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Organs Can Be Regenerated? What Else Can Grow on the Arm?

Yumeng Yan


Part1 What is this about?


Is it true that organs can be regenerated? This is certainly not possible at this stage. But through the combination of 3D printing technology and surgical techniques, it may be possible to save patients trapped in pain from the abyss of misery.

Carine, the female patient was diagnosed with nasal cavity cancer in 2013. Unfortunately , cancer attacked Carine’s nasal cavity. After the treatments, she successfully defeated the cancer but lost a large part of her nose as well as the anterior (frontal) region of her palate at the same time.

Since then, her doctors have tried to help Carine to build her nose with flap grafts and silicone nose prostheses, but have eventually failed four times. Finally, the doctors decided to try a completely unprecedented innovation: “growing” a new nose from her arm-using a custom 3D printed bio-material placed under the skin of Carine’s forearm to build a nose structure and transplant it into Carine’s face. The attempt was very successful and even restored her sense of smell and let her return to her normal life.

Currently, Carine is not conscious of the new transplant nose, and the doctors stated that a third neurological surgery will be needed to help restore her sensation.

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Part2 How a cancer patient got her nose back?


After learning of this potentially successful innovation, Cerhum, a manufacturer of medical devices specializing in bone reconstruction worked with the ENT and facial cervical surgery teams at the University Hospital of Toulouse after trials in which artificial "bones" were found to be successfully implanted into patients.

They first customized the skeleton structure from Carine’s pre-chemotherapy face and printed out using 3D technology and preserved the model in cryogenic condition.

This year, her doctors implanted the preserved 3D nose into the skin of Carine’s forearm,and let it grow in the arm for two months. In the procedure of the implantation, a skin flap in the patient’s temple area was placed over the "skeleton" of the nose by the doctors. After a period of time, the blood vessels and cells in the forearm were grown and filled along the model structures to construct a complete biological model of the nose.


After two months, everything was ready for the once again implantation. Before the transplant, the doctors took the new nose, along with the tissue

surrounding it and some of the blood vessels which nourish it, transplanted it away from Carine’s forearm to the correct spot of her face. Microsurgery was performed to connect the blood vessels of the new nose that grew out of the arm skin to those originally in the patient's face, allowing blood to flow again in this new nose. After the surgery, Carine was required to stay in the hospital for a mere ten days and followed a course of antibiotics for three weeks post-surgery and is now reported to be doing well.


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Part3 How can one 3D print bone?


Firstly, the biomaterial used for transplant surgery are chemicals such as Hydroxyapatite (HAP) and Tri-Calcium Phosphate (TCP). These chemicals are a synthetic porous material, produced by our bone cells, and tissues can grow around this mineral and then shape into desired configurations depending on the location of the bone. They can also be produced very cheaply, so they are the perfect materials.


Next, the produced nose structure has specially designed pores and channels that prepare for the blood vessel formation. It’s just like a prop material which could shape the nose. After the transplantation to the forearm, the skin of the forearm is wrapped around the periphery of the material and the patient’s body cells to fill the inside of the material. A skin flap is also attached from the temple area at the time of implanting. A skin flap is something which is made up of both skin and the subcutaneous tissue, it could retain the blood circulation during the implanting—it depends whether growing out a new nose.

So why was the forearm chosen as the breeding ground for the new nose? The 3D material was implanted into the forearm because it is a thin area of the skin, and it’s more similar to the skin of the face. The blood vessels in this area are also easily accessible and convenient for the surgically connected to the blood vessels of the new nose. Such a reconstruction had never been performed before since there were very few blood vessels that were available for the reconstructed tissue to connect to. This time, the reason why the scientists paid so much attention to the formation of the blood vessels when growing the new nose is also to eventually connect the nose on Carine’s arm to the correct position on the face.


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Part4 What else may the arm grow?


After the successful surgery, Carine told us about her new nose. It has let her restore her normal appearance, and has also allowed her to breathe more smoothly. She can even smell the flowers coming from her garden.


his is the first case of nasal reconstruction completed with 3D printed biomaterials. Carine’s nasal transplant is the first of its kind, but before her also had a case of a custom-sized penis transplantation.


Malcolm McDonald also had a successful 15cm custom-sized penis transplant. McDonald lost his genitals when a blood infection caused Septicemia, which led to blackened fingers, toes and penis. With the decaying penis he had no choice but to have his testicles and penis removed. Fortunately , later with the help of donor money, McDonald successfully completed a custom penis transplant.



Doctors removed the skin flap from his left arm, and wrapped it around a vein that belongs to somewhere in his body to create a temporary penis, which was then grafted onto the arm. When the doctors thought the time was ready for the surgery to re-graft it to the pubic area, McDonald had to suspend the operation midway through because of hypoxemia. Since then, the operation had been put on hold due to the epidemic and other issues, so the penis had been hanging from his arm for six years. Earlier this year, the operation was finally put into action. Although the procedure was particularly complicated, doctors eventually succeeded in transplanting the penis from his arm to his groin. After using a pimp to inject saline, McDonald’s penis was finally restored to its original form.



Scientists are very optimistic about this technology and consider it very promising and relevant. The use of advanced technology tools, whether through 3D bioprinting, stem cell induction, or mechanical mimicry, may be all available in the near future for more complex and serious diseases that could make people happier and more convenient. For patients like Carine and MacDonald, such technologies can provide great comfort and create greater social and health value to them.


Reference

1. https://interestingengineering.com/health/3d-printed-nose-grown-on-patients-arm 2. https://www.independent.co.uk/news/uk/home-news/malcom-macdonald-norfolk penis-arm-b2071498.html

3. https://www.lemonde.fr/en/science/article/2022/11/22/new-nose-successfully-gr own-on-french-woman-s-arm_6005178_10.html

4. https://cirimat.cnrs.fr/



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