高分子生物材料 人工器官 张国庆

Wiki: An artificial organ is a man-made device that is implanted or integrated into a human to replace a natural organ, for the purpose of restoring a specific function or a group of related functions so the patient may return to a normal life.

人工器官的分类 Bone/joint replacement 骨 / 关节替代 Skin/soft tissues replacement 皮肤 / 软组织替代 Internal organs 内脏 Sensory organs 感觉器官

人工器官的功能 Life support to prevent imminent death while awaiting a transplant (e.g. artificial heart) 接 受器官移植期间的生命维系 Dramatic improvement of the patient‘s ability for self care (e.g. artificial limb) 改善病人的自 理能力 Improvement of the patient‘s ability to function socially (e.g. cochlear implant) 改善 病人的社会生活 Cosmetic - after cancer, surgery or an accident.

常见的人工器官 Artificial Hearts 心脏 Artificial Lungs 肺 Artificial Kidneys 肾脏 Artificial Pancreas 胰脏 Artificial Hips and Knees 股骨和膝盖 Artificial bladder 膀胱

Artificial Hips The most common reason for replacing the hip joint is because of damage to the hip by osteoarthritis. Other reasons include infection or a fractured hip, which commonly occurs in older women as a complication of osteoporosis or a fall. The new joint is put in during a major operation known as a total hip replacement (THR). About 35,000 THRs are carried out each year in England and Wales on the NHS, and a considerable number more in private hospitals.

Artificial Hips The joint consists of three parts: A metal ball (titanium alloy) that replaces the top of the femur or leg bone. Attached to this ball is a metal stem, which is inserted down into the centre space of the femur. The metal ball and stem are stuck to the bone using cement. A spherical plastic cup is inserted separately in the bone of the pelvis. The metal ball of the artificial hip joint is then pushed into this cup, joining the leg and the pelvis. The ball can move around in the cup, so the joint can bend and move.

Artificial hearts 人工心脏 An artificial heart is a prosthetic device that is implanted into the body to replace the biological heart. It is different from a heart bypass machine, which is an external device (a CardioPulmanory Bypass - CPB). A CPB is only suitable for a few hours use, while artificial hearts have so far been used for periods of well over a year.

History of Artificial Hearts WWII: first open heart surgeries 1953: heart-lung machine successfully used during heart surgery 1958: Drs. Willem Kolff and Tetsuzo Akutsu sustain a dog for 90 minutes with a PVC artificial heart 1967: Dr. Christian Barnard transplants a donor heart into a 59 year old man (he survived 18 days) PVC heart (1958)silicone heart (1965)

1969: Dr. Denton Cooley uses an artificial heart to sustain a patient waiting for a donor (survived 3 days) 1972: Cyclosporine introduced to suppress immune responses of transplant recipients 1982: Dr. William DeVries implants the Jarvik-7 artificial heart into Dr. Barney Clark (he survived 112 days) Liotta heart (1969)Jarvik-7 (1982) History of Artificial Hearts

Why Artificial Hearts Fail Immune response “rejects” transplant or side effects due to immune suppression Infection due to tubes and wires passing through skin Formation of clots Damage to red blood cells Lack of pulsatile blood flow?

Parts of Artificial Hearts Heart is basically a pump, but with a lot of subtleties. Lower the need for transplants Foreign-body rejection a problem Right is Abiocor

Artificial Hearts 1963 – first patented device (Uni Utah) 1982 – first patient 61-year-old Barney Clark, survived for 112 days 2001 – Abiocor, self-contained, approved for human use - the longest implantation so far is 602 days (20.4 months). Main use is still for person waiting for a transplant

Artificial Kidneys A portable, self-contained artificial kidney has not yet been developed. A dialysis machine is a critical life support device that completely replaces the duties of a kidney – like an Iron Lung, it is a separate machine. Dialysis machine is used as a temporary measure, because of a disease or for a person waiting for a kidney transplant.

Dialysis Machine

Solution

Polymer membrane vs glomerulus

Silicon microfibrication

3D Printing Play Video

Pancreas The pancreas is below the stomach and above the duodenum. It releases endocrine hormones (insulin, amylin and glucagon) into the portal vein, where it flows directly to the liver. Diabetes is the inability of the beta cells of the pancreas to produce sufficient insulin.

Artificial Pancreas Helps diabetics control their blood glucose level by providing the substitute endocrine functionality of a healthy pancreas. The lack of insulin production is the motivation to develop a substitute. Insulin replacement therapy is appreciated for its life- saving capability, but manually managing the blood sugar level with insulin alone is arduous and inadequate.

Artificial Pancreas Different approaches under consideration: Medical equipment approach - using an insulin pump under closed-loop control using real-time data from a continuous blood glucose sensor. (nearly there) The biotechnology approach - the development of a bio- artificial pancreas. When surgically implanted, the device will behave as the original pancreas and will be viable for years. (Speculation) The gene therapy approach - the therapeutic infection of a diabetic person by a genetically engineered virus which causes a DNA change of intestinal cells to become insulin- producing cells. (Speculation)

Artificial Pancreas The Insulin pump is used to automatically deliver basal insulin continuously, and bolus insulin at meal times by pressing the buttons. Before meals, a blood glucose value is entered into the pump to calculate the correction bolus to bring the blood glucose level back to the target value