Advancing the Frontiers of Medicine
By Aminna Ackridge and Mikalyn Haney
The Origin: The story of artificial organ technology can be traced back to a doctor in Japan named Dr. Tsunamasa Inou who was a very important player in the development of organ transplants and artificial organ technology. He created a team that would later contribute on an international scale to the development of artificial organs, and in launching the official “Artificial Organs” journal of the International Society for Artificial Organs in 1977. Dr Inou was known for attempting to use an artificial kidney from a dog lung, for improving blood purification modalities, and increasing the survival rate of post transplant patients through domestic immune -suppressive drugs (Nakamoto, 2017).
The Development: The development of an artificial organ can be a slow and long process. When new information is found, that technology cannot be transferred directly to the patient, because is must go through the proper channels of clinical trials, manufacturing, business investments, regular approvals and check ups, call back considerations, and many other factors that could potentially delay the patient receiving the organ (Malchesky, 2014). The development of stem cell research, tissue engineering, and 3D printing have given hope to a new rise in artificial technology (Galeon, 2017). Recent developments have come about in a laboratory in Switzerland. Nathaniel Stuart from The Engineer (2017) reports that they have successfully 3D printed a silicone heart that greatly resembles a humans. This technology could eventually become the easy, affordable, and reliable way to donor shortages issues.
Meeting the Demand: There continues to be a shortage of organs, and the current efforts being made are not enough anymore. The amount of people on dialysis today in the US is over 600,000, and due to the high demands over 6,500 people are currently using a mechanical circulatory support devices (Malchesky, 2014). The kidney is in the highest demand of the transplants, and the need for them continues to rise. Artificial organs also include other mechanisms such as ventricular assistance, life support, dialysis, and insulin control (Malchesky, 2014). Artificial organs can be used for patients who are far from the top of the transplant list and are in desperate need of one. The hope of artificial organ technology is to help enhance an individual’s quality of life.
Maintenance: A great concern with artificial organ is the maintenance of organs throughout the lifetime of the recipient. With the advancement of mechanical, tissue based, and hybrid organs, ethical considerations need to address frequency of replacement for obsolete organs, knowledgeable clinical providers and technicians on staff for routine examinations and emergencies, commercial marketing and policies and standards, and privacy of information in regards to tracking data for artificial organs.
Much data and experience comes from the pacemaker, first developed in 1960 (Hutchison & Sparrow). Since then companies have consistently produced improved models for the market. Policies and standards have been put in place to ensure new pacemakers work with old pacemaker leads, which are more risky to replace. Without this consideration, patients health and lives may be in great danger. By examining these topics through current knowledge of the pacemaker, it is clear to see the future ethical challenges that will arise with the development of other artificial organs.
The Cost: The average cost of an artificial organ is $20,000, and about 2% of Americans have an artificial organ or joint (Malchesky, 2014). Artificial organs are needed for cardiac assist devices, orthopedic devices, neuroprostheses and neurological support, urological support, visual support, blood cell and tissue replacement, and autoimmune and metabolic therapy treatments. This new technology makes for a global market estimated to be worth around $415 billion in 2016. Cost of healthcare is on the rise, with the U.S. spending $8,500 annually per person (Malchesky, 2016). The number of patients requiring artificial organs far exceeds the amount that actually receive treatment each year with the projected numbers increasingly becoming worse. Cost effectiveness is controversial when also taking into consideration mobility and quality of life. Healthcare professionals need to begin focusing on preventative measures such as the use of artificial organs in order to restore normal organs function instead of end-stage organ failure.
An important factor to remember is that the financial cost of an organ is only a fraction of the cost for the complete transplantation procedure. Included in this cost is the selection of recipients to receive a transplant, those that are deemed worthy of receiving an organ when there is constantly a shortage (Kunter, 1987). Location, family status, mental and physical health history, etc, are all influencers when determining if someone is most cost-effective. Another factor to consider is quality of life after transplantation and immunosuppression (p.32). Since the first successful organ transplant, survival rates have increased with improved technology and sanitation knowledge.
Galeon, D. (2017). Artificial Organs: We’re Entering an Era Where Transplants Are Obsolete. Health and Medicine. Wired, December 4th 2017.
Hutchison, K., Sparrow, R. (2016). What Pacemakers Can Teach Us about the Ethics of Maintaining Artificial Organs. Hastings Center Report. Vol. 46 Issue 6, December 2016.
Kutner, N. (1987). Issues in the Application of High Cost Medical Technology: The Case of Organ Transplantation. Journal of Health and Social Behavior, Vol. 28, No. 1, 1987.
Malchesky, P. (2014). Are Artificial Organs Still Needed? Artif Organs, Vol. 38, No. 10, 2014.
Malchesky, P. (2016). Artificial Organs: Are the Cost Sustainable? Artificial Organ. Vol. 40, No. 2, 2016
Nakamoto, S. (2017). In Memoriam Tsunemasa Inou: A Pioneer in Artificial Organs and Transplantation in Japan. Artif Organs, Vol. 41, No. 10, 2017.
Stuart, N. (July, 2017). Soft artificial heart completes initial trials in Swiss project. The Engineer. Retrieved from theengineer.co.uk
Worldwide Public Relations. (2017). UK Artificial Organs & Bionic Implants Market – Growth,Trends & Forecast. Retrieved from openpr.com