Revolution in plastic surgery: human tissue rolls out of printer

Creating new pieces of bone, muscle, skin or fat with a 3D printer to heal injuries. Sounds futuristic? The first steps are already being taken today! We spoke with plastic surgeon and professor Phillip Blondeel about his research into tissue engineering.

3D Bioprinter

With tissue engineering you make replicas of human tissue in the lab. How does the technique work exactly?

Phillip Blondeel: "We make the new tissue based on stem cells from the patient. We use stem cells because they have two special properties. The stem cells can renew themselves and they can grow into numerous specific cells such as a muscle cell, skin cell or fat cell.

We deliberately harvest the stem cells from the patient instead of buying them. We do this by isolating them from the fat layer. There's a lot of potential in our fat, which is often a reassuring thought (laughs).

In our lab, we then work with the stem cells to 3D bioprint tissue. This is done in a liquid matrix, a kind of gel that we developed. For example, we try to build an identical copy of, for example, a piece of fat, skin or other tissue from the patient." 

In which procedures can this technique be advantageous?

"For example, we see a lot of breast cancer patients for breast reconstruction. We hope to  one day use tissue engineering to build breasts for those patients.

Let's say you have breast cancer. While you receive the necessary treatments such as radiotherapy or chemo, we build new tissue in our lab with your own stem cells. When the other treatments are finished, we will incorporate that piece of tissue into your body. This way, we build something with your own fabric that fits perfectly, with the same volume and shape."

What makes tissue engineering better than the existing techniques?

"With the current techniques, we are reaching the limits. For example, by removing a piece of tissue from a different place to use in recovery from an injury, you always create a new scar or the patient experiences pain.

We can eliminate all these disadvantages if we can create new tissue for these procedures in our lab. Our dream is to eliminate all existing complications. No complex surgery, no scars, no pain, no defenses or other misery from operations."

Perfect, no drawbacks. So why is the technique not yet being applied in practice?

"In two words: blood flow. That is the major obstacle today. Currently, we can only print a few cubic centimeters of human tissue because we are not yet able to achieve blood flow. And because no blood vessels run through the printed tissue, larger pieces of tissue die immediately."


3D-bioprinting facility in The Core with Dr. Florian Vanlauwe (PhD student), Dr. Bernard Depypere (plastic surgeon, UZ Gent), Prof. Dr. Phillip Blondeel (plastic surgeon) and Prof. Dr. Ramon Llull (Wake Forest University School of Medicine)

So further research is needed for that?

"That's right! One of the branches we are now delving into is the development of new endothelial cells, or cells that make blood vessels. That's the holy grail of tissue engineering. If we find that key, then larger pieces of tissue can be printed.

In order to move forward faster, we are fully committed to collaboration. For example, we are in a partnership with Ghent University, Ghent University Hospital, imec and VIB: GATE (Ghent Advanced Therapies and Tissue Engineering). In it, we gather all the expertise in cell and tissue technology.

But we are also looking abroad. We just started working with Wake Forest University in America, the absolute mecca for tissue engineering. By associating with them, we can take bigger steps.

And we have new research facilities as well. In The Core, the new research building on the campus of Ghent University Hospital, we have our own core facility '3D Bio Printing'. Very diverse profiles from the biomedical sciences are welcome to work with us. That's really fun!" 

Tissue engineering research is likely to require a lot of resources?

"Definitely. The fact that we have come this far today is largely due to donations. In fact, we rely heavily on private initiatives. For example, we have been receiving a nice amount of money from a generous donor for several years now. Thanks to this continuous support, we are able to produce an impressive number of publications that advance our research."

So when will the real application of tissue engineering follow?

"I estimate that it will take 25 to 35 years before we print tissue with a mass of more than 50 grams. But it's hard to predict. Research is done in steps and a coincidence can suddenly accelerate it.

What we are already doing today is inserting stem cells directly into the patients. We see that they have a regenerative effect. If we insert stem cells into damaged areas, they will affect the local ecosystem. Thus, they change the environment of the damaged cells. We are already applying this to cancer patients: radiotherapy often causes skin damage. If we inject the stem cells into that region, the damaged skin regains suppleness and a normal color."

Support the Breast Engineering Fund

Do you want to give Ghent University's research into tissue engineering a boost? Then make a donation to the Breast Engineering Fund of Prof. Dr. Phillip Blondeel. Your donation is welcome on account number BE26 3900 9658 0329 with Communication "Breast Engineering Fund".  Donations to Ghent University are tax deductible from 40 euros on an annual basis and on the condition that you provide us with your national register number.

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