This technology gets more astounding by the day.
Six-week-old Kaiba Gionfriddo suffered from a rare lung obstruction called bronchial malacia that made it impossible for him to breathe:
With hopes dimming that Kaiba would survive, doctors tried the medical equivalent of a “Hail Mary” pass. Using an experimental technique never before tried on a human, they created a splint made out of biological material that effectively carved a path through Kaiba’s blocked airway.
What makes this a medical feat straight out of science fiction: The splint was created on a three-dimensional printer.
“It’s magical to me,” said Dr. Glenn Green, an associate professor of pediatric otolaryngology at the University of Michigan who implanted the splint in Kaiba. “We’re talking about taking dust and using it to build body parts.”
Kaiba's mother, April, rather wonderfully described the technology that saved her child as "pretty nifty". It is indeed!
Green, who has been practicing for two decades, and a UM colleague, biomedical engineer Scott Hollister, had been working for years toward a clinical trial to test the splint in children with pulmonary issues when they got a phone call from a physician in Ohio who was aware of their research.
"He said, 'I've got a child who needs (a splint) now,' " referring to Kaiba, said Green. "He said that this child is not going to live unless something is done."
Green and Hollister got emergency clearance from their hospital and the Food and Drug Administration to try the experimental treatment -- which had been used only on animals -- on Kaiba. The child was airlifted from Akron Children's Hospital to C.S. Mott Children's Hospital at UM.
"It was a mixture of elation and, for lack of a better word, terror," said Hollister, a professor of biomedical and mechanical engineering who has been studying tissue regeneration for more than 15 years. "When someone drops something like this in your lap and says, 'Look, this might be this kid's only chance' ... it's a big step."
Green and his team obtained a CT scan of Kaiba's lungs so the splint could be custom fitted. They used the scan to build a computer model of the splint and then fed the model into a 3D-printer. The printer constructed the splint out of a powder material called polycaprolactone, or PCL:
PCL is malleable; it can be fashioned into all kinds of intricate structures. When a splint is created using PCL, it becomes a sort of biological placeholder, propping up structures while the body heals around it.
PCL has been used for years to fill holes left behind in the skull after brain surgery, according to Hollister. As time passes, PCL degrades and is excreted out of the body, hopefully leaving behind a healed organ.
What followed in Kaiba's case was a painstaking process of creating the splint on the printer in layers. Information about each layer is transmitted from the computer to a laser beam, which melts the PCL into a 3-D structure.
"We can put together a complete copy of a body part on the 3-D printer within a day," Green said. "So we can make something very specific for a patient very quickly."
Green then took the splint, measuring just a few centimeters long and 8 millimeters wide, and surgically attached it to Kaiba's collapsed bronchus. It was only moments before he saw the results.
"When the stitches were put in, we started seeing the lung inflate and deflate," Green said. "It was so fabulous. There were people in the operating room cheering."
"This case is a wonderful example that regenerative technologies are no longer science fiction," said Dr. Andre Terzic, director of the Mayo Clinic Center for Regenerative Medicine, who was not involved in Kaiba's case. "We are increasingly ... finding new solutions that we didn't have before."
It's now fifteen months later and Kaiba is still breathing on his own. The splint is expected to take three years to degrade, during which time Kaiba's lungs should develop normally.