Geibel aims to use the patient's own cells to print sections of their intestine as well as the infrastructure, or rods, to secure the implant in place once in the patient's body. If successful, short gut syndrome patients will be able to receive iterative intestinal implants that align with the child's natural growth cycle.
In 2014, Yale announced a collaboration with 3-D bioprinting technology maker Organovo to develop bioprinted tissues for surgical implantation research. Geibel's research strategy has been intentionally slow and methodical, with no end date marked out as of yet. Instead, he is creating incremental benchmarks, including printing smaller cylindrical items, such as blood vessels and arteries, to be studied in rats.
He says his cautious approach will be instrumental in showing payers the viability of 3-D printing. "We'll be able to prove that using the individual's own cells reduces risk of rejection and might eliminate the need for antirejection drugs, which have their own side effects." Also the cost comparisons will be persuasive, he says.
For instance, total parenteral nutrition, a common treatment for intestinal failure, can cost $100,000 to $200,000 a year. "As reagents get more expensive and patients require recurrent hospitalizations, that number jumps up," he says. "These patients cost an incredible amount of money to maintain." As 3-D printing costs decrease, implants, he says, will likely be less expensive than the alternative.
So although he expects insurance companies to initially consider 3-D implants "risky" and to be conservative in approval, ultimately, he says he expects them to understand the advantage to the patient and overall care costs.
Payers already recognize the value of 3-D printing, and that will only increase if the science is supportive, according to Geibel. "If you're getting into 3-D printing, move cautiously," he says.
Henry Ford Hospital's O'Neill says, "If you don't have a clinical use for 3-D printing, it will die out." However, he says he is confident that helping resolve cardiac issues will be just one of many applications that will keep the technology around.