A small-scale, 3D-printed human heart (Noor et al.; Advanced Science, 2019}

Israeli Scientists Create First 3D-Printed Human Heart

Achievement has significant ramifications for future organ donation and transplants

Researchers in the laboratory of Prof. Tal Dvir at Tel Aviv University have printed the first “whole, living, pulsating” 3D vascularized engineered human heart, they reported in a press release on Monday. By combining the use of a 3D printer with cells and biological material extracted from a patient, the scientists became the first in the world to accomplish this feat.

“People have managed to 3D-print the structure of a heart in the past, but not with cells or with blood vessels,” said Dvir, who led the research for the study. “This is the first time anyone has successfully engineered and printed an entire heart, replete with cells, blood vessels, ventricles and chambers.”

Their findings were published on April 15 in Advanced Science. Research was conducted by Dvir, Dr. Assaf Shapira of TAU’s Faculty of Life Sciences, and Nadav Moor, a doctoral student in Dvir’s lab.

Shapira, manager of the lab, explained to The Media Line that the process comprises extracting tissue from the patient in a simple procedure, separating the required cells and genetically reprogramming them to become heart cells and blood vessel-forming cells. The scientists then combine them with gel-like, extracellular material to form a “bioink,” which is then placed in the printer, eventually printing a patient-specific, immune-compatible heart.

“Our model typically takes three to four hours to print the whole organ,” Shapira said.

Prof. Robert Klempfner, director of the Cardiac Rehabilitation and Prevention Institute at Tel Aviv’s Sheba Medical Center, told The Media Line that imaging has advanced to a point where we now have 3D echocardiography and 3D reconstructions based on MRI imaging, but this breakthrough takes it to a whole new level.

“Cardiac muscle is very complex [because] it’s not just a muscle. There are other elements that you need to account for, such as a conduction system and valve apparatus. The ability to combine these different types of tissues and create an environment where these tissues can thrive together isn’t just exciting, it’s groundbreaking,” he said.

Heart disease is the leading cause of death in the US, according to the Centers for Disease Control and Prevention (CDC), accounting for one in every four deaths. The World Health Organization estimated that 17.9 million people die each year from cardiovascular diseases, nearly one-third of all deaths globally.

Heart transplantation is the only treatment currently available for people with end-stage heart failure. In addition to the shortage of heart donors, another problem with transplantation is the risk that the body will reject the donor’s heart. Since the body perceives the donor’s heart as a foreign object, the initial response of the immune system is to attack the donor’s heart. Therefore, patients take immunosuppressants to reduce the activity of the immune system.

Shapira emphasized that the new technology could eliminate the need for patients to receive transplants from donors, as well as the difficult search to find matches.

“We believe, and it is well established in the scientific literature, that when you use the patient’s own cells and biological material, it will not provoke a significant immune response, and the body will not reject the organ, as it won’t be considered foreign,” he said.

At present, the newly grown organs are not clinically applicable.

“Right now, it’s a small human heart, the size of a rabbit’s heart, but we will grow it in a specialized bioreactor – an incubator that provides tissues and organs with oxygen and nutrients – and after a few weeks, the tissue will mature and be transplanted into animal models,” Shapira said.

How long will the public have to wait to receive this new technology?

“Maybe in 10 years, there will be organ printers in the finest hospitals around the world,” Dvir stated in a press release, “and these procedures will be conducted routinely.”

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