The University of Southampton

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The Moral Dilemma of Limb Regeneration: We Have the Technology, But Should We Use It?

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Limb regeneration is a field of research that captured my attention after Dr. Nicholas Evans’ lecture on tissue engineering. The thought of regrowing lost limbs or even organs, was once something only seen in science fiction (like Dr. Conners in The Amazing Spider Man) however thanks to the advancements in tissue engineering and regenerative medicine, it is now becoming a reality. The basic idea of limb regeneration is to stimulate the body’s own regenerative abilities to grow new tissue, bone, muscle, nerves and blood vessels. Many animals are already capable of this such as a salamander.

The process of limb regeneration starts with the formation of a blastema which is a mass of undifferentiated cells capable of enacting growth and regeneration into organs or body parts. The cells have been reprogrammed to become pluripotent. Once the blastema is formed, the cells differentiate into the various types of tissue that make up the limb. They are guided by a complex network of signalling molecules and gene expression patterns. The process is similar to the normal embryonic development of a limb but, it is much faster. While the possibility of regrowing limbs is exciting, it also raises some ethical concerns.

Developing new medical technologies and procedures is expensive and regrowing limbs is no exception! This raises the question of who would have access to this technology? Will it only be made available to the wealthy or to those with good insurance? This could further widen the gap between social classes so is this really necessary?

Another concern is the impact of limb regeneration on the existing prosthetics industry. Prosthetics have come a long way in recent years and many people have benefitted from the advancements in this field. However, if limb regeneration becomes a reality, what happens to the prosthetics industry? Will there still be a need for prosthetics or will they become obsolete? This raises questions about the economic impact of limb regeneration.

Perhaps the most significant ethical concern is the question of whether limb regeneration is even ethical in the first place. Some argue that it is playing God and that scientists and doctors should not be meddling with nature in this way. On the other hand, others argue that it is perfectly ethical as long as it is used for good and not for frivolous reasons like armed forces around the world creating super soldiers.

Despite these ethical concerns, there are many potential benefits to limb regeneration. For example, it could greatly improve the quality of life for amputees, allowing them to regain or gain lost functionality and independence. It could also decrease the use of prosthetics as I said earlier, which can sometimes be uncomfortable and difficult to use. Limb regeneration could also lead to advancements in other fields such as organ regeneration. I believe that the potential benefits exceed the ethical concerns as there are numerous applications of such a process and it would have a significant impact on human health and well-being.

In the end, the decision of whether or not to pursue limb regeneration is a complex one that requires careful consideration both the potential benefits and the ethical concerns. Limb regeneration is an exciting field of research that has the potential to revolutionise medicine and drastically improve the lives of many. With the points I have brought up and with your own opinion, I now ask you, should we use it?

Hip replacement – the past, and the future.

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Recently I have had the privilege to come to Prof. Douglas Dunlops’ clinic, where I have gained a lot of understanding on orthopaedic surgery. One thing that interested me the most was looking at the development and evolution of hip replacement strategies, and where it can lead us in the future, hence why I have decided to write this blog.

From the beginning

Sir John Charnley was the first to research and develop total hip replacements. He aimed to create a total hip replacement using a synthetic substance between the femur head and the socket, instead of using the natural synovial fluid. After failed attempts with PTFE, Charnley eventually used Ultra-high-molecular-weight polyethylene (UHMWPE) for the first time in 1962. After five years of observing his patients Charnley announced the method as safe, allowing other surgeons to use his patented design and officially making the first functionally total hip replacement. After Charnley’s patent lapsed over 100 kinds of hips were licences, one of them being the EXETER. Its success arose from its tapered stem, allowing it to be easily popped out and replaced, but even-though 92% of them last over 30 years, hip prosthetics still seem to fail.

Less history, more science

Prof. Douglas Dunlop gave me a lot of insight on all the reasons why hip replacements fail, but one that stood out to be the most and seemed to reoccur was corrosion. The same way the natural femoral head of the hip joint erodes with time, the synthetic joint can cause wear and tear of the cartilage, leading to the formation of a shallow socket and osteolysis. On top of that, physical shearing forces slowly remove the protective film on the metal surface, and any taper interference will corrode the metal further.

Prof. Dunlop also showed me an x-ray of an elderly patient who had undergone multiple hip replacement surgeries. The shallow socket of the patient caused by hip displasia required for the the prosthetic to be ‘screwed’ into place along with cement loosening. Each time the stem was replaced, the femur had to be reamed, increasing the risk of fracture, prosthetic loosening and infection. This patient had a 3M Capital hip, which prompted the national joint registry due to its poor performance. At the time, the Southampton General hospital was also using a CPT Zimmer brand prosthetic with a fracture rate of 3.4%, giving them a low rating on the registry. In order to overcome this issue, Prof. Dunlop, alongside researchers at Southampton University came up with a solution.

The future of prosthetics

35 years ago, another patient at Southampton General had a similar issue. Her prosthetic migrated and became loose, leaving behind a gap in the bone. In 2003, bone graft from the bone bank was used, but eventually that also failed as screws loosened and the femoral head migrated. It was clear to me that any other attempt at revision would also be unsuccessful, but Prof. Dunlop told me about a new cutting edge technology that has the potential to change prosthesis for ever.

To overcome this issue, 3D custom implants were used, and held in place using stem cells. Not only is the shape of the implant a precise shape for the patient, but the stem cells act as a ‘glue’, allowing for bone formation and encouraging regeneration of the surface layer of damaged cartilage. The removal of old prosthetics may leave behind scar tissue, therefore stem cells may be the only solution to a patient where biology has failed. Upon further reading I have discovered that Dr. Daniel Wiznia of Yale University has developed a similar approach, and deduced that stem cells are a credible strategy and have considerable potential in the future of prosthesis.

Moving away from monoblock stems and exchanging them for a stem with an exchangeable ceramic head seemed to me like a very impactful advancement, but after hearing about the use of 3D printing and stem cells, it has become clear to me that scientists are not done there. It is fascinating to see how the approaches to prosthesis have changed in the last 60 years, and leaves us to think where it can lead us in the future. By writing this blog I aim to show just how fast science is progressing and how successfully scientists are coming up with solutions to clinical problems.

I got the opportunity to listen to Prof. Dunlop talk about his work
Source of information on Sir John Charnley

The Revolution of 3D Printing in Prosthetic Limbs

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Introduction

In recent years, remarkable advancements in the field of prosthetics have been sparked by the development of 3D printing. This technology has revolutionised the way in which we can provide more customisable, affordable, user-friendly prosthetic limbs. One of the biggest advantages of such technology are found in its capability to be accessible to so many where, according to NGO LIMBS, only 5% of almost 40million amputees have access to prosthetic devices(1). This blog aims to expand on the incredible inclusion of 3D printing in the world of prosthetic limbs and how it has the potential to transform lives.

Bone Health Preservation

3D printing allows for custom-fit sockets which have the benefit of using digital scans of patients to develop prosthetics which are more efficient in reducing friction and evenly distributing weight across the limb. This means that bone is less likely to be lost as a result of the prosthetic, which can sometimes occur when the prosthetic socket is not an accurate enough fit. Another benefit of this technology, is its capacity for easy adjustments and remodelling to ensure a consistently well-fitted prosthetic, decreasing the chance of any complications leading to disuse and resultant bone health consequences. Additionally, the 3D printing of prosthetics often uses thermoplastics which are much lighter weight and therefore place much less pressure on the bones. Resultantly, bone density is more likely to be preserved and fractures are more likely to be avoided, aiding the maintenance of bone strength.

Disadvantages and Solutions

Although there are benefits to the use of thermoplastics in prosthetics, they are a less strong or durable option when compared with other materials used in prosthetics, such as carbon fibre. This means that it generally has a shorter lifespan and is more likely to need replacing and therefore may be significantly less suitable for use in lower-limb prosthetics. This may particularly be the case for patients who have more active, high-impact lifestyles, or those with higher body weights.

Therefore, a more suitable use for 3D printing technology in prosthetics, as proven thus far, may be in upper-body limbs and in children. This combats complications of exerting too much pressure on the lighter-weight thermoplastic, and enhances the technology’s potential for durability. This may be a particularly beneficial advance in technology for children and growing adults. This is due to, as before mentioned, the precise adjustability of 3D printing. Additionally, it is a far cheaper option for prosthetics as traditional prosthetics can cost thousands to replace as children are out-growing them. The organisation, e-NABLE began a project whereby many constructed and donated 3D printed prosthetic hands to children for free to aid research in the area.

Summary

The amazing affordability and accessibility provides an abundance of potential for 3D printing in the field of prosthetics. Although there may currently be limitations as to what field of prosthetics this technology might be best suited to, there is hope that technological advances in thermoplastics or finding more suitable materials may lead 3D printing to be the future of prosthetics.

(1) – https://www.sculpteo.com/en/3d-learning-hub/applications-of-3d-printing/3d-printed-prosthetics/

Chimera Concerns

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World First:

The first human/animal chimera was a human/rabbit chimera documented in Cell Research 2003 where the scientists from Shanghai Second Medical University fused human skin cells with rabbit eggs and allowed them to develop in laboratory dishes for several days before their human embryonic stem cells were harvested. This raises many ethical issues, specifically with embryonic stem cell harvesting as many people see the destruction of the embryo to retrieve these cells to be ending a human life, and some scientists even argue the research is not necessary in the first place.

Primate Chimeras:

A simplified diagram of the processed used to produce the human/monkey chimera cells.

The negative reaction to the 2003 paper did not deter a team of researchers from China, Spain and the USA from creating the first human/monkey chimera in 2021, who injected human epithelial pluripotent stem cells (hEPSCs) into macaque blastocysts.

This video shows the growth of one of the chimeric embryos, with the human cells highlighted in orange where you can see them migrating and undergoing mitosis.

Images of the chimera cells under different staining

In over half of the injected embryos TD+ human cells were found within the embryonic disc which is responsible for detaching embryonic cells from the blastocyst walls and forms a trilaminar embryo- an important step in embryonic development.

Ethical Considerations:

As it stands at the embryonic stage of development there are already ethical concerns with regard to the harvesting of embryonic stem cells from these chimera embryos, as some consider this to be killing a living organism, however if these cells were allowed to grow and able to produce an adult organism the concerns become even more sinister- organ farming.

Growing human organs in animals for the sole purpose of transplanting them into awaiting human patients is a conflicted topic for many reasons. Jehovah’s Witnesses famously refuse blood transfusions, and many more would likely object to receiving an organ grown inside an animal. The possibility of growing human organs using the patient’s own cells may persuade more, but many would still object to receiving an organ grown inside of an animal. Furthermore, there are research limitations on primates due to their similarity with humans, but it is this very similarity which could make them one of the best candidates for organ farming.

On the other side of the fence, you could argue that harvesting organs from animals like monkeys and pigs is no different than farming any other sort of animal product, with the added benefit of saving lives. One of the considerations with chimera organ harvesting is which animals we create chimeras from. Monkeys are typically thought in the west to be too intelligent to eat, and many religions disallow the consumption of pork so would likely refuse organs from one too, however pigs and monkeys are typically viewed as the best vessels for growing human organs. If the animal used is already farmed en masse, how bad is it really?

According to the HRSA website, there are 104,234 people in the US on the national transplant waiting list as of 24/03/23, and 17 people die every day waiting for an organ transplant. over 42,000 organ transplants were performed in the US in 2022. If human/monkey chimera technology advanced to the point of transplanting mature organs into human recipients, it could help to alleviate the organ crisis we face in the world today.

Human/animal chimeras for organ harvesting could save thousands in the future, but is it worth sacrificing animals to play God?

WILL STEM CELL POTENTIALLY SURPASS OUR POV ON ETHICS

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Over the past few weeks I’ve had the privilege to learn about the various topics and categories of what we know as engineering and topics. From our lectures, 2 topics had especially stood out to me, and these were stem cells, and Bioethics. And they went surprisingly hand in hand.

What are stem cells?

Stem cells utilise the ability of differentiation to the max by possessing the gift of differentiating into any of the cells in our body, asymmetrically or symmetrically. Just from this you can see they have the potential to make many strides in modern medicine, in fact there have already been papers regarding their use in surgeries already. 

An example of stem cells potential in surgeries can be their use in deep tissue repair following burns to the face.

A paper from Ncbi states: current treatments with skin replacement aren’t capable of generating fully functional skin, and mentions “ administration of growth factors has occurred, it comes with many consequences- in summary : “ using stem cells in treating burns is justified here, as stem cells are able to secrete these growth factors in a sustained manner”(Kareem NA, et al (2021))  Allowing me to believe they’re a more beneficial alternative to current components in surgery. 

My own research on other articles concerning stem cells, left me with a lasting impression on how they can revolutionise modern medicine in the future. HOWEVER, I was reminded of our ethics and law lectures, and while stem cells are viewed in such an amazing light, they can easily be abused and researched with the wrong intent. 

Jeremy Bentham. (1748-1842) the one who created the Theory of consequentialism

After reading multiple articles I noticed that the intent of research always originates from the researchers own moral compass. Which correlates to the theory on consequentialism, it defines the right action in terms  of promotion of good consequences, concerned with maximising the good outcome.

Ensuring the benefit of humanity isn’t perceived as exploring our potential evolutionary consequences. 

FROM A RELIGIOUS POV 

Christianity- found in a paper published by the University of Notre Dame 

“Clearly, the church favours ethically acceptable stem cell research” however later states “we must respect life at all times especially when your goal is to save lives”. Telling me that, we want to respect life as much as possible so in the future, when research has developed further, we don’t overshadow our morals as human beings by exploring humanities limits through human subjects. 

Islamic perspective: an article on Georgetown explains that “ they’ve prohibited using embryonic stem cells which have the potential to develop into a life in research as it entails their destruction during the process of procurement”. 

Explaining that if using stem cells in the lab involves developing a life form to be used for experimentation, it cannot be condoned as morally right because in the later stages of development is when they believe this life form is endowed with a soul. 

WHAT DOES ALL THIS MEAN FOR US IN THE FUTURE

In my opinion Stem cells will help solve various problems in medicine in the future, these include the issue of waiting for donors for a transplant, or an alternative to animal experimentation. I believe that those conducting research using stem cells only view it as a means to benefit us without compromising our moral compasses as human beings. 

CONCLUSION 

To conclude, the use of stem cell research provide an essential role both now and in the future for counteracting various problems in the medical field, ranging from unforeseen diseases yet to sprout, to limbs lost during accidents causing trauma. However this only applies if they’re used for the specific benefit they have in mind, and there is a thin line between using stem cells as a means for improving our quality of life, and using stem cells to explore the capabilities of us as humans.

Bionic Athletes

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A few years ago, I completed some work experience alongside an orthopaedic surgeon, where I got to see a total hip replacement surgery take place. Before taking part in this experience, I had the mindset that it was only older patients needing these sorts of surgeries. But to my surprise, it was a female in her mid 30s that came into the theatre.

The presentation given by MatOrtho sparked my interest once again in this area of bioengineering. They mentioned that Andy Murray, a top 10 tennis player, had received one of their hip resurfacing implants. As a keen sportsperson myself I was intrigued to hear that top athletes can receive such implants and return to the same level of sports performance.

From the presentation they explained that osteoarthritis of the hip is the most common reason for needing a hip implant. Osteoarthritis of the hip causes: severe pain, swelling, and stiffness which causes reduced motility. The image to the right highlights what an X-Ray of an osteoarthritic hip looks like.

I also learnt some of the major differences between total hip replacements and hip resurfacing implants.

The Pros of Hip Resurfacing

I found these two images which I think show the physical differences of the two types of implants quite well. The example of the hip resurfacing implant is the model developed by MatOrtho know as ADEPT. This model has a patient satisfaction of over 95%.

MatOrtho’s website also provided a good list of the benefits that come with the hip resurfacing implant. This included that, hip resurfacing patients can return to a wider variety of sporting activities without restriction, hip resurfacing significantly reduces the risk of dislocation and has a lower risk of postoperative infection than the total hip replacement.

https://www.matortho.com/products/adept-hip-resurfacing-system#:~:text=Hip%20resurfacing%20significantly%20reduces%20the,of%20mortality%20compared%20to%20THR.

So from reading further about the hip resurfacing it seems that the main selling point is that younger patients who receive this type of implant can return to a fully active lifestyle…

The research that has been done has shown that the hip resurfacing has majorly increased the majority of the patient’s ability to take part in sport after the hip replacement. And not only take part, but excel in sport performance.

The future

This made me think what effect a hip resurfacing procedure could have on a person with a perfectly healthy hip. Although there’s no research on hip resurfacing in healthy patients, the advancements that have been made so far in going from the total hip replacement to developing the hip resurfacing implant is already major.

It is not only science and engineering that is constantly trying to break boundaries, athletes are a prime example of where records are being broken on a regular basis. Athletes are always looking for ways that they can improve their sports performance within their training and diet. Could it be possible that we could introduce these types of implants so that one day athletes could purposely get them as a way of increasing their sports performance?

I decided to get in contact with consultant orthopaedic surgeon, Paul Magill to get his opinion on whether orthopaedic implants could be introduced as a way to increase sports performance.

Interview with Paul Magill

Your eyes are now obsolete

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After doing some research into interfacing electronic signals with the body, I stumbled upon bionic eyes. One device was the ARGUS II, implanted into five patients in England as part of a clinical trial. This article included praise from current ARGUS users Including a man who can now see his grandchildren running around. The articles surrounding the device was overwhelmingly positive until they got more recent then the narrative around ARGUS changed. 

The device is comprised of three modules. An electrode array, video processing unit and a camera. The brain interprets the signals as flashes and the vision created is more akin to an entirely new sense. In this video Ray describes the vision produced as arcs.

The arcs represent the most important parts of the picture. This should be moving objects and edges; the device must accurately pick out the pixels which will convey the most relevant information to the patient. The Video processing unit (VPU) is what does this. It utilizes edge detection algorithms like the matrix mechanics of convolution which I am familiar with from both computer science and quantum mechanics. 

An example of edge detection

The electrical components in the device have several purposes: data and power transfer and biological interfacing. The former is achieved by using magnetic induction. For data transfer the VPU unit encodes signals into radio waves. Which are then converted to tiny alternating currents by a receiver in the implanted region. The data can then be extracted from these currents. Power is transferred by the same physical principle tweaked for this purpose. The final challenge is at the biological interface. The ARGUS II uses micro-electrodes. These define the vision achievable by the device. Advancements in nano-tubes could really improve the quality of the vision created due to physical constraints of wider electrodes.

Despite the quality-of-life improvements seen from most recipients and the prospect of new iterations of devices the device manufacturer Second Sight collapsed and merged with Nano Precision Medical ceasing to develop its ARGUS implant line switching to other projects. The devices had never become profitable. All engineers were laid off and, unlike previously promised, support for the ARGUS models was stopped. Second Sight also failed to inform patients of the collapse. Now users are left to hope their device continues working as normal since replacement parts need to be sourced from the community and many relied upon devices have been rendered not functional by previously routinely fixed hardware issues.

In the EU manufacturers must provide spare parts for a washing machine for 10 years after the appliance has been discontinued. This law was introduced to help limit the environmental impact of E waste and protect consumers. The standard used for washing machines should be the absolute minimum used for implanted medical devices. I believe strongly in the right to repair and choose to repair my own technology, therefore qualified engineers should have access to the parts for device repair long after they have stopped being implanted. 

This is a prime example of our increasing vulnerability in the face of high-tech, smart and connected devices which are proliferating in the healthcare and biomedical sectors.

Elizabeth M Renieris, professor of technology ethics at the University of Notre Dame told the BBC https://www.bbc.co.uk/news/technology-60416058

Many have been left with defunct devices still implanted in their body. I believe the stress and anxiety caused for these people is unforgivable and the law needs to catch up, money and company reputation must stop being placed above patients and transparency.

Commercial Autogenic Cell Therapy Evolution at a Glance.

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The lectures I recently received about tissue engineering piqued my interest, specifically with the commercial availability of autogenic cells such as CarticelTM and as I looked further the development of such products was very interesting.

The 4 generations of autogenic chondrocyte implantation (ACI):

First Generation:

A 1st generation ACI procedure is shown in the video below where you can see the harvesting of periosteal tissue from the tibia, suturing of the periosteum into the knee joint, securing with fibrin glue and finally the injection of chondrocytes below this periosteal patch. Genzyme is a company which delivers this service and has reported success rates of 70-90%. Problems with this procedure include overgrowth of the implanted cells which can degrade joint function and cause pain; however this can be easily fixed by the shaving away of excess cartilage. Procedures of this type cost around $40,000, far too expensive for many people, especially in countries without nationalised healthcare such as America where insurance may not cover the procedure.

Second Generation:

Carticel is an example of 2nd generation ACI. A biopsy of cartilage is taken from lesser weight bearing areas so that chondrocyte cells can be isolated and expanded over a period of 4-6 weeks. The expanded cells are reinserted into the damaged joint to form new, healthy cartilage. On their website, Carticel states that their product is intended for the repair of “symptomatic cartilage defects of the femoral condyle caused by acute or repetitive trauma, in patients who have had an inadequate response to a prior arthroscopic or other surgical procedure”. According to the Bioinformant, Carticel autologous chondrocyte implantation costs between $15,000 and $35,000. This cost raises ethical questions because a large subset of people who would benefit from this procedure cannot afford it.

Third Generation:

Spherox is a company which offers 3rd generation ACI with a £10,000 price tag, however the Royal Orthopaedic Hospital (ROH) in Birmingham has provided this procedure and it is now eligible for patients on the NHS according to the ROH website. Spherox works in a different way to Carticel, by taking chondrocytes and producing spheroids of neocartilage composed of expanded autologous chondrocytes and their associated matrix. A sample of healthy tissue is taken from the patient in keyhole surgery and the sample is grown into chondrocyte spheroids. When the spheroids are implanted into the patient’s knee cartilage, they bind to the defective tissue and produce new cartilage tissue. For NHS patients in the UK, Spherox has far fewer ethical concerns regarding cost because the price of the operation is less than the cost caused by such injuries if left untreated to both the NHS and the patient’s quality of life.

The Future:

4th generation ACI therapy has not yet entered mainstream medicine, however various trials are underway. Some research is investigating the role of gene therapy in cartilage repair producing “temporarily and spatially defined delivery of therapeutic molecules to sites of cartilage damage”. According to this paper, the use of elastin as a scaffold is being investigated, as well as the use of a nonviral gene delivery system to allow mesenchymal stem cells to produce osteogenic growth factors.

Empowering Amputees with 3D Printed Prosthetic Limbs: The Future of Accessibility

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After attending a lecture by Dr Dickinson and Professor Browne on prosthetic limbs, I found myself intrigued by the manufacturing process behind them. After doing some of my own research, I stumbled upon the recent revolution in 3D printing. In more developed countries such as the United Kingdom and the United States, prosthetics are readily accessible and are usually fitted around 2-6 months after surgery. However, this is far from the case in lower-income countries like Cambodia. It is estimated around 100 million people worldwide require a prosthetic limb; 80 percent of whom do not even have access to this resource. Recent advances in 3D printing technology have made it much easier to construct prosthetic limbs, making it quicker and more affordable as well as being far more tailored to the individual.

A photo showing a donated prosthetic from Guillermo Martínez to a Kenyan child, synthesised from 3D printing

The benefits of 3D printing

There are several benefits to using 3D printing technology for prosthetic limbs, including:

  1. Customisability: Traditional prosthetics can be difficult and time-consuming to customise, often requiring manual adjustments and moulds. With 3D printing, prosthetic limbs can be designed and printed based on precise measurements of the amputee’s residual limb, resulting in a better fit and greater comfort.
  2. Affordability: Traditional prosthetic limbs can be expensive, with some models costing tens of thousands of dollars. 3D printing technology offers a more affordable alternative, making prosthetics accessible to a wider range of people.
  3. Rapid production: Traditional prosthetics can take several weeks or even months to produce. With 3D printing, prosthetic limbs can be designed and printed in a matter of hours or days, allowing for faster delivery to those in need.
  4. Reduced waste: Traditional prosthetic limbs often require a significant amount of material waste, as moulds must be created and adjusted multiple times. 3D printing eliminates the need for moulds and produces little to no waste, making it a far more environmentally-friendly option.
  5. Innovation: 3D printing technology is constantly evolving, with new materials and designs being developed all the time. This means that prosthetic limbs can continue to improve and become more functional over time, offering even greater benefits to amputees.

Overall, the capability of 3D printing to produce highly tailored prosthetic limbs is one of its main benefits. Contrary to conventional manufacturing methods that call for moulds and human adjustments, 3D printing enables swift and simple production of accurate dimensions and customised designs. As a result, amputees can get prosthetic limbs that match their unique requirements and preferences, enhancing their quality of life entirely.

The drawbacks

While 3D printing technology has many benefits for the production of prosthetic limbs, there are also some potential drawbacks or challenges to consider:

  1. Limited strength and durability: Some 3D printed materials may not be as strong or durable as traditional materials used in prosthetic limbs, which could result in a shorter lifespan or increased risk of breakage.
  2. Quality control: There is currently limited regulation and oversight of 3D printed prosthetic limbs, which could result in lower quality or safety standards compared to traditional prosthetics.
  3. Limited accessibility: While 3D printing technology has the potential to make prosthetic limbs more affordable and accessible, there are still limitations to its widespread availability, particularly in lower-income or developing regions.
  4. Limited design options: While 3D printing technology allows for greater customisability, there may be limitations in terms of available designs or features compared to traditional prosthetic limbs.
  5. Training requirements: As 3D printing technology is still relatively new, there may be a lack of specialised training or expertise in the field of 3D printed prosthetic limbs, which could result in lower quality or inconsistent results.

It is important to consider that many of these challenges are currently being addressed by researchers and developers working in the field of 3D printed prosthetic limbs. As the technology continues to improve, it is likely that many of these issues will be resolved over time.

“The ability to create customised prosthetic limbs through 3D printing technology has revolutionised the field of prosthetics, offering greater accessibility and affordability to those in need.”

Dr. Albert Chi, Medical Director of 3D Printing at Shriners Hospitals for Children

Animal Organ Donors – Is it Worth it?

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After attending lectures on stem cells and tissue engineering, I found myself to be very intrigued by chimeras and the diversity capabilities of specific cells. Specifically, the possibility that we could potentially grow human organs in another species, with the intention of organ donation, was something that seemed so unbelievable to me. This provoked me to research further into how close to achieving this we may be, as there is also bound to be ethical issues surrounding this worth discussion. Currently, the NHS weekly statistics reports that 6963 people are currently waiting for organ transplants in the UK. The NHS also reports that 30 in 100 patients experience organ rejection following the implementation of a donated organ. Therefore, I believe it to be an important issue worth researching to find more solutions for.

Pablo Ross (Thursday September 28 2017) working on creating organs from human stem cells that can be grown in pigs and other livestock. Photo Brian Baer

What research is currently being done?

Investigation of this subject lead me to find the research done by Dr. Pablo Ross who has used his extensive veterinary experience, combined with his in-depth knowledge of stem cells to conduct experiments on creating a human-pig chimera. So far, the research and its limited funding, has lead as far as creating chimeras which contain approximately every 1 in 100,000 cells of the pigs being human because pigs and humans are such distant relatives. With this being the extent of current research, it is fair to say we are not yet at a point where human-pig chimeras are able to provide functional help in the medical world. The end goal is that one day we may grow an organ that is fully human or at least made up of enough human cells that it may overcome the prevalent issue of organ rejection.

How ethical is it?

The immediate issue that should be addressed is that testing on animals can not always be seen as entirely ethical as they cannot provide their own informed consent for such procedures and research to take place. It is because of this that humans must make the decision to evaluate if the potential harm to the animals outweighs the benefits of the research or not. The benefits of this line of research, if successful, could potentially lead to a huge reduction in organ rejection, as well as a largely reduced waiting time for all those suffering with organ failure. However, the concept of breeding animals for the purpose of organ donation to humans, which is potentially a very invasive procedure, raises many ethical concerns. My thoughts are that if the research is to be done at all, it may be, in some sense, more fair to use animals who are already being bred with the purpose of being used for their meat as then more of the animal can be used, instead of disregarded.