Michał Wszoła MD, PhD, a transplant surgeon, participated in the first pancreatic islet transplants and pancreas transplants in Poland. He is the chairman of the Scientific Council of the Foundation on Research and Science Development and the CEO of Polbionica, which develops innovative therapies using 3D bioprinting technology.

'There is a dramatic shortage of organs for transplantation, the solution may be bionic organs', the researcher explained.

In Poland alone, there are about 20,000 people with severely complicated type 1 diabetes - and these are potential recipients of the pancreas. Such transplants also save patients with chronic inflammation of this organ. 'In the best year, 40 such transplants took place in Poland, last year there were 28', Wszoła reminds.

Approx. 1,500 pancreas transplants are performed annually around the world, and there are about 3 million patients who require a transplant. The situation is similar with kidney, liver, heart and lung transplants.

'We cannot meet the demand for organs from deceased people. But the bioprinting method may open up one of the ways to produce personalised organs for specific patients', the scientist says. The bionic pancreas he has developed (created using 3D bioprinting technology) restores the body's ability to regulate blood sugar levels and is expected to revolutionise diabetes treatment.

Wszoła explains that in some cases, only pancreatic islets can be transplanted to patients. These small, about half a millimetre balls scattered throughout the pancreas (there are about a million of them) consist of cells that produce insulin and glucagon. In patients with diabetes, the immune system destroys the pancreatic islets, which is why patients require their transplantation.

It turned out, however, that during the process of isolating the pancreatic islets from the pancreas, the vascular system and extracellular matrix are destroyed. The matrix is a mixture of collagen fibres that surround all cells and constitute a specific adhesive between them. Hence my idea that if we print the vascular system and matrix and attach pancreatic islets from a donor to them, they will have a better chance of survival', the transplantologist explains.

He describes organ bioprinting: 'Imagine a large syringe with the appropriate amount of the patient's cells mixed with a substance imitating the matrix. All this has the consistency of a gel. The bioprinter is a computer-controlled arm that, layer by layer, arranges the material from the syringe into the appropriate shape. Then, using physicochemical factors - for example, temperature or light - we make this gel-like substance solidify'.

He adds that another syringe adds bioink (a material composed of living cells and a carrier), from which a vascular system is created in the bionic pancreas. 'When we raise the temperature of the printed pancreas to body temperature, the bioink dissolves. Empty spaces are formed in places where blood vessels were made of it. Through such a vascular system we can pass a perfusion fluid, a nutrient that will keep the cells alive before they enter the recipient's body and blood flows through the vessels', he says.

The pancreas created in this way is stored in a bioreactor (a sterile device enabling, among other things, the cultivation of organs, tissues and cells), in which it is nourished via a perfusion fluid. In such a device, the organ can be transported to a hospital, where it will be implanted into a patient.

Wszoła's team has completed the main phase of preclinical research. The bionic pancreas was tested on animals, and scientists managed to successfully transplant it into a pig. Multi-stage preparations for transplanting the organ into a human are currently underway. 'Clinical trials are scheduled for next year. The most important thing now is to ensure the safety of patients', the transplantologist says.

'Probably in 2026 we will be ready to perform the first implantation of a bionic pancreas in a human', he declares.

He recalls that when he started talking about his idea of printing the pancreas in 2011, for most of his interlocutors it was a science fiction story. 'Many people still treat it this way. But scientists have this tendency to think outside the box. Nothing is impossible for us, there are only challenges and more or less probable solutions', he emphasises.

In his opinion, tissue bioprinting is a very promising technique, also for creating other organs.

'We cannot yet print three quarters or a whole human, but maybe one day it will be possible. However, bioprinting is probably not the only method by which it will be possible to obtain various tissues. Currently, research is underway in the world on laser or holographic printing techniques, and the future may be the combination of several techniques to produce different organs', he believes.

According to the CEO of Polbionica, the costs of printing and transplanting a bionic pancreas should not exceed EUR 200,000. 'My team and I have calculated that such an investment in a patient with chronic pancreatitis or severely complicated type 1 diabetes in Poland pays off in less than 7 years, in the United States in 3 years, and in many Western European countries - in 5 years. This is because a patient with a bionic pancreas can work, is not dependent on a companion, does not occupy a hospital bed and does not have to be treated due to further deepening complications related to the underlying disease', Wszoła explains.

The 3D bionic pancreas project, carried out by Polbionica and the Foundation on Research and Science Development, is co-financed by the Polish National Centre for Research and Development under the STRATEGMED III programme. The consortium members in the programme are the Nencki Institute of Experimental Biology of the Polish Academy of Sciences, the Warsaw University of Technology, the Medical University of Warsaw, the Infant Jesus Hospital, and Medispace. Polbionica won the Seal of Excellence competition and is in the process of signing an agreement with the Polish National Centre for Research and Development. As part of this competition, it will receive EUR 2.5 million for activities related to conducting the first bionic pancreas transplantation in a human.

Science in Poland, Anna Bugajska

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