Health: Artificial skin heralds a new era of surgery

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The Independent Online
Body parts could be bought from the laboratories of the 21st century. Scientists have already grown human skin, bone and liver outside the body and heart muscle is next. Jeremy Laurance, Health Editor, looks towards a new medical frontier.

The world's first human skin grown entirely in the laboratory could herald a new era in transplant surgery, a scientist claimed yesterday.

Instead of relying on organs taken from other bodies doctors may soon be able to harvest specially grown replacements.

The aim is to overcome the shortage of donor organs and provide human tissue grown for specific purposes.

The first example, human skin called Dermagraft, is grown on a biodegradeable mesh that dissolves once the transplant is complete and is specially designed for the treatment of foot ulcers suffered by diabetics.

Cells taken from the foreskins of newly circumcised boys are used to seed the mesh and the skin grows in an incubator that mimics conditions in the womb over two weeks.

Dr Gail Naughton, inventor of the technique known as tissue engineering, said it was already being used to grow other body parts, including whole bones and living joints, incorporating bone and cartilage together.

Living joints had been successfully transplanted into animals said Dr Naughton, who is president of Advanced Tissue Sciences, a biotechnology company based in California.

The first human trials involving laboratory-grown cartilage are to begin in the United States and the United Kingdom next year.

"This is not science fiction. Physiological transplants replacing the plastic and metal currently used will happen some day," Dr Naughton said.

She added that the difficulties of growing human cells in the laboratory had been overcome by studying the normal growth process. That meant tight control of temperature, oxygen, nutrition and waste removal.

"In nine months in the womb a human develops from one cell to a fully grown foetus. By looking at the growing environment and what the cells need we have been able to mimic the state in the womb," Dr Naughton said.

"The only thing that limits transplant surgery is the availability of tissue and organs. Here we have the ability to grow tissue in the laboratory from starter cells that have been highly tested."

One cell bank taken from a single foreskin was enough to produce 5 million strips of Dermagraft skin.

The product, developed with Smith and Nephew, the pharmaceutical company, was designed for the treatment of foot ulcers. But Dr Naughton said that there was "no reason" why it should not be used to improve a scar.

"It could also be used to repair wrinkles. Collagen from cows has been tried but how much better to use human baby collagen," she said.

Livers had been grown for up to six months in culture and had made the right proteins and enzymes. Transplanting them was difficult because they needed a complex blood supply and they died before it could be established.

Heart muscle was "not difficult to grow at all", and a laboratory-grown version might one day be used to replace a patch of a diseased heart.

Trials of Dermagraft had shown that it speeded healing of foot ulcers in diabetics.

Although the product costs pounds 250 for each small square, and eight are needed for implanting at one week intervals, the total cost is still less than with conventional treatment, according to a review of the product by the University of York Health Economics Consortium.

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