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    Artificial organs - State-of-the-art technology for device-based and cell/tissue-based approaches

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    Authors
    Geertsma RE
    Dekker RJ
    de Bruijn ACP
    Wassenaar C
    Hilbers ESM
    Roszek B
    Type
    Report
    Language
    en
    
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    Title
    Artificial organs - State-of-the-art technology for device-based and cell/tissue-based approaches
    Translated Title
    Artificiele organen Stand der wetenschap voor benaderingen met medische hulpmiddelen en met cel/weefsel-producten
    Publiekssamenvatting
    Onderzoek naar oplossingen voor zieke of falende organen van de mens is de laatste jaren sterk in opkomst. Het gaat hierbij zowel om medische hulpmiddelen van niet-levende materialen als om toepassingen met levende cellen of weefsels. Dergelijke producten kunnen de wachttijd tot een transplantatie overbruggen, of de werking van een orgaan gedurende lange tijd ondersteunen. Kunstorganen die falende organen volledig kunnen vervangen zijn nog niet op de markt.
    Dit RIVM-rapport geeft een overzicht van de ontwikkeling van zowel medische hulpmiddelen als cel/weefselproducten die (gedeeltelijk) falende orgaansystemen ondersteunen, repareren of vervangen. Het gaat daarbij om het hart, de longen, de lever, de nieren, de pancreas, de blaas en de darmen.
    Voor het hart, de nieren, de pancreas en de blaas bestaan medische hulpmiddelen als overbrugging naar een transplantatie of als langetermijnondersteuning van het orgaan. Er vinden klinische studies plaats met een totaal kunsthart, en met ondersteunende hulpmiddelen voor hart, lever en nieren.
    Cel/weefselproducten zijn nog niet op de markt. Klinische studies vinden plaats voor het hart en de nieren. Onderzoek naar zogenoemde bioartificiele levers en pancreassen op basis van varkenscellen leek veelbelovend, ook in kleinschalig klinisch onderzoek. Vanwege ethische en veiligheidsredenen is dit momenteel in Nederland en vele andere landen verboden.
    Andere concrete toepassingen voor totale kunstorganen worden de komende vijf tot tien jaar niet in klinische studies verwacht. Aangezien Nederlands onderzoek op dit gebied mondiaal vooraan meeloopt, zullen eventuele internationale doorbraken wel snel hun weg vinden in ons land.

    The challenge of treating diseased or failing human organs has been the driving force behind an increasing number of research programmes in recent years. Increased attention is being given to the potential of medical devices constructed from non-living materials as well as to applications utilizing living cells or tissues. Such products can serve as a bridge to transplant or serve as long-term chronic support systems. Artificial organs that can fully replace a failing organ are not yet commercially available.
    This RIVM report provides a comprehensive overview of the development of both medical device-based and cell/tissue-based solutions for (partly) failing organ systems of the heart, lungs, liver, kidney, pancreas, bladder and bowel. These solutions are assessed for both total organ replacement and as technologies supporting or repairing damaged organs.
    Established medical devices functioning as a bridge to transplant or as long-term chronic support systems currently exist for the heart, kidneys, pancreas and bladder. Clinical trials are ongoing with a total artificial heart device and with heart, liver and kidney support devices.
    Cell/tissue products are not yet commercially available, although clinical trials in this field are ongoing for the heart and kidney. The results of research, including small-scale clinical trials, on the so-called bioartificial liver and pancreas, based on the use of porcine cells, were promising. However, the research on such bioartificial organs is currently banned in the Netherlands and many other countries for ethical and safety reasons.
    Other applications for total artificial organs are not expected to enter clinical trials within the next 5 or even 10 years. Since Dutch academic research groups and clinicians are working on cutting-edge technology in this field, it can be expected that applications in Dutch clinics will closely follow international developments.
    Publisher
    Rijksinstituut voor Volksgezondheid en Milieu RIVM
    Sponsors
    Inspectie Gezondheidszorg
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