A Printer Will Print Organs in Shortage

Will scientists manage to create an artificial human by 2045? How can it be determined whether the brain can live separately from the body? Will the puppies of a two-headed dog also be two-headed? If people begin to resemble robots, and robots people, then what will be the main difference between them? We spoke to Ph.D. physicist and mathematician Sergei Selishchev, who holds the positions of head of the biomedical systems department at the National Research Institute of Electronic Technology and that of editor-in-chief of the magazine “Medical Technology”, about his views on future scenarios.

2045: I propose that we speak about the near future, specifically about the year 2045. Futurists predict that by that time, a completely artificial human body will have been created. Mr. Selishchev, do you believe that there are sufficient bases for making such claims?

Sergei Selishchev: About seven or eight years ago, there was an article in the magazine Scientific American titled “Bionic Human”, about this very idea of an artificial body, grown from living tissue.

Over a span of several decades, artificial organs went from being equipment that takes up half a room to 3-D printers that “print” organs made of living cells.

The first generation of artificial organs is the so-called bedside artificial organs. Among them was a device for hemodialysis that became very well-known, the so-called “artificial kidney”. The device attaches to a patient lying on a hospital bed, and the person’s blood passes through the artificial kidney, which cleans it and then sends it back into the person. There is an artificial heart that looks like a large cupboard and, naturally, also is not something integrated into the patient’s body.

There are portable artificial organs. They are not integrated into a person’s body either but are small enough that they can be carried around on one’s person. The latest such organ that received a great deal of press was the “prosthetic blood circulation device”. It looks like a small drawer that the patient carries with him or on himself, and inside the drawer is a pump and electronics that help the heart to function.

There are also systems that can be fully implanted into one’s body, either artificial or bio-artificial. Not all body parts have full-fledged counterparts either—there are difficulties in reproducing the eye and nerve tissue—but that will be allowed sooner or later. Man is acquiring artificial organs, and machines are acquiring “human” characteristics. This raises the question: “What’s the difference between man and a machine?”

There is one function that artificial systems are incapable of fulfilling but that humans are capable of: reproduction. And if you want to create a full-fledged counterpart, a kind of biorobot that is just like a human, then the central problem that needs to be solved is to teach it to reproduce. That is a complex problem from both the point of view of technology and from an ethical standpoint.

2045: If you leave out reproduction, do you think a fully artificial body will be created by 2045?

S.S.: I think so, yes. There are no overarching or unsolvable technical problems when it comes to the creation of a fully artificial body. All the tasks are clear and potentially solvable. But the question arises: What’s the point? Robots, certainly, are needed—they help to do work that is routine or arduous, to fly in outer space, and so on. As regards artificial organs and an artificial human body, the main point of creating them is as a form of high-tech medical care.

Most importantly, unrejectable bio-artificial organs will save and ease the lives of millions of sick people. There are currently a lot of people on the waiting lists for kidney and pancreas transplants. I’m not even talking about the demand for intelligent prostheses, a field that has demonstrated simply incredible success over the last decade. All of that is necessary, all of that is desirable, and all of that is being done. As regards the creation of a system equivalent to a living being, I don’t fully understand why that’s really necessary.

2045: An equivalent will make it possible to extend life span to 200-300 years by replacing organs that have gotten out of alignment. They will, most likely, be grown from a person’s very own stem cells. Moreover, it is a kind of next step in the process of evolution. The human form—like, however, all others—is adapted to a large range of conditions. So why not take the next evolutionary step? Why not use technology to equip ourselves for life on Mars, Venus, or life under water?

S.S.: Sometimes a space suit or a diving suit is all you need to equip yourself with in an unaccustomed environment. As regards evolution, we have genes and we have DNA, which has been very poorly studied. There is an obvious comparison: If you were to imagine the decoded part of DNA as a sports stadium, the undecoded part of it would be equivalent to the circumference of the entire Earth.

The situation with DNA is reminiscent of the Age of Discovery: We know for sure that there is something somewhere, but we don’t have a full or cohesive picture. And we cannot answer the question of why evolution stopped specifically with humans.

2045: Perhaps it hasn’t stopped yet. It has a lot of time.

S.S.: I mean for the moment. We have no evidence that this evolution has ceased. There are many hypotheses on that regard.

2045: Perhaps my conception of evolution is too integrated. For me it is a process over the course of which foundations that provide more and more variability and variety are selected, foundations that in turn ensure adaptiveness. We are currently entering the technological stage of evolution, which is accelerating more and more.

S.S.: Such a broad view of evolution also has a right to exist—I won’t argue with you. But recall the famous Soviet surgeon and transplantation pioneer Vladimir Demikhov, who created a dog with two heads. Two heads have still never been passed down to anyone by way of evolution!

With all the truths and untruths today, cloning technologies are progressing. They could perhaps be said to represent the cutting edge in terms of replaceable organs and an artificial body. Predictions will be able to be made in the near future, but with regard to evolutionary development, it’s difficult for me to make any sort of prediction.

The main criterion for how to direct development of such fields as biology, medicine, and bionics, is death from one or another illness. The leading cause of death internationally is heart and vascular diseases, and the development of technology is in many ways directed toward fighting them in particular.

The first implantable cardiac defibrillators appeared after the Second World War. Compared to modern devices, they were rather primitive. The inventors of one of the first electric cardiac defibrillators were graduates of a medical university in the American city of Minneapolis—they founded the company Medtronic, which is currently one of the leaders in the field of implantable devices. The sales volume produced by that one company is more than that for all medical equipment in Russia.

Electric cardiac defibrillators have now become highly intelligent devices. They don’t simply maintain a certain rhythm but are installed on the heart and help it restore (at least partially) normal functionality.

Over the last 30 years, Americans working in this field have managed to achieve a decrease in the death rate from heart and vascular diseases. However, they have not yet managed to have an impact on the growth in the death rate from diabetes or pancreatic cancer. And so even while science continues to advance, development occurs alongside growth in the rate of death by illness. The industry’s primary efforts are aimed toward addressing this.

2045: That is certainly a noble and important task. But there is also work being done on not only normalizing the functionality of individual organs but also improving it. I know that runners with certain kinds of prostheses are barred from competition because they go faster than regular athletes.  

S.S.: The American agency DARPA (Defense Advanced Research Projects Agency) has an extensive bionics program, including a military one. They’re already thinking about how to jump higher.

2045: Is it possible to create systems that would be able to keep a certain individual organ alive, for instance the brain?

S.S.: I can say that the heart can be preserved for a rather long time—there are practically no fundamental limitations on that. Why do you want to keep the brain alive separate from the body?

2045: There is an opinion that the brain is capable of living several times longer than the rest of the body and that its main diseases stem not from neurodegenerative processes but from a deficit of certain energy supplies that arises as a result of wear and tear on the body and from a lack of harmonious functioning in bodily systems.

S.S.: If that’s what you want to find out, then you simply need to run experiments! Separate the brain of a rat and see how long it survives. You need to select animals with a short life span and begin to experiment on them.

2045: We have an idea to create a center that will take up the work of integrating technologies and innovations, research and interfaces that are somehow related to the creation of an artificial body. How should such a center be organized in order to achieve results?

S.S.: If you pick people in the right way, then you will achieve a scientific result no matter what. It’s difficult even to think of a field of knowledge that would not be relevant to the tasks that stand before your center.

2045: Would you be interested in participating in the work of the center?

S.S.: Areas of work like the bio-artificial kidney, artificial skin and bioprinting technology are appealing to me. In my opinion, you can leave the job of unifying the different areas for last. Organs are 3-dimensional, people are 3-dimensional, and even cyborgs have three dimensions. 3-d printing is a logical route of development for cellular technologies and an artificial body.