Tag Archives: organ

The altruistic organ donor: ‘I was talking to my kidney’

Almost 5,000 people are on the waiting list for a kidney transplant, but the number of living kidney donors in the UK fell to an eight-year low in 2017.

Carl Pinder is one member of a reasonably exclusive club after he decided to donate a kidney altruistically to a stranger.

“I was thinking: well, why not?” he remembers. “And I was trying to come up with reasons why not. And even up to the day I was thinking, why not? I never saw it as a serious operation, although everyone seemed to think it was. All I’ve got is three little scars.”

The donation on 15 February 2016 by Pinder, who was 58 at the time, started a process that changed two strangers’ lives. His organ went to Barbara Hallam, 68. Barbara’s daughter, who had wanted to donate to her mother but was not a match, gave her kidney to a four-year-old girl in Scotland. And all because Pinder thought: why not?

But even though he wears his sacrifice lightly and says he would do it again, the number of altruistic donations is down by more than one-fifth from a high of 110 in 2014 to 87 last year.

Figures released this week by the NHS show an overall decline in living kidney donation, with 990 donors in 2017 – the fewest in eight years.

Last year, 261 people died waiting for a kidney transplant, many of whom could have been saved through increased living kidney donation.

What is especially important about altruistic donations is that they can start chains of transplants. In Pinder and Hallam’s case, the chain had two links, but they can be up to three links long.

Hallam, from Sheffield, had spent four years on dialysis. After finding that neither of her daughters were compatible, doctors told them there was another option, donor-pair pooling, where they could be matched with another donor-recipient pair – if one could be found. “My daughter was quite keen to give her kidney to a stranger, so that I could get on to the altruistic list quicker and find a more compatible match,” she says.

The operation – keyhole surgery performed under general anaesthetic – takes about two or three hours and leaves a few small scars. It involves a hospital stay of several days and at least a month off work, but Pinder, who discharged himself early, makes light of it. “I won’t pretend it wasn’t sore; it was,” he says. “[But] two days later, I walked down to the village shop, which is about a mile away. Two weeks later, I was out gently jogging.”

Paul Gibbs, a transplant surgeon at Portsmouth Hospitals NHS trust and trustee of the Give A Kidney charity, says altruistic donors are similar to Pinder: they are typically over 55, have had a good life and are looking for a way to give back. “There’s just this group of people that feel they’ve got a spare part they don’t need and someone is in need of it,” Gibbs says. “They see it as a complete no-brainer.”

Candidates face a battery of tests to see whether they are suitable, not least psychologically. “It’s really just to ensure that they have understanding of what they are doing, understand their motivation and just to check that they’ve got the mental strength and social support to deal with not only the success, but also the failure,” says Gibbs.

There is no guarantee that an altruistic donor will ever hear from their recipient. But Pinder and Hallam agreed to eventually meet. “It was weird,” he says, recalling. “I was sat next to her talking to my kidney, as it were. I don’t quite know how to describe, it was sort of surreal, almost. But it was good.”

Hallam says she was nervous to meet Pinder, but his nonchalance and lack of fuss put her totally at ease. “I’ve not seen him again,” she says. “But we do keep in touch every so many months and find out how each other’s going on. I want to make sure that he knows that his kidney is absolutely top notch.”

Jeremy Hunt launches opt-out organ donation plans in England and Wales

Health secretary Jeremy Hunt is to launch plans for an opt-out system of organ donation, asking people to overcome their “fatal reluctance” to discuss the issue with family and friends.

Under the plans, everybody in England and Wales would be presumed to be happy to donate their organs on their death, unless they have signed up to a register stating that they do not want that to happen. In practice, however, it is unlikely that organs would be taken against the wishes of the family.

The government’s ambition to change the NHS organ donation programme was announced by Theresa May in her Conservative party conference speech in October. Last year, she said, “500 people died because a suitable organ was not available. And there are 6,500 on the transplant list today.”

NHS Blood and Transplant’s figures show that 1,100 families in the UK decided not to allow organ donation because they were unsure, or did not know whether their relatives would have wanted to donate an organ or not.

“Every day, three people die for want of a transplant, which is why our historic plans to transform the way organ donation works are so important. We want as many people as possible to have their say as we shape the new opt-out process,” said Hunt.

“As well as changing the law, we also need to change the conversation – it can be a difficult subject to broach, but overcoming this fatal reluctance to talk openly about our wishes is key to saving many more lives in the future.”

The consultation will ask three questions: how much say should families have in their deceased relative’s decision to donate their organs? When would exemptions to “opt-out” be needed, and what safeguards will be necessary? How might a new system affect certain groups depending on age, disability, race or faith?

There are particular shortages of organs for people from ethnic minority backgrounds. Only about 6% of donors are black or Asian, although those groups make up about 10% of the population. Orin Lewis, chief executive of the Afro-Caribbean Leukaemia Trust and co-chair of the National BAME Transplant Alliance, said: “As a parent of a young man who sadly passed away from multiple organ failure, I gladly welcome the prime minister’s decision to instigate a much-needed public consultation on the relative positive and negative merits of England having an opt-out donation policy.”

There is still debate over how well an opt-out system works. Spain is often hailed as a success story and has a good supply of organs. However, the opt-out was introduced at the same time as big investments in the transplant programme, and in particular the appointment of transplant coordinators who instigate conversations with the family of a dying patient. If families refuse, their wishes are always respected.

Wales launched an opt-out system in December 2015 and the following June it was announced that it had already been a success. Half the 60 organs transplanted in the six months came from people whose consent had been presumed. But a recent year-on-year comparison showed little difference, with 101 donors under the old system and 104 under presumed consent.

In Wales, 6% of the population have signed the opt-out register. The policy requires that the consent of next-of-kin must always be sought.

Hugh Whittall, director of the Nuffield Council on Bioethics, said there were concerns that the government was asking how an opt-out system should be introduced, rather than whether it should. “The government should not be making this change until there is evidence that it works, and until we are confident that it won’t undermine people’s trust in the system in the long-term,” he said.

“That evidence is simply not there yet, though we do know some things that do work. Key amongst those is raising public awareness, encouraging family discussion, and better support and communication between specialist nurses and bereaved families.

“Even in systems where an opt-out approach has been adopted (such as Spain), it is generally recognised that these are the elements that have made a difference, rather than the legal basis of the donation.”

Keith Rigg, consultant transplant surgeon, said too many people were waiting and he welcomed the opportunity for discussion. “Encouraging people to talk openly with their families about their organ donation wishes is really important. There are strong feelings for and against opting out and there is no convincing evidence from Wales yet that this had made a difference. It is important that any proposed changes are based on evidence, encourage the wishes of individuals to be known and acted on, and support families to make the right decision about their loved ones at the time of their death,” he said.

Organ donation saves lives. Why don’t more people sign up for it? | Cole Moreton

I used to be squeamish and not want to think about organ donation – ugh, no thanks – until I saw something truly extraordinary that changed my mind. The mother of a boy who had died reached out to touch a stranger who had been saved by him. Sue Burton put her hand on the chest of Marc McCay and felt a flutter under her palm. The beating of a heart that had been born inside her.

The heart that had given life to her son Martin for 16 years, until he was suddenly struck down by a brain haemorrhage, without warning, in the middle of the night. The heart that had been removed from his body, packed in ice and flown across the country in a race against time, to be put in the body of another 16-year-old, called Marc.

Now here he was, 13 years later, the boy grown into a man. “To be able to feel the heart that Martin was born with still beating, that’s incredible,” said Sue. Tears were shed, including mine. I was there as a reporter who would tell the story of this modern medical miracle in a Radio 4 series and now a new paperback book called The Boy Who Gave His Heart Away. But in that moment, it all became personal. Everything changed.

Before that I hadn’t wanted to know about organ donation. To be honest, I still feel sick at the thought of someone I love – or myself – being cut up and given away. That’s understandable, right? Reactions like that are part of the reason why only one-third of us sign up to be a donor, although surveys show that almost everyone thinks it’s a good idea in principle.

We marvel at stories like that of 13-year-old Jemima Layzell, whose sudden collapse was a tragedy for her family, but whose organs went to save or improve the lives of a record eight people, the most ever in the history of the NHS transplant service. But still, we don’t sign the register or carry a donor card.

NHS Organ Donor Card.


‘The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted.’ Photograph: BRD Associates

We avoid having the conversation with our families. Confusion ensues, if the terrible moment ever comes.

The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted. They feel safer saying no. Meanwhile, more than 6,000 people are waiting for transplants at any one time and some have not got long. Last year, 457 men and women, boys and girls died while they were on the list.

But frankly I didn’t know or really care about any of this until I met Sue Burton and Linda McCay, the mothers of the two boys Martin and Marc, who have formed an incredible and unlikely bond.

The people who get the organs almost never meet the families of those who gave. Thanks are usually passed on via the hospitals, anonymously, by letter or email, with a first name and age only. Anything more is extremely rare. But Linda did make contact with Sue, through a remarkable series of coincidences. One was still grieving and one was grateful, but they each felt understood by the other because of all they had been through – separately, hundreds of miles apart – when their boys suddenly fell sick in the summer of 2003.

I met Sue first and she told me how the doctor in Nottingham asked if she would consider organ donation just moments after saying that Martin was brain dead and there was no hope for him. The timing seems brutal, but she says it was a mercy. “If he had left it another half an hour or hour I would have been so consumed by grief I wouldn’t have known my own name, let alone been able to answer the question.”

Sue and her husband Nigel, an aircraft technician in the RAF who raced back from exercises in the Nevada desert to be by his son’s bedside, had already discussed organ donation. They knew what they wanted to do. That makes it so much easier to deal with a terrible moment, if and when it comes.

They actually felt some relief in the midst of overwhelming grief, that good might come of their tragedy. It helped them then and it helps them now to know Marc was saved by Martin.

And when we were talking about this, Nigel asked me about my own children: “If one of them needed a heart in order to survive, would you want them to have it?” Of course, I said. I understood why Linda had even begged the doctors to take the heart from her living body and give it to her son. I would do anything to save them.

“Then how could you deny that to another parent and their child, if yours had already gone?”

I had no answer, except to sign up as a donor. I hope you do the same.

Cole Moreton is the author of The Boy Who Gave His Heart Away, published by Harper Element

Organ donation saves lives. Why don’t more people sign up for it? | Cole Moreton

I used to be squeamish and not want to think about organ donation – ugh, no thanks – until I saw something truly extraordinary that changed my mind. The mother of a boy who had died reached out to touch a stranger who had been saved by him. Sue Burton put her hand on the chest of Marc McCay and felt a flutter under her palm. The beating of a heart that had been born inside her.

The heart that had given life to her son Martin for 16 years, until he was suddenly struck down by a brain haemorrhage, without warning, in the middle of the night. The heart that had been removed from his body, packed in ice and flown across the country in a race against time, to be put in the body of another 16-year-old, called Marc.

Now here he was, 13 years later, the boy grown into a man. “To be able to feel the heart that Martin was born with still beating, that’s incredible,” said Sue. Tears were shed, including mine. I was there as a reporter who would tell the story of this modern medical miracle in a Radio 4 series and now a new paperback book called The Boy Who Gave His Heart Away. But in that moment, it all became personal. Everything changed.

Before that I hadn’t wanted to know about organ donation. To be honest, I still feel sick at the thought of someone I love – or myself – being cut up and given away. That’s understandable, right? Reactions like that are part of the reason why only one-third of us sign up to be a donor, although surveys show that almost everyone thinks it’s a good idea in principle.

We marvel at stories like that of 13-year-old Jemima Layzell, whose sudden collapse was a tragedy for her family, but whose organs went to save or improve the lives of a record eight people, the most ever in the history of the NHS transplant service. But still, we don’t sign the register or carry a donor card.

NHS Organ Donor Card.


‘The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted.’ Photograph: BRD Associates

We avoid having the conversation with our families. Confusion ensues, if the terrible moment ever comes.

The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted. They feel safer saying no. Meanwhile, more than 6,000 people are waiting for transplants at any one time and some have not got long. Last year, 457 men and women, boys and girls died while they were on the list.

But frankly I didn’t know or really care about any of this until I met Sue Burton and Linda McCay, the mothers of the two boys Martin and Marc, who have formed an incredible and unlikely bond.

The people who get the organs almost never meet the families of those who gave. Thanks are usually passed on via the hospitals, anonymously, by letter or email, with a first name and age only. Anything more is extremely rare. But Linda did make contact with Sue, through a remarkable series of coincidences. One was still grieving and one was grateful, but they each felt understood by the other because of all they had been through – separately, hundreds of miles apart – when their boys suddenly fell sick in the summer of 2003.

I met Sue first and she told me how the doctor in Nottingham asked if she would consider organ donation just moments after saying that Martin was brain dead and there was no hope for him. The timing seems brutal, but she says it was a mercy. “If he had left it another half an hour or hour I would have been so consumed by grief I wouldn’t have known my own name, let alone been able to answer the question.”

Sue and her husband Nigel, an aircraft technician in the RAF who raced back from exercises in the Nevada desert to be by his son’s bedside, had already discussed organ donation. They knew what they wanted to do. That makes it so much easier to deal with a terrible moment, if and when it comes.

They actually felt some relief in the midst of overwhelming grief, that good might come of their tragedy. It helped them then and it helps them now to know Marc was saved by Martin.

And when we were talking about this, Nigel asked me about my own children: “If one of them needed a heart in order to survive, would you want them to have it?” Of course, I said. I understood why Linda had even begged the doctors to take the heart from her living body and give it to her son. I would do anything to save them.

“Then how could you deny that to another parent and their child, if yours had already gone?”

I had no answer, except to sign up as a donor. I hope you do the same.

Cole Moreton is the author of The Boy Who Gave His Heart Away, published by Harper Element

Organ donation saves lives. Why don’t more people sign up for it? | Cole Moreton

I used to be squeamish and not want to think about organ donation – ugh, no thanks – until I saw something truly extraordinary that changed my mind. The mother of a boy who had died reached out to touch a stranger who had been saved by him. Sue Burton put her hand on the chest of Marc McCay and felt a flutter under her palm. The beating of a heart that had been born inside her.

The heart that had given life to her son Martin for 16 years, until he was suddenly struck down by a brain haemorrhage, without warning, in the middle of the night. The heart that had been removed from his body, packed in ice and flown across the country in a race against time, to be put in the body of another 16-year-old, called Marc.

Now here he was, 13 years later, the boy grown into a man. “To be able to feel the heart that Martin was born with still beating, that’s incredible,” said Sue. Tears were shed, including mine. I was there as a reporter who would tell the story of this modern medical miracle in a Radio 4 series and now a new paperback book called The Boy Who Gave His Heart Away. But in that moment, it all became personal. Everything changed.

Before that I hadn’t wanted to know about organ donation. To be honest, I still feel sick at the thought of someone I love – or myself – being cut up and given away. That’s understandable, right? Reactions like that are part of the reason why only one-third of us sign up to be a donor, although surveys show that almost everyone thinks it’s a good idea in principle.

We marvel at stories like that of 13-year-old Jemima Layzell, whose sudden collapse was a tragedy for her family, but whose organs went to save or improve the lives of a record eight people, the most ever in the history of the NHS transplant service. But still, we don’t sign the register or carry a donor card.

NHS Organ Donor Card.


‘The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted.’ Photograph: BRD Associates

We avoid having the conversation with our families. Confusion ensues, if the terrible moment ever comes.

The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted. They feel safer saying no. Meanwhile, more than 6,000 people are waiting for transplants at any one time and some have not got long. Last year, 457 men and women, boys and girls died while they were on the list.

But frankly I didn’t know or really care about any of this until I met Sue Burton and Linda McCay, the mothers of the two boys Martin and Marc, who have formed an incredible and unlikely bond.

The people who get the organs almost never meet the families of those who gave. Thanks are usually passed on via the hospitals, anonymously, by letter or email, with a first name and age only. Anything more is extremely rare. But Linda did make contact with Sue, through a remarkable series of coincidences. One was still grieving and one was grateful, but they each felt understood by the other because of all they had been through – separately, hundreds of miles apart – when their boys suddenly fell sick in the summer of 2003.

I met Sue first and she told me how the doctor in Nottingham asked if she would consider organ donation just moments after saying that Martin was brain dead and there was no hope for him. The timing seems brutal, but she says it was a mercy. “If he had left it another half an hour or hour I would have been so consumed by grief I wouldn’t have known my own name, let alone been able to answer the question.”

Sue and her husband Nigel, an aircraft technician in the RAF who raced back from exercises in the Nevada desert to be by his son’s bedside, had already discussed organ donation. They knew what they wanted to do. That makes it so much easier to deal with a terrible moment, if and when it comes.

They actually felt some relief in the midst of overwhelming grief, that good might come of their tragedy. It helped them then and it helps them now to know Marc was saved by Martin.

And when we were talking about this, Nigel asked me about my own children: “If one of them needed a heart in order to survive, would you want them to have it?” Of course, I said. I understood why Linda had even begged the doctors to take the heart from her living body and give it to her son. I would do anything to save them.

“Then how could you deny that to another parent and their child, if yours had already gone?”

I had no answer, except to sign up as a donor. I hope you do the same.

Cole Moreton is the author of The Boy Who Gave His Heart Away, published by Harper Element

Organ donation saves lives. Why don’t more people sign up for it? | Cole Moreton

I used to be squeamish and not want to think about organ donation – ugh, no thanks – until I saw something truly extraordinary that changed my mind. The mother of a boy who had died reached out to touch a stranger who had been saved by him. Sue Burton put her hand on the chest of Marc McCay and felt a flutter under her palm. The beating of a heart that had been born inside her.

The heart that had given life to her son Martin for 16 years, until he was suddenly struck down by a brain haemorrhage, without warning, in the middle of the night. The heart that had been removed from his body, packed in ice and flown across the country in a race against time, to be put in the body of another 16-year-old, called Marc.

Now here he was, 13 years later, the boy grown into a man. “To be able to feel the heart that Martin was born with still beating, that’s incredible,” said Sue. Tears were shed, including mine. I was there as a reporter who would tell the story of this modern medical miracle in a Radio 4 series and now a new paperback book called The Boy Who Gave His Heart Away. But in that moment, it all became personal. Everything changed.

Before that I hadn’t wanted to know about organ donation. To be honest, I still feel sick at the thought of someone I love – or myself – being cut up and given away. That’s understandable, right? Reactions like that are part of the reason why only one-third of us sign up to be a donor, although surveys show that almost everyone thinks it’s a good idea in principle.

We marvel at stories like that of 13-year-old Jemima Layzell, whose sudden collapse was a tragedy for her family, but whose organs went to save or improve the lives of a record eight people, the most ever in the history of the NHS transplant service. But still, we don’t sign the register or carry a donor card.

NHS Organ Donor Card.


‘The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted.’ Photograph: BRD Associates

We avoid having the conversation with our families. Confusion ensues, if the terrible moment ever comes.

The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted. They feel safer saying no. Meanwhile, more than 6,000 people are waiting for transplants at any one time and some have not got long. Last year, 457 men and women, boys and girls died while they were on the list.

But frankly I didn’t know or really care about any of this until I met Sue Burton and Linda McCay, the mothers of the two boys Martin and Marc, who have formed an incredible and unlikely bond.

The people who get the organs almost never meet the families of those who gave. Thanks are usually passed on via the hospitals, anonymously, by letter or email, with a first name and age only. Anything more is extremely rare. But Linda did make contact with Sue, through a remarkable series of coincidences. One was still grieving and one was grateful, but they each felt understood by the other because of all they had been through – separately, hundreds of miles apart – when their boys suddenly fell sick in the summer of 2003.

I met Sue first and she told me how the doctor in Nottingham asked if she would consider organ donation just moments after saying that Martin was brain dead and there was no hope for him. The timing seems brutal, but she says it was a mercy. “If he had left it another half an hour or hour I would have been so consumed by grief I wouldn’t have known my own name, let alone been able to answer the question.”

Sue and her husband Nigel, an aircraft technician in the RAF who raced back from exercises in the Nevada desert to be by his son’s bedside, had already discussed organ donation. They knew what they wanted to do. That makes it so much easier to deal with a terrible moment, if and when it comes.

They actually felt some relief in the midst of overwhelming grief, that good might come of their tragedy. It helped them then and it helps them now to know Marc was saved by Martin.

And when we were talking about this, Nigel asked me about my own children: “If one of them needed a heart in order to survive, would you want them to have it?” Of course, I said. I understood why Linda had even begged the doctors to take the heart from her living body and give it to her son. I would do anything to save them.

“Then how could you deny that to another parent and their child, if yours had already gone?”

I had no answer, except to sign up as a donor. I hope you do the same.

Cole Moreton is the author of The Boy Who Gave His Heart Away, published by Harper Element

Organ donation saves lives. Why don’t more people sign up for it? | Cole Moreton

I used to be squeamish and not want to think about organ donation – ugh, no thanks – until I saw something truly extraordinary that changed my mind. The mother of a boy who had died reached out to touch a stranger who had been saved by him. Sue Burton put her hand on the chest of Marc McCay and felt a flutter under her palm. The beating of a heart that had been born inside her.

The heart that had given life to her son Martin for 16 years, until he was suddenly struck down by a brain haemorrhage, without warning, in the middle of the night. The heart that had been removed from his body, packed in ice and flown across the country in a race against time, to be put in the body of another 16-year-old, called Marc.

Now here he was, 13 years later, the boy grown into a man. “To be able to feel the heart that Martin was born with still beating, that’s incredible,” said Sue. Tears were shed, including mine. I was there as a reporter who would tell the story of this modern medical miracle in a Radio 4 series and now a new paperback book called The Boy Who Gave His Heart Away. But in that moment, it all became personal. Everything changed.

Before that I hadn’t wanted to know about organ donation. To be honest, I still feel sick at the thought of someone I love – or myself – being cut up and given away. That’s understandable, right? Reactions like that are part of the reason why only one-third of us sign up to be a donor, although surveys show that almost everyone thinks it’s a good idea in principle.

We marvel at stories like that of 13-year-old Jemima Layzell, whose sudden collapse was a tragedy for her family, but whose organs went to save or improve the lives of a record eight people, the most ever in the history of the NHS transplant service. But still, we don’t sign the register or carry a donor card.

NHS Organ Donor Card.


‘The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted.’ Photograph: BRD Associates

We avoid having the conversation with our families. Confusion ensues, if the terrible moment ever comes.

The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted. They feel safer saying no. Meanwhile, more than 6,000 people are waiting for transplants at any one time and some have not got long. Last year, 457 men and women, boys and girls died while they were on the list.

But frankly I didn’t know or really care about any of this until I met Sue Burton and Linda McCay, the mothers of the two boys Martin and Marc, who have formed an incredible and unlikely bond.

The people who get the organs almost never meet the families of those who gave. Thanks are usually passed on via the hospitals, anonymously, by letter or email, with a first name and age only. Anything more is extremely rare. But Linda did make contact with Sue, through a remarkable series of coincidences. One was still grieving and one was grateful, but they each felt understood by the other because of all they had been through – separately, hundreds of miles apart – when their boys suddenly fell sick in the summer of 2003.

I met Sue first and she told me how the doctor in Nottingham asked if she would consider organ donation just moments after saying that Martin was brain dead and there was no hope for him. The timing seems brutal, but she says it was a mercy. “If he had left it another half an hour or hour I would have been so consumed by grief I wouldn’t have known my own name, let alone been able to answer the question.”

Sue and her husband Nigel, an aircraft technician in the RAF who raced back from exercises in the Nevada desert to be by his son’s bedside, had already discussed organ donation. They knew what they wanted to do. That makes it so much easier to deal with a terrible moment, if and when it comes.

They actually felt some relief in the midst of overwhelming grief, that good might come of their tragedy. It helped them then and it helps them now to know Marc was saved by Martin.

And when we were talking about this, Nigel asked me about my own children: “If one of them needed a heart in order to survive, would you want them to have it?” Of course, I said. I understood why Linda had even begged the doctors to take the heart from her living body and give it to her son. I would do anything to save them.

“Then how could you deny that to another parent and their child, if yours had already gone?”

I had no answer, except to sign up as a donor. I hope you do the same.

Cole Moreton is the author of The Boy Who Gave His Heart Away, published by Harper Element

Organ donation saves lives. Why don’t more people sign up for it? | Cole Moreton

I used to be squeamish and not want to think about organ donation – ugh, no thanks – until I saw something truly extraordinary that changed my mind. The mother of a boy who had died reached out to touch a stranger who had been saved by him. Sue Burton put her hand on the chest of Marc McCay and felt a flutter under her palm. The beating of a heart that had been born inside her.

The heart that had given life to her son Martin for 16 years, until he was suddenly struck down by a brain haemorrhage, without warning, in the middle of the night. The heart that had been removed from his body, packed in ice and flown across the country in a race against time, to be put in the body of another 16-year-old, called Marc.

Now here he was, 13 years later, the boy grown into a man. “To be able to feel the heart that Martin was born with still beating, that’s incredible,” said Sue. Tears were shed, including mine. I was there as a reporter who would tell the story of this modern medical miracle in a Radio 4 series and now a new paperback book called The Boy Who Gave His Heart Away. But in that moment, it all became personal. Everything changed.

Before that I hadn’t wanted to know about organ donation. To be honest, I still feel sick at the thought of someone I love – or myself – being cut up and given away. That’s understandable, right? Reactions like that are part of the reason why only one-third of us sign up to be a donor, although surveys show that almost everyone thinks it’s a good idea in principle.

We marvel at stories like that of 13-year-old Jemima Layzell, whose sudden collapse was a tragedy for her family, but whose organs went to save or improve the lives of a record eight people, the most ever in the history of the NHS transplant service. But still, we don’t sign the register or carry a donor card.

NHS Organ Donor Card.


‘The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted.’ Photograph: BRD Associates

We avoid having the conversation with our families. Confusion ensues, if the terrible moment ever comes.

The NHS says that three bereaved families a week refuse to donate because they’re not sure what their loved one would have wanted. They feel safer saying no. Meanwhile, more than 6,000 people are waiting for transplants at any one time and some have not got long. Last year, 457 men and women, boys and girls died while they were on the list.

But frankly I didn’t know or really care about any of this until I met Sue Burton and Linda McCay, the mothers of the two boys Martin and Marc, who have formed an incredible and unlikely bond.

The people who get the organs almost never meet the families of those who gave. Thanks are usually passed on via the hospitals, anonymously, by letter or email, with a first name and age only. Anything more is extremely rare. But Linda did make contact with Sue, through a remarkable series of coincidences. One was still grieving and one was grateful, but they each felt understood by the other because of all they had been through – separately, hundreds of miles apart – when their boys suddenly fell sick in the summer of 2003.

I met Sue first and she told me how the doctor in Nottingham asked if she would consider organ donation just moments after saying that Martin was brain dead and there was no hope for him. The timing seems brutal, but she says it was a mercy. “If he had left it another half an hour or hour I would have been so consumed by grief I wouldn’t have known my own name, let alone been able to answer the question.”

Sue and her husband Nigel, an aircraft technician in the RAF who raced back from exercises in the Nevada desert to be by his son’s bedside, had already discussed organ donation. They knew what they wanted to do. That makes it so much easier to deal with a terrible moment, if and when it comes.

They actually felt some relief in the midst of overwhelming grief, that good might come of their tragedy. It helped them then and it helps them now to know Marc was saved by Martin.

And when we were talking about this, Nigel asked me about my own children: “If one of them needed a heart in order to survive, would you want them to have it?” Of course, I said. I understood why Linda had even begged the doctors to take the heart from her living body and give it to her son. I would do anything to save them.

“Then how could you deny that to another parent and their child, if yours had already gone?”

I had no answer, except to sign up as a donor. I hope you do the same.

Cole Moreton is the author of The Boy Who Gave His Heart Away, published by Harper Element

Could 3D printing solve the organ transplant shortage?

Erik Gatenholm first saw a 3D bioprinter in early 2015. His father, Paul, a professor in chemistry and biopolymer technology at Chalmers University of Technology in Gothenburg, had bought one for his department. It cost somewhere in the region of $ 200,000. “My father was like, ‘This thing can print human organs,’” Gatenholm recalls, still awestruck. “I said, ‘Bullshit!’ Then it printed a little piece of cartilage. It wasn’t cartilage, but it was like, this could be cartilage. That was the moment when it was like, ‘This is frickin’ cool!’”

Gatenholm, who had long owned a regular 3D printer, decided then that he wanted to do something in 3D bioprinting. His language might be a bit Bill & Ted – he grew up between Sweden and the US, where his father is a visiting professor – but his intent and ambitions are very serious. Gatenholm had started his first biotech company aged 18 and he realised that if this machine had the potential to print organs, like his father said, then it had the potential to radically change the world of medicine.

There is a global shortage of organs available for lifesaving transplants. In the UK, for example, you can now expect to wait an average of 944 days – more than two-and-a-half years – for a kidney transplant on the NHS. There’s a similar shortage of liver, lungs and other organs. The lack of transplant tissues is estimated to be the leading cause of death in America. Around 900,000 deaths a year, or around one-third of all deaths in the US, could be prevented or delayed by organ or engineered tissue transplants. The demand, simply, is endless.

Gatenholm’s father introduced him to Héctor Martínez, one of his students who was doing a PhD on tissue engineering, and early on another student, Ivan Tournier, was also involved in the brainstorming. “We were talking about doing some experiments,” says Gatenholm, who is 27, tall and handsome even by Swedish standards.

“So I said, ‘Why don’t we just go online and buy the ink we need?’ And Ivan said, ‘Well, there’s no ink. You can’t buy it.’ And I was like, ‘What do you mean?’ It was the dumbest thing I ever heard. There’s a bunch of printers on the market, just buy the ink. And he said, ‘No, you don’t understand, there is no ink. You have to make it yourself, you have to mix something.’ So I was like, ‘Just make an ink then!’”

Not much bigger than a hotel minibar... a Cellink 3D bioprinter.


Not much bigger than a hotel minibar… a Cellink 3D bioprinter. Photograph: Cellink.com

Cellink was born from this lightbulb moment in January 2016. Although the technology is the stuff of science fiction, the business principle is classic “razor and blades”. In this model, which is as old as the inventor King Gillette, at the turn of the last century, you practically give away the razor and you make the money on the disposable blades. And repeat, for ever. Or inkjet printers: everyone knows the serious returns are in the replacement ink cartridges.

In bioprinting, Gatenholm and Martínez developed and brought to market the world’s first standardised bioink: it is made primarily from a material called nanocellulose alginate, which is extracted in part from seaweed. If you owned a 3D bioprinter, here, finally, was a product you could effectively buy off the shelf.

The impact of Cellink, especially considering its tender years, has been remarkable. The company has already won a slew of awards: for innovation and entrepreneurialism, as well as the rapturous backing from Sweden’s version of Dragons’ Den. Ten months after its launch, Gatenholm went to the stock market, becoming listed on Nasdaq First North. The initial public offering was oversubscribed by 1,070%.

When I meet Gatenholm in Gothenburg, he still seems to be coming to terms with his company’s newfound liquidity. The office, frankly, is chaotic: there’s an iron on the floor and suit jackets on a peg, in case he’s called on to attend an impromptu client meeting. He and 32-year-old Martínez are working 16-hour days as standard. “The couch is nice to sleep on,” laughs Gatenholm. His office doesn’t actually have anywhere to sit. Cellink is taking on staff so quickly that Gatenholm and Martínez had to give up their chairs to new employees. “We donated them to science,” says Gatenholm wryly.

But Gatenholm is clear: bioprinting’s time is now. “As an entrepreneur, you’re always looking for a blue ocean,” he says. “Entrepreneurs are always asking, ‘Where’s a new area that you become the name of it? And you can claim it?’ I guess I saw bioink and bioprinting to be one of those.”

He shakes his head in disbelief: “No one was doing the ink!”


You die because your organs break. If we can start replacing them, we can extend life. That’s really neat!

Erik Gatenholm, Cellink

Bioprinting, as Gatenholm cheerily accepts, is something of a trippy idea and one that raises some ethical concerns. The principles are very similar to conventional 3D printing: you start by using a computer program to make a virtual representation of what you’d like to make and then a printer builds it slice by slice – sometimes around a pre-prepared scaffold – until you have the finished object. But instead of jewellery, little statues or parts for cars, bioprinters offer the potential to create living tissue.

In the beginning, this might mean printing skin or cartilage, which are relatively simple structures and are more straightforward to grow outside the body. Eventually, however, the pioneers of this technology believe they will be able to create complex organs, such as hearts and livers, from scratch. These could then be used in human transplants.

Scientists and commercial companies around the world are working on the project. In fact, something of a race is on. San Diego-based Organovo has been around since 2007 and has had some success in printing parts of lung, kidney and heart muscle. In 2015, it announced a partnership with the cosmetics behemoth L’Oréal on a plan to supply 3D-printed skin. Ultimately, the goal is to eradicate the need for animal trials.

L’Oréal is committing massive resources to bioprinting. In September last year, the company revealed that its scientists were also working with the France-based startup Poietis. The aim this time was to produce synthetic hair follicles. This, it turns out, is devilishly complex: there are more than 15 different cell types in each follicle and there is a cyclical process of fibre production that needs to be stimulated in vitro.

Erik Gatenholm and Héctor Martínez , co-founders of Cellink.


Erik Gatenholm and Héctor Martínez , co-founders of Cellink. Photograph: Cellink.com

Many have tried, all have failed, but L’Oréal and Poietis are confident they are close to cracking it. The key is the bioprinter that Poietis has developed: most machines push bioink through a nozzle; theirs uses a laser that deposits cells one by one, at a rate of 10,000 drops per second, without damaging the cells. “The way it works is actually quite simple and is similar to inkjet printing,” Fabien Guillemot, the CEO and chief scientific officer of Poietis, explained in the video announcing the collaboration. “It prints 3D structures, in this case, biological tissues, by successively layering microdrops of cells on a surface.”

Poietis calls its innovation 4D bioprinting. “The fourth dimension is time,” said Guillemot. “Because our laser-assisted bioprinting technology can print the cells basically one at a time, it enables us to guide the interaction between the cells and their environment until they produce the biological functions we are looking for.”

In the short to medium term, L’Oréal hopes that its sunscreens and age-defying serums will work more effectively because it can now endlessly test products on a material that reacts exactly like human skin. Perhaps your hair will look more lustrous after using its shampoo, but it’s obvious that the impact of such technology could reach far beyond the cosmetics aisle of the supermarket.

If skin can be printed in a lab, then it’s not a stretch to imagine it being used to treat severe burns. At present, skin grafts, which can lead to bleeding and infection and typically involve a long recovery time, are the most common form of treatment for such burns.

Meanwhile, the developments in synthetic hair follicles appear to open the way for commercial products that reduce hair loss or even implants. “Obviously, our objective for the future is to be able to test innovative molecules using systems of follicles created in vitro,” says José Cotovio, of L’Oréal’s research and innovation department, “but also to increase our understanding of the key processes behind phenomena such as hair ageing, hair loss and hair growth.”

This is just the tip of it – other researchers are working on how to create human organs. “There’s enormous human benefit in bioprinting,” says Gatenholm. “You die because your organs break. That’s why you die. If we can start replacing them, maybe we can extend the human lifespan… That’s really neat!”

We are a little way off from these developments being a reality. But not too far: bioprinted skin could be five years away, thinks Gatenholm. “Within 10 years, we’ll start seeing some implants in the cartilage field, either partial or full,” he says. “Replacement organs, it’s our lifetime.” He adds, smiling: “It’s in our lifetime.”

Already, inevitably, there are some ethical concerns. These range from fears over the quality and the efficacy of artificial skin and implants to the accusation that bioprinting will allow humans to “play God”. Perhaps the most thorough investigation of these issues has been undertaken by a team at the Science, Technology and Innovation Studies department at the University of Edinburgh.

The researchers, led by Dr Niki Vermeulen and Dr Gill Haddow, are unfazed by the horror-movie fantasy of a bioprinted Frankenstein’s monster. “Assuming that God exists, and is someone who can create and influence life, there are already lots of technologies that allow human beings to play God, such as genetics,” says Haddow. “Bioprinting allows people to make small parts of the body and is used for medical applications.”

A RegenHU 3D bioprinter at work at Zurich University of Applied Sciences.


A RegenHU 3D bioprinter at work at Zurich University of Applied Sciences. Photograph: BSIP/UIG via Getty Images

A much bigger hurdle that 3D bioprinting needs to overcome, they believe, are the costs. Although it is tempting to hope that the ability to make artificial organs will solve the problem of waiting lists, that is unlikely to be the case. “This is an extremely expensive technology that, if it is realised, only a few will be able to afford,” warns Vermeulen. “There is a risk that the health inequalities and postcode lottery that currently exist will also make it unavailable for most people.”

In short, they conclude, the problems and delays that patients experience in the NHS, the US healthcare system and elsewhere “will persist in the context of bioprinting”.

“Ideally, you’d like to think that exporting a relatively cheap bioprinter to a country or region with a non-optimal healthcare structure would enable people to have access to the therapies such a machine could provide. In reality, these printers can only work within an existing healthcare infrastructure that has the capacity to make use of it.”

Cost has certainly been a prohibitive barrier in these early days of 3D bioprinting. The best machines, such as EnvisionTEC’s 3D Bioplotter and RegenHU’s 3DDiscovery, are priced in excess of £150,000 and, as a result, are usually only found in labs at universities. However, here, too, Cellink is keen to shake things up a little. Although it started out supplying bioink, the company soon moved into hardware. On the table next to us in Gatenholm’s office is “Bob”, his pet name for the Inkredible+ 3D bioprinter that Cellink developed and which he carts around trade shows.

The Inkredible+ is an attractive machine: a little smaller than a hotel room minibar, it is clean and white and has blue LEDs. But what really catches the eye is the price. Cellink makes three 3D bioprinters, which cost from just £7,600 to £29,900. The savings, Gatenholm explains, come in part from using cost-effective 3D printer components instead of super-expensive motor rail systems. Also, again in the spirit of the razors and blades business model, Cellink knows that the more people own 3D bioprinters, the more bioink it will sell.

Gatenholm is proud that his company is driving down the costs of 3D bioprinting. While Cellink’s clients include MIT, Harvard and University College London, the company is also making the new technology available to hobbyists. Gatenholm doesn’t know how these people will use their machines and inks – perhaps for printing tissues to test drugs or taking cells from a cancerous tumour and using multiple versions to work out how best to treat it – but that is what makes the new technology so exciting.

“Many of those big bioprinting companies are really pissed off,” says Gatenholm. “But to be honest, the consumers are the ones who drive the market and the consumers want to do this. And for us, I don’t know where the cure for cancer is going to come from. I don’t know if it’s India, or Japan, or South America, or New York, but we want to give everybody a chance to work on it.”

The dark coloured dots are viable fibroplast cells created with a RegenHU 3D bioprinter at Zurich University of Applied Sciences.


The dark coloured dots are viable fibroplast cells created with a RegenHU 3D bioprinter at Zurich University of Applied Sciences. Photograph: BSIP/UIG via Getty Images

The challenges of printing a human heart

Why would we want to bioprint a heart?
Apart from its geometry, the heart is one of the least complicated organs in the body. It doesn’t perform complicated biochemistry like the liver and kidneys and it is well understood by science, unlike other organs such as the brain. For this reason, the heart could theoretically be one of the easiest organs to bioprint and therefore a good place for the bioprinting industry to start. There are 3,500 people in Europe on the waiting list for a heart transplant, many of whom have needed a new heart for more than two years.

How would you bioprint a heart?
The most promising method could prove to be bioprinted cell scaffolds. Instead of printing layer upon layer of living cells to form a 3D structure, like a conventional 3D printer would do with plastic or metal, the bioprinter would first be used to print a biodegradable scaffold structure of the heart, a kind of skeleton for cells. This scaffold would mimic the heart’s extracellular matrix that provides structural support to cells and helps direct them to where they should be. Heart cells could then be printed into the scaffold, where they would interact and link to form the structure of the heart. After the cells mature into the full structure of the heart, the scaffold could be broken down, leaving a fully functioning heart ready for transplantation. This technique does already exist, albeit on a smaller scale. A scaffold was used to bioprint a small patch of working heart muscle, which was shown to be able to repair a mouse heart that had been damaged by a heart attack.

Why can’t we bioprint a heart already?
Bioprinting a small patch of muscle and bioprinting a whole heart are very different feats. But why is this? There is one problem with creating whole organs that has to be overcome: blood vessels. All blood vessels have proved difficult to create with bioprinting, but creating capillaries, which can be smaller in diameter than the smallest cell, has been nearly impossible. Manufacturing a working vascular system would be such a huge achievement that Nasa is offering a $ 500,000 prize for the first research team that can do it. The Vascular Tissue Challenge will award the prize for a 1cm thick piece of human tissue with a fully working blood system that can survive for 30 days in vitro.

How far away are we from bioprinting our organs?
Estimates for a date when organ bioprinting will be viable vary wildly, with one team claiming that they will be able to bioprint a heart within six years. No one knows for certain when these techniques will be approved as safe to use for human transplants. However, the sheer number of research scientists working in the 3D bioprinting field, coupled with developments in an industry that is predicted to be worth more than $ 1.3bn by 2021, means that we can be sure that it isn’t too far away. Agnes Donnelly

Could 3D printing solve the organ transplant shortage?

Erik Gatenholm first saw a 3D bioprinter in early 2015. His father, Paul, a professor in chemistry and biopolymer technology at Chalmers University of Technology in Gothenburg, had bought one for his department. It cost somewhere in the region of $ 200,000. “My father was like, ‘This thing can print human organs,’” Gatenholm recalls, still awestruck. “I said, ‘Bullshit!’ Then it printed a little piece of cartilage. It wasn’t cartilage, but it was like, this could be cartilage. That was the moment when it was like, ‘This is frickin’ cool!’”

Gatenholm, who had long owned a regular 3D printer, decided then that he wanted to do something in 3D bioprinting. His language might be a bit Bill & Ted – he grew up between Sweden and the US, where his father is a visiting professor – but his intent and ambitions are very serious. Gatenholm had started his first biotech company aged 18 and he realised that if this machine had the potential to print organs, like his father said, then it had the potential to radically change the world of medicine.

There is a global shortage of organs available for lifesaving transplants. In the UK, for example, you can now expect to wait an average of 944 days – more than two-and-a-half years – for a kidney transplant on the NHS. There’s a similar shortage of liver, lungs and other organs. The lack of transplant tissues is estimated to be the leading cause of death in America. Around 900,000 deaths a year, or around one-third of all deaths in the US, could be prevented or delayed by organ or engineered tissue transplants. The demand, simply, is endless.

Gatenholm’s father introduced him to Héctor Martínez, one of his students who was doing a PhD on tissue engineering, and early on another student, Ivan Tournier, was also involved in the brainstorming. “We were talking about doing some experiments,” says Gatenholm, who is 27, tall and handsome even by Swedish standards.

“So I said, ‘Why don’t we just go online and buy the ink we need?’ And Ivan said, ‘Well, there’s no ink. You can’t buy it.’ And I was like, ‘What do you mean?’ It was the dumbest thing I ever heard. There’s a bunch of printers on the market, just buy the ink. And he said, ‘No, you don’t understand, there is no ink. You have to make it yourself, you have to mix something.’ So I was like, ‘Just make an ink then!’”

Not much bigger than a hotel minibar... a Cellink 3D bioprinter.


Not much bigger than a hotel minibar… a Cellink 3D bioprinter. Photograph: Cellink.com

Cellink was born from this lightbulb moment in January 2016. Although the technology is the stuff of science fiction, the business principle is classic “razor and blades”. In this model, which is as old as the inventor King Gillette, at the turn of the last century, you practically give away the razor and you make the money on the disposable blades. And repeat, for ever. Or inkjet printers: everyone knows the serious returns are in the replacement ink cartridges.

In bioprinting, Gatenholm and Martínez developed and brought to market the world’s first standardised bioink: it is made primarily from a material called nanocellulose alginate, which is extracted in part from seaweed. If you owned a 3D bioprinter, here, finally, was a product you could effectively buy off the shelf.

The impact of Cellink, especially considering its tender years, has been remarkable. The company has already won a slew of awards: for innovation and entrepreneurialism, as well as the rapturous backing from Sweden’s version of Dragons’ Den. Ten months after its launch, Gatenholm went to the stock market, becoming listed on Nasdaq First North. The initial public offering was oversubscribed by 1,070%.

When I meet Gatenholm in Gothenburg, he still seems to be coming to terms with his company’s newfound liquidity. The office, frankly, is chaotic: there’s an iron on the floor and suit jackets on a peg, in case he’s called on to attend an impromptu client meeting. He and 32-year-old Martínez are working 16-hour days as standard. “The couch is nice to sleep on,” laughs Gatenholm. His office doesn’t actually have anywhere to sit. Cellink is taking on staff so quickly that Gatenholm and Martínez had to give up their chairs to new employees. “We donated them to science,” says Gatenholm wryly.

But Gatenholm is clear: bioprinting’s time is now. “As an entrepreneur, you’re always looking for a blue ocean,” he says. “Entrepreneurs are always asking, ‘Where’s a new area that you become the name of it? And you can claim it?’ I guess I saw bioink and bioprinting to be one of those.”

He shakes his head in disbelief: “No one was doing the ink!”


You die because your organs break. If we can start replacing them, we can extend life. That’s really neat!

Erik Gatenholm, Cellink

Bioprinting, as Gatenholm cheerily accepts, is something of a trippy idea and one that raises some ethical concerns. The principles are very similar to conventional 3D printing: you start by using a computer program to make a virtual representation of what you’d like to make and then a printer builds it slice by slice – sometimes around a pre-prepared scaffold – until you have the finished object. But instead of jewellery, little statues or parts for cars, bioprinters offer the potential to create living tissue.

In the beginning, this might mean printing skin or cartilage, which are relatively simple structures and are more straightforward to grow outside the body. Eventually, however, the pioneers of this technology believe they will be able to create complex organs, such as hearts and livers, from scratch. These could then be used in human transplants.

Scientists and commercial companies around the world are working on the project. In fact, something of a race is on. San Diego-based Organovo has been around since 2007 and has had some success in printing parts of lung, kidney and heart muscle. In 2015, it announced a partnership with the cosmetics behemoth L’Oréal on a plan to supply 3D-printed skin. Ultimately, the goal is to eradicate the need for animal trials.

L’Oréal is committing massive resources to bioprinting. In September last year, the company revealed that its scientists were also working with the France-based startup Poietis. The aim this time was to produce synthetic hair follicles. This, it turns out, is devilishly complex: there are more than 15 different cell types in each follicle and there is a cyclical process of fibre production that needs to be stimulated in vitro.

Erik Gatenholm and Héctor Martínez , co-founders of Cellink.


Erik Gatenholm and Héctor Martínez , co-founders of Cellink. Photograph: Cellink.com

Many have tried, all have failed, but L’Oréal and Poietis are confident they are close to cracking it. The key is the bioprinter that Poietis has developed: most machines push bioink through a nozzle; theirs uses a laser that deposits cells one by one, at a rate of 10,000 drops per second, without damaging the cells. “The way it works is actually quite simple and is similar to inkjet printing,” Fabien Guillemot, the CEO and chief scientific officer of Poietis, explained in the video announcing the collaboration. “It prints 3D structures, in this case, biological tissues, by successively layering microdrops of cells on a surface.”

Poietis calls its innovation 4D bioprinting. “The fourth dimension is time,” said Guillemot. “Because our laser-assisted bioprinting technology can print the cells basically one at a time, it enables us to guide the interaction between the cells and their environment until they produce the biological functions we are looking for.”

In the short to medium term, L’Oréal hopes that its sunscreens and age-defying serums will work more effectively because it can now endlessly test products on a material that reacts exactly like human skin. Perhaps your hair will look more lustrous after using its shampoo, but it’s obvious that the impact of such technology could reach far beyond the cosmetics aisle of the supermarket.

If skin can be printed in a lab, then it’s not a stretch to imagine it being used to treat severe burns. At present, skin grafts, which can lead to bleeding and infection and typically involve a long recovery time, are the most common form of treatment for such burns.

Meanwhile, the developments in synthetic hair follicles appear to open the way for commercial products that reduce hair loss or even implants. “Obviously, our objective for the future is to be able to test innovative molecules using systems of follicles created in vitro,” says José Cotovio, of L’Oréal’s research and innovation department, “but also to increase our understanding of the key processes behind phenomena such as hair ageing, hair loss and hair growth.”

This is just the tip of it – other researchers are working on how to create human organs. “There’s enormous human benefit in bioprinting,” says Gatenholm. “You die because your organs break. That’s why you die. If we can start replacing them, maybe we can extend the human lifespan… That’s really neat!”

We are a little way off from these developments being a reality. But not too far: bioprinted skin could be five years away, thinks Gatenholm. “Within 10 years, we’ll start seeing some implants in the cartilage field, either partial or full,” he says. “Replacement organs, it’s our lifetime.” He adds, smiling: “It’s in our lifetime.”

Already, inevitably, there are some ethical concerns. These range from fears over the quality and the efficacy of artificial skin and implants to the accusation that bioprinting will allow humans to “play God”. Perhaps the most thorough investigation of these issues has been undertaken by a team at the Science, Technology and Innovation Studies department at the University of Edinburgh.

The researchers, led by Dr Niki Vermeulen and Dr Gill Haddow, are unfazed by the horror-movie fantasy of a bioprinted Frankenstein’s monster. “Assuming that God exists, and is someone who can create and influence life, there are already lots of technologies that allow human beings to play God, such as genetics,” says Haddow. “Bioprinting allows people to make small parts of the body and is used for medical applications.”

A RegenHU 3D bioprinter at work at Zurich University of Applied Sciences.


A RegenHU 3D bioprinter at work at Zurich University of Applied Sciences. Photograph: BSIP/UIG via Getty Images

A much bigger hurdle that 3D bioprinting needs to overcome, they believe, are the costs. Although it is tempting to hope that the ability to make artificial organs will solve the problem of waiting lists, that is unlikely to be the case. “This is an extremely expensive technology that, if it is realised, only a few will be able to afford,” warns Vermeulen. “There is a risk that the health inequalities and postcode lottery that currently exist will also make it unavailable for most people.”

In short, they conclude, the problems and delays that patients experience in the NHS, the US healthcare system and elsewhere “will persist in the context of bioprinting”.

“Ideally, you’d like to think that exporting a relatively cheap bioprinter to a country or region with a non-optimal healthcare structure would enable people to have access to the therapies such a machine could provide. In reality, these printers can only work within an existing healthcare infrastructure that has the capacity to make use of it.”

Cost has certainly been a prohibitive barrier in these early days of 3D bioprinting. The best machines, such as EnvisionTEC’s 3D Bioplotter and RegenHU’s 3DDiscovery, are priced in excess of £150,000 and, as a result, are usually only found in labs at universities. However, here, too, Cellink is keen to shake things up a little. Although it started out supplying bioink, the company soon moved into hardware. On the table next to us in Gatenholm’s office is “Bob”, his pet name for the Inkredible+ 3D bioprinter that Cellink developed and which he carts around trade shows.

The Inkredible+ is an attractive machine: a little smaller than a hotel room minibar, it is clean and white and has blue LEDs. But what really catches the eye is the price. Cellink makes three 3D bioprinters, which cost from just £7,600 to £29,900. The savings, Gatenholm explains, come in part from using cost-effective 3D printer components instead of super-expensive motor rail systems. Also, again in the spirit of the razors and blades business model, Cellink knows that the more people own 3D bioprinters, the more bioink it will sell.

Gatenholm is proud that his company is driving down the costs of 3D bioprinting. While Cellink’s clients include MIT, Harvard and University College London, the company is also making the new technology available to hobbyists. Gatenholm doesn’t know how these people will use their machines and inks – perhaps for printing tissues to test drugs or taking cells from a cancerous tumour and using multiple versions to work out how best to treat it – but that is what makes the new technology so exciting.

“Many of those big bioprinting companies are really pissed off,” says Gatenholm. “But to be honest, the consumers are the ones who drive the market and the consumers want to do this. And for us, I don’t know where the cure for cancer is going to come from. I don’t know if it’s India, or Japan, or South America, or New York, but we want to give everybody a chance to work on it.”

The dark coloured dots are viable fibroplast cells created with a RegenHU 3D bioprinter at Zurich University of Applied Sciences.


The dark coloured dots are viable fibroplast cells created with a RegenHU 3D bioprinter at Zurich University of Applied Sciences. Photograph: BSIP/UIG via Getty Images

The challenges of printing a human heart

Why would we want to bioprint a heart?
Apart from its geometry, the heart is one of the least complicated organs in the body. It doesn’t perform complicated biochemistry like the liver and kidneys and it is well understood by science, unlike other organs such as the brain. For this reason, the heart could theoretically be one of the easiest organs to bioprint and therefore a good place for the bioprinting industry to start. There are 3,500 people in Europe on the waiting list for a heart transplant, many of whom have needed a new heart for more than two years.

How would you bioprint a heart?
The most promising method could prove to be bioprinted cell scaffolds. Instead of printing layer upon layer of living cells to form a 3D structure, like a conventional 3D printer would do with plastic or metal, the bioprinter would first be used to print a biodegradable scaffold structure of the heart, a kind of skeleton for cells. This scaffold would mimic the heart’s extracellular matrix that provides structural support to cells and helps direct them to where they should be. Heart cells could then be printed into the scaffold, where they would interact and link to form the structure of the heart. After the cells mature into the full structure of the heart, the scaffold could be broken down, leaving a fully functioning heart ready for transplantation. This technique does already exist, albeit on a smaller scale. A scaffold was used to bioprint a small patch of working heart muscle, which was shown to be able to repair a mouse heart that had been damaged by a heart attack.

Why can’t we bioprint a heart already?
Bioprinting a small patch of muscle and bioprinting a whole heart are very different feats. But why is this? There is one problem with creating whole organs that has to be overcome: blood vessels. All blood vessels have proved difficult to create with bioprinting, but creating capillaries, which can be smaller in diameter than the smallest cell, has been nearly impossible. Manufacturing a working vascular system would be such a huge achievement that Nasa is offering a $ 500,000 prize for the first research team that can do it. The Vascular Tissue Challenge will award the prize for a 1cm thick piece of human tissue with a fully working blood system that can survive for 30 days in vitro.

How far away are we from bioprinting our organs?
Estimates for a date when organ bioprinting will be viable vary wildly, with one team claiming that they will be able to bioprint a heart within six years. No one knows for certain when these techniques will be approved as safe to use for human transplants. However, the sheer number of research scientists working in the 3D bioprinting field, coupled with developments in an industry that is predicted to be worth more than $ 1.3bn by 2021, means that we can be sure that it isn’t too far away. Agnes Donnelly