• Question: How do people grow organs for transplants??

    Asked by SherlockLives to John, Laura, Luke, Rob, Ruth on 20 Jun 2016.
    • Photo: Laura Finney

      Laura Finney answered on 20 Jun 2016:

      I believe that organs can now be grown from stem cells but this technology isn’t making organs at a good enough rate yet so we still need donors.

      Stem cells are basically cells which haven’t decided what they are going to be yet – whether they will be heart cells or kidney cells or eye cells or any other cell. So we can take them and for example tell them to be a liver cell, and then they will grow into a liver!
      I’m not sure of the technical stuff because I’m not a biologist but that is the basics of it.

      There is an article on it which is quite good!
      http://www.independent.co.uk/news/science/scientists-ability-to-grow-living-organs-boosts-patient-transplant-hopes-9688828.html

    • Photo: Robert Williams

      Robert Williams answered on 20 Jun 2016:

      At the moment organs are donated by people who die and the doctors use tissue typing to check that a donated organ is compatible to the person receiving it. For example from Identical twin or a family member – it is more difficult from an unrelated donor.
      Having said that the recipient still needs to take anti-rejection drugs for the rest of their life.
      Now, a new technology uses Stem Cells from a person to re-grow and new organ or body part such as cartilage for ears or joints.
      The Stem cells are – I think – grown in a lab in a culture with small amounts of the cells from the organ that is needed and the Stem Cells pick up the nature of the cells and regrow a new organ.

    • Photo: Luke Williams

      Luke Williams answered on 21 Jun 2016:

      Alrighty then – as Robert said the current method for transplants is *generally* from donors. This may be as simple as a family member donating a kidney (which still carries risk, to be fair) or it may be someone donating organs after their death.

      Other options do exist, but are at varying stages of development:

      1) Personalised transplants using donated organs – this is where a given organ is decellularised, i.e. all the living cells are removed from it. This leaves a scaffold which can then be reseeded using stem cells from the patient. [Status- Research in progess. Several organs and tissues work, but I do not believe this method has been actively used in medicine just yet. I believe this technique is also being considered for xenotransplantation, using donated organs from pigs, decellularising them and then adding stem cells.]

      2) Regenerative medicine – instead of actually transplanting organs, stem cells can be used to heal certain conditions rather than needing entire organs and additional complexity. [Status- Clinical trials. Particular emphasis has been on areas such as the eye, due to potential issues with stem cells “escaping” the eye has been particularly considered because it is immunoprivileged – this means that the immune system does not activate in quite the same manner, reducing the risk of potential issues as it is less likely stem cells can wander.]

      3) Grown to order organs (in vitro) – See Laura’s post. [Status – Difficult to say, I think some limited clinical trials have been done on specific organs, from that article. I hadn’t heard of any previously though.]

      4) Chimeric organs grown in vivo (pigs) – Human or human/pig mixed organs grown in pigs. (Alternative animals have also been considered) [Status – Research in Progress – the proof of principle has recently been done using the recently discovered CRISPR gene editing system. It had been proposed as a technique for a while, but I think things have got a lot further since the use of the CRISPR system got underway.]

      5) Synthetic organs – 3D printing or otherwise producing entirely synthetic organs. Stem cells are then used to put cells on it [Status – Clinical trials – tracheas are the most obvious example of this one. Produce the cell free structure, and then add stem cells.]

      I have had to be a little vague in places – it’s been a while since I kept up with the regenerative medicine field and so I’ve forgotten a fair bit, apologies for that. I would say though it really depends on what you want to do. There are various bits of the body that have been looked at in all manner of ways. Growing blood vessels has been looked at, for example, as has entire corneas and skin. There are a variety of methods, and as far as I am aware, there are researchers looking at every possible way of doing things to see which is better.

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