratta, A., von Tengg-Kobligk, H., Zechmann, C., Unterhinninghofen, R., Kauczor, H., & Giesel, F. (2010). 3D printing based on imaging data: review of medical applications. Int J CARS, 5(4), 335-341. http://dx.doi.org/10.1007/s11548-010-0476-x The authors of this article explains that rapid prototyping can find its way in the medical application in a scenario where there is a need for prosthetics and particularized surgical planning. Rapid prototyping has a great potential for the growth of new medical applications. 3D HUMAN HEART PRINTING TECHNOLOGY 11 9. Morad, R. (2015, October 26). Hearts and Arteries Could Be 3D-Printed Cheaply. Retrieved March 6, 2016, from http://news.discovery.com/tech/biotechnology/hearts-and-arteriescould-be-3d-printed-cheaply-151026.htm In this article, the author cites step by step details of the creation and the materials used in 3 D printing of coronary arteries hearts and body parts, including the type, price and convenience of printing on demand. The challenges of using some of the materials are explained in detail, including a video presentation which demonstrates the 3 D printing process and creation of body parts. 10. Andrews, R. (2015, October 26). Researchers Can Now 3D Print a Human Heart Using Biological Material. Retrieved March 5, 2016, from http:/www.iflscience.com/health-andmedicine/human-heart-can-now-be-3d-printed-using-biological-material The author presented information relative to 3 D Printing Technology and the construction of various human organs including the heart. Various materials such as fibrin and collagen which are used for the construction of these organs of the human heart are identified, and the author presented the challenges and implications with detailed solutions to the problems. `