By Alan Langnas, University of Nebraska Medical Center
Organ transplantation has seen tremendous advances in the last 20 years, but I believe the changes that will come over the next 20 years will transform this area of medicine. By 2034, we will routinely grow new organs from a patient’s own cells and we will have new non-invasive therapies as simple as pills and food additives that will eliminate the need for surgery.
There are several factors that lead me to this prediction. Today, we are reaching the limits of current drug and surgical therapies and we are hopelessly limited by a shortage of organ donors. But advances in other areas of medicine are producing innovations that can greatly enhance the transplantation process. At the University of Nebraska Medical Center our work focuses on kidney, liver, and intestinal transplants and non-transplant therapies to restore function to patients. Our research revolves around multidisciplinary, innovative solutions that yield the best results for each patient.
Tissue engineering holds great promise by taking an individual’s pluripotent cells, manipulating them in the laboratory into a particular kind of cell, and growing these cells into the organ that is needed. The University of Nebraska Medical Center is the nation’s busiest intestinal transplantation center and tissue engineering research will be a major focus for us over the next decade. We are already working to take a patient’s own cells to create neo-intestines that over the course of several months can be transplanted into a patient to allow them to become nutritionally independent once again.
By 2034, in addition to tissue engineering, I believe the field of proteomics and genomics will have yielded useful information that will allow us to do more personalized medicine and transplantation. This individual focus will not only allow personalized transplantation therapies, but, more importantly, personalized anti-rejection medications customized to a patient’s own immune system.
Surgery remains a barbaric adventure, but we will continue to advance non-surgical therapies in new ways in the decades to come. Already, we have pills that can cure hepatitis C, eliminating the need for liver transplantation for these patients. By 2034, biomedical research may yield preventative compounds as food additives to improve health and reduce the need for invasive surgery and transplantation. If someone could figure out how to put a compound in whiskey to limit alcohol’s damage to the liver, there would be fewer liver transplants, which would be a good thing for all.
With the epidemic of metabolic syndrome and associated type 2 diabetes, I am hopeful that transplant therapies could be applied here as well. Cell transplantation for both type 1 and type 2 diabetes would revolutionize the lives of these patients and help them avoid not just the quality of life issues associated with the management of diabetes, but also the devastating complications of the disease.
Alan Langnas, D.O., is Professor of Surgery and Chief of Transplantation at the University of Nebraska Medical Center. He is Director of the Nebraska Center for Transplant Medicine. He directs the Liver Transplantation team and the Intestinal Transplantation team. Dr. Langnas received his undergraduate degree from the University of Michigan and medical education at the Kansas City University of Medicine and Biosciences. He has been on the faculty of the University of Nebraska Medical Center for 25 years. Dr. Langnas was president of the American Society of Transplant Surgeons in 2013-14. Transplantation research at the University of Nebraska Medical Center is funded by a variety of sources including the National Institutes of Health and the Juvenile Diabetes Research Foundation.