Anthony Salvagno

10/29/08

Tissue engineering employs the harmony of biology and mechanics

into a cohesive structure. Using engineering techniques and biological

processes, one can create many “devices” that serve important functions

especially those that pertain to the human body. In the most generic terms,

tissue engineering is the fabrication of tissue from cells and organic

materials to improve or replace specific biological function. Tissue can be

anything from a portion of specialized cells all the way up to the higher order

organs which themselves perform a specific task.

What was once thought of as fiction is in fact now a cold, hard reality

that has many benefits and from my perspective very little downside.

Imagine a woman, trapped in a fire and while she is saved she loses half her

face and three-quarters of her body to burn scars. In the past, skin grafts

would be used to take healthy skin from an unburned section of her body to

cover up the scarred sections. With modern techniques, new skin can be

grown from just a couple of cells and be placed on the burned sections to

give the appearance that has ever happened before.

What about the millions of people in need of organ transplants in some

form. There are several major problems with this. In most cases (like heart

transplants) the list of recipients is a lot longer than the list of donors and as

of 12:17 pm EST 10/29/08 there are over 100,000 waiting list candidates for

organ donation (www.unos.orgUnited Network for Organ Sharing). Even if

there were an equal number of donors and recipients, the search does not

end there. Each organ has to be a match for the recipient based on various

things including blood type. If the organ doesn’t match the patient, the body

will reject the transplant and could cause other major complications in the

procedure.

Tissue engineering could put an end to all of this and more. There are

several methods of development that could be used in this process and each

employs a different cell type (based on donor). Autologous cells are

obtained from the same individual they intended to be implanted. Allogenic

cells come from an organism of the same species (typical transplants).

Xenogenic cells come from a donor from a different species. Syngeniccells

are taken from identical organisms as in the case of twins or clones. Primary

cells come from and organism, while secondary cells come from a cell bank

(grown in vitro). Stem cells are undifferentiated cells (have no specialized

purpose) usually obtained from embryos (but can be obtained other ways). I

will discuss more on the first three types, than I will the last few options.

(http://en.wikipedia.org/wiki/Tissue_engineering Wikipedia)

There are many ethical debates as to whether stem cells should even

be used, mostly because of the embryonic usage, but if other means of

obtaining stem cells become prevalent, then the method of using stem cells

for tissue engineering can become extremely useful. Since stem cells are

undifferentiated, scientists would be able to control how the cells evolve and

could manufacture anything from essentially nothing. Right now the

manufacturing process would use specific cells (for example heart cells to

make a heart) to create the tissue/organ in need, but what if the recipient (I

am assuming they are using autologous cells) has no usable cells (like in the

case of sickle-cell anemia)? A stem cell from the patient can be used to

create anything of need since it doesn’t have the necessary traits to make it

faulty.

The idea of autologous replants has many benefits. Imagine going to

the doctor and discovering that you need a new kidney. The doctor takes a

sample from your healthy kidney and in time you have a new kidney home-

grown and fully functional. The downside is the cost could be very high

compared to other techniques(to be discussed), but this method is arguably

the most ethical and probably the most safe. I also see this method

becoming useful in the event that other technologies aren’t present or it is

too late for certain actions to be taken.

Xenogenic replants consist of a tissue or organ grown from an

organism of another species. Preliminary studies have been performed on

rodents and even larger animals (like pigs) to see if these animals could

support human cells with success. In this case an organ can be grown on an

animal, not as the animal’s body part, but rather in addition to it. For

example I have seen images of a human ear grown on the body of a rat

protruding from its back.

Major general public fears are certain to arise. For one, there is the

man/animal barrier that many feel would be crossed. In the case of an

actual organ DNA from the recipient species (a person) would be used to

create the organ and the animal is just the host. In the example of the ear,

however, the skin from the rodent would be the skin for the body part and

that is where the ethical concern lies. I don’t know how many people would

be opposed to having such an operation, but I would bet it is very high.

Alloreplants would be engineered tissue/organs grown from another

person, or even from one person. I envision a mass production technique,

where one individual would donate cells and from that extraction a whole

“crop” of tissue/organs could be used by a large portion of society. In this

scenario when you need the new kidney, the doctor would just call

Organomics (my fictional organ company, which now that I think of it is a

pretty clever name) and order a medium, type B+ left kidney and the order

will beshipped in 3-5 business days. Because the organ is mass-grown the

cost could be significantly lower than the previous type of replant, and could

be accessible to a much larger part of the population.

A major downside to this is what if there is a disease that is spread

amongst the crop of tissue? All receivers of the “device” could be infected.

While occurrences like this happen frequently with mechanical parts, a

company just recalls the defective object and replaces it and all is well, in

biology such a mishap would be disastrous and could result in deaths of

patient-customers! While there are bound to be problems with this kind of

technology (as there is in all technology), the reputation of the company is

placed at tremendous stakes and so extreme measures to ensure safety and

efficiency will no doubt be in place. Doing anything less would result in

bankruptcy.

Another potential ethical concern (not just for this case, but for all

tissue engineering) would be in the area of an organ black market. While

there are various reasons that this can happen (and probably exists even

today), the one major reason I see this is if the cost of the technology is too

great except for the richest people.

The other ethical concern that I see is the idea of extending a human

life. Perhaps with this technology people will be able to receive transplants

indefinitely and could constantly receive new organs, skin, bones, blood, and

as long as the brain is functional a person could live for a very long time.

This could be the new form of plastic surgery. From this arises

overpopulation, diminishing food supplies, species extinction (other

organisms), etc. And since technology prices are bound to decrease, more

and more people would be able to afford such luxuries.

Overall I see tissue engineering as a mostly a benefit, and while there

are some drawbacks, the good outweighs the bad by a lot. When such a

technology comes to fruition major limitations will need to be placed to make

sure there isn’t an abuse of the technology. There will also need to be

regulations on the precautions taken (like in the case of mass-produced

tissue and organs) to produce engineered tissue. This technology has the

ability to help everyone in the world; a larger percentage of waiting list

candidates will get what they need, a larger percentage of transplant

recipients will survive the process (already pretty high), burn victims have a

hope for full recovery, physical deformations could be a thing of the past.

The possibilities are endless! (Sorry for being clichéd.)