The Impact and Challenges of Bioprinting on Modern Day

Medicine
ELIZABETH A. MURPHY, AWD 3302, NORTHEASTERN UNIVERSITY
PUBLISHED: AUGUST 12, 2016
Abstract
3D printing is a manufacturing process that allows for the synthesis of three-dimensional solid
objects from digital files. Bioprinting takes the concept of 3D printing and advances it one step
further for the fabrication of artificial tissue and organs. Since its origins in 2002, it has evolved
into an industry of great promise with significant contributions to the areas of prosthetics and
organ transplantation. The research on bioprinting is vast but widespread and very specific to
one subtopic topic per article. As such, this paper serves as a more comprehensive look at the
technology and draws conclusions for the future. It reviews the technical challenges of
fabricating live cells and remaining competitive in a fast pace market while debating if the full
scope of bioprinting, synthesizing organs and integrating live cells into prosthetics, will ever be
feasible.
Keywords: bioprinting, additive manufacturing, fabrication, prosthetics, artificial tissue and
organs, bionics, computer aided design, cell ink
filament to extrude material in layers from
INTRODUCTION
3D printing is a form of additive
manufacturing that allows solid, three

the bottom up. SLS uses a laser to sinter

powdered material together into one solid
structure. 3D

dimensional objects to be created from

computer aided design (CAD) files. This
technology is cost effective and quick and
has become synonymous with rapid
prototyping. There are two main methods of
3D printing: selective laser sintering (SLS)
and fused deposition modeling (FDM).
FDM works by using a metal wire or plastic

printing has applications in almost every

industry, one of which is biomedical.

cells [6], particularly size. As a result, the

first working bioprinter was created in 2008.
The timeline of the advances in bioprinting
varies greatly between the areas of
organs/tissues and prosthetics. While 3D
printed prosthetics are widely used at this
point in time, there is much work to be done
Figure 1- Schematic of the Fused Deposition
Modeling Process (Source: emeraldinsight.com)

for the feasibility of artificial organs/tissues.

This is due to the many differences in
biological impact and the varying
complexities of the concepts. Cass [5] notes
that synthetic or natural polymers and
decellularized extracellular matrix (ECM)
are among common materials used in
bioprinting.
Artificial organs/tissues have the ability
to revolutionize the biomedical industry as
well as the quality/span of life for an
incomprehensible amount of people. The
fabrication of whole organs would eradicate

Figure 2- Schematic of the Selective Laser

Sintering Process
(Source:
learnersbook.com)

Bioprinting is the application of 3D

the need for those in need to wait on the

transplant list for compatible organs. It
could also lessen the chances for the body to

printing in the biomedical industry. This

reject organs based on the fact that the cells

concept uses the technology for the

that makeup the organ could be specifically

fabrication of artificial organs/tissues and

designed to work harmoniously with each

prosthetics. The dawn of this technology

individual recipient. This technology also

was due to the realization by Professor

shows great promise in drug testing, which

Makoto Nakamura that there is great

could reduce the need for both animal and

similarity between printer ink and human

human clinical trials.

Bioprinting in prosthetics is already

in implementing live cells into damaged

making great strides in the world by

tissue to form patches. This concept is

providing a significantly more cost effective

known as cell ink which serves to

option to amputees in need. Another benefit

compare filling in the tissue to drawing the

to 3D printed prosthetics is additional ease

cells in with a pen. Due to these

in personalizing the artificial limb as objects

breakthroughs, fabricated tissue is becoming

are designed in CAD and can be easily

quite prevalent in experimental testing.

manipulated. There is always room for

Specifically, the technology is being utilized

growth and bioprinted prosthetics is no

for testing drug safety and screening toxicity

exception with greater bionic technology

[8].

and the introduction of live cells to artificial

limbs on the horizon.
BIOPRINTING FOR ORGANS/TISSUE
The fabrication of artificial

There is much dispute amongst

researches about the feasibility of the
fabrication of whole organs. Although the
volume of research may be equal for both

organs/tissues has great potential despite the

arguments, the strength and conviction is

great technical obstacles that must be

found in those certain of the fact that it will

overcome. In particular, the scope for this

be made possible in the future. One notable

technology is quite enormous according to

recent breakthrough is the creation of a

Murphy and Atala [2] stating that

bioprinter referred to as ITOP (Integrated

bioprinting has already been used for the

Tissue and Organ Printing System) at Wake

generation and transplantation of several

Forest Institute for Regenerative Medicine.

tissues, including multilayered skin, bone,

This device has the ability to create whole

vascular grafts, tracheal splints, heart tissue

organs using technology similar to fused

and cartilaginous structures. While creating

deposition modeling (FDM) in that it

whole organs is currently in a primitive

synthesizes the organs from the bottom up

state, printing live tissue proves to be rather

by depositing layers of material made of

advantageous. The fabricated functional

biodegradable plastics and stem cells. Even

tissue has a greater lifespan than that of live

more impressive is the organs ability to

organs with some lasting for a number of

withstand implementation [7]. So far,

weeks [1]. There is much work being done

muscle tissue has been created and

successfully inserted into rats.

Figure 3: ITOP (Integrated Tissue and Organ Printing System) (Source: Nature.com)

BIOPRINTING IN PROSTHETICS
Prosthetics refer to artificial devices that
fill the void of a missing body parts. In the
past, they were

incredibly complex and expensive pieces of

technology. The timeline of acquiring a
traditional prosthetic limb can range from
weeks to months because they must be
created specifically for the user in terms of
size and need/application of the wearer. [6]
Figure 4- Traditional Prosthetic leg (Source:
stlfinder.com)

Great advances have been made for 3D

printing prosthetics. These devices can be
made entirely void of live tissue, which
eradicates most of the issues seen in
bioprinting of fabricating and sustaining live
artificial tissue. The devices range in color,
size, texture, and functionality, depending on
the needs and desires of the wearer. The
fabrication process is quick in comparison to
the process of its predecessors. In recent
years, it has become as simple as sending a
picture with a ruler for scale to print these
parts. Current 3D printed limbs can serve to
increase existing limb function or provide
movement to a completely paralyzed limb.
These devices are currently made for feet,
hands, whole legs, and whole arms creating
quite a developing market. While it is not
rendering medical prosthetics obsolete,
bioprinting for prosthetics is certainly
providing a competitive alternative [13].

Figure 5- 3D Printed Hand (Source:

Thingiverse.com)

The impact in this sector is already

significant and, with the research being done
on utilizing printed live tissue, the
technology will see great advances. There is
hope that, down the line, it will be feasible
to incorporate live tissue into the interfaces
of these devices to instill the feeling of a
natural limb in its user. While that may be
some time away from fruition, there are
studies that predict that fully functional
prosthetics as low as $5 are not far from
culmination. A particularly appealing aspect
to 3D printed prosthetics is the fact that the
most expensive part of the process is the
labor [13]. With many doctors already doing
pro-bono work, there is great possibility that
engineers and technicians will do the same
thus increasing the affordability immensely.
COMPLICATIONS AND OBSTACLES

The complications faced in bioprinting

organs for transplant. Every 12 seconds, a

are vast but the overarching categories are

new name is added onto the organ transplant

material, temperature, environment, and

list with numbers nearing 123,000. [3] Many

support. Sethi quite simply sums that it is

people spend years waiting for their number

easier to print in plastic than living cells

to be called to no avail and it is not

but remains hopeful for the future despite

uncommon for the body to reject the organ

the long road ahead [1]. The process of

after transplant. Bioprinting seeks to

standard 3D printing becomes turned on its

alleviate this burden. While the creation of

head due to the temperature issue as the high

whole organs may be far from the finish

temperatures used in standard 3D printing

line, the concept of adding healthy,

would destroy the material. A support of

fabricated cells into damaged tissue is well

sorts will also be necessary throughout the

underway. The greater lifespan of this

process to give the part shape without

fabricated tissue will allow for a wider span

causing damage. The material chosen must

of testing including toxicology, metabolic,

be able to endure printing and remain viable

and drug-drug interactions. [1]

once printed. The environment must

resemble the human body enough that the
material may survive incubation and
transition into the body without rejection.
Despite all of this, there are many dedicated
scientists and engineers currently at work to
overcome these challenges and forever
change the biomedical industry. Much
headway has already been made in creating
such environments and breakthroughs of
both material science and genetic
engineering are on the horizon.
CONCLUSION
Bioprinting could provide countless
amounts of people with a second chance at
life by increasing the number of available

The benefits of bioprinting are currently

more tangible in prosthetics with huge
potential to transform the face of the
industry by lowering cost and increasing
variability among products. [1] The lifespan
of most prosthetics averages only 5 years so
affordability is an enormous factor. While
the quality of these printed mechanical
appendages cannot match the current bionic
standard, their speed and cost gives them a
competitive advantage. Since the dawn of
the technology, non-profit organizations like
Not Impossible, LLC have emerged to cater
to low-income populations who previously
lacked options. [14]

In the fourteen years since its birth,

reduced and potentially eradicated need for

bioprinting has shown significant advances

humans and animals in clinical drug trials,

and the scope of its ability is constantly

and the affordability and specification of

growing more and more vast. This

artificial limbs for amputees.

technology has the potential to save a great

amount of lives and better the quality of
even more that are currently suffering. This
will be achieved with the eventual
fabrication of organs for transplant, the

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ACKNOWLEDGEMENT
The author would like to thank Anuradha
Gulati and Professor Thomas Akbari for
their insight and guidance throughout this
process.

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