Genes & Technology

Advancements in cell biology, genetics, and immunology since the 1970s have revolutionized medicine. Technologies like CT, MRI, and PET scans provide detailed insights, while keyhole surgery and lasers enhance safety and ease.

Evidence-Based Medicine

Physicians had long emphasised the crucial role of blood, but the first documented blood transfusion occurred in 1665 when English physician Richard Lower conducted an experiment. He drained a dog of most of its blood and then transfused blood from another dog into his own body. The first dog recovered, but the donor dog died. This sparked interest in France and England for similar experiments, but due to the number of deaths resulting from these procedures, the Royal Society banned them the following year.

Early Beginnings: James Lind’s Pioneering RCTs

James Lind, a Scottish naval surgeon in 1747, embarked on pioneering RCTs by allocating sick sailors with scurvy to distinct treatments, including seawater, vinegar, cider, and citrus fruits. This laid the groundwork for understanding the efficacy of vitamin C in treating scurvy. While clinical trials advanced in the 19th century, individual practitioners primarily conducted them.

Early Beginnings: James Lind’s Pioneering RCTs

James Lind, a Scottish naval surgeon in 1747, embarked on pioneering RCTs by allocating sick sailors with scurvy to distinct treatments, including seawater, vinegar, cider, and citrus fruits. This laid the groundwork for understanding the efficacy of vitamin C in treating scurvy. While clinical trials advanced in the 19th century, individual practitioners primarily conducted them.

20th Century Advances: National Bodies and Coordinated Trials

In the 20th century, the establishment of national bodies like the UK’s Medical Research Council (MRC) in 1913 played a pivotal role in coordinating and funding clinical trials, elevating their standards. Archie Cochrane, a prominent figure in the MRC, conducted his initial RCT during World War II, testing vitamin supplements for ankle edema among prisoners of war in Salonika, Greece.

Post-war, Cochrane’s meticulous research in a Welsh MRC unit focused on pneumoconiosis in coal miners, emphasizing data accuracy and standardization. This dedication paved the way for improved scientific evidence in medical interventions.

Archie Cochrane’s passion for enhancing scientific evidence found its pinnacle in the establishment of the Cochrane Collaboration in 1993. Originally founded in the UK and now known as Cochrane, it operates globally in 43 countries. The collaboration’s mission is to collect and disseminate reviews of clinical trials, urging healthcare professionals to base their decisions on the most robust available evidence.

The legacy of James Lind and Archie Cochrane endures, with their contributions shaping the landscape of evidence-based medicine and promoting a paradigm shift towards informed and validated clinical practices.

20th Century Advances: National Bodies and Coordinated Trials

In the 20th century, the establishment of national bodies like the UK’s Medical Research Council (MRC) in 1913 played a pivotal role in coordinating and funding clinical trials, elevating their standards. Archie Cochrane, a prominent figure in the MRC, conducted his initial RCT during World War II, testing vitamin supplements for ankle edema among prisoners of war in Salonika, Greece.

Cochrane’s meticulous research in a Welsh MRC unit focused on pneumoconiosis in coal miners, emphasizing data accuracy and standardization. This dedication paved the way for improved scientific evidence in medical interventions.

Archie Cochrane’s passion for enhancing scientific evidence found its pinnacle in the establishment of the Cochrane Collaboration in 1993. Originally founded in the UK and now known as Cochrane, it operates globally in 43 countries. The collaboration’s mission is to collect and disseminate reviews of clinical trials, urging healthcare professionals to base their decisions on the most robust available evidence.

The legacy of James Lind and Archie Cochrane endures, with their contributions shaping the landscape of evidence-based medicine and promoting a paradigm shift towards informed and validated clinical practices.

Monoclonal Antibodies

Antibodies, crucial proteins in the body’s defence against foreign cells, were conceptualized by Paul Ehrlich in 1891. By the 1960s, the understanding of their lock-and-key interaction with antigens led to the identification of B-cells as their source, each primed with a unique antibody.

Birth of Monoclonal Antibodies (mAbs)

In 1975, immunologists César Milstein and Georges Köhler achieved a milestone, creating monoclonal antibodies—precise, artificial replicas of a single antibody. Their method involved hybridomas, lab-engineered cell fusions combining plasma cells and myeloma cells. This breakthrough offered an unlimited supply of identical antibodies, a departure from the body’s natural polyclonal production.

Monoclonal Antibodies

Antibodies, crucial proteins in the body’s defence against foreign cells, were conceptualized by Paul Ehrlich in 1891. By the 1960s, the understanding of their lock-and-key interaction with antigens led to the identification of B-cells as their source, each primed with a unique antibody.

Birth of Monoclonal Antibodies (mAbs)

In 1975, immunologists César Milstein and Georges Köhler achieved a milestone, creating monoclonal antibodies—precise, artificial replicas of a single antibody. Their method involved hybridomas, lab-engineered cell fusions combining plasma cells and myeloma cells. This breakthrough offered an unlimited supply of identical antibodies, a departure from the body’s natural polyclonal production.

Applications Across Medicine

Monoclonal antibodies quickly became pivotal in medicine. From innovative cancer treatments to blood type identification, they constitute a significant portion of new drugs and diagnostic tools. Their ability to detect biological weapons, aid pregnancy tests, prevent organ rejection in transplants, identify blood clots, and target specific cells in cancer treatment showcases their diverse applications.

Applications Across Medicine

Monoclonal antibodies quickly became pivotal in medicine. From innovative cancer treatments to blood type identification, they constitute a significant portion of new drugs and diagnostic tools. Their ability to detect biological weapons, aid pregnancy tests, prevent organ rejection in transplants, identify blood clots, and target specific cells in cancer treatment showcases their diverse applications.

Advancements and Future Prospects

While not a universal cure, monoclonal antibodies continue to evolve in utility. They play a role in treating autoimmune diseases like rheumatoid arthritis, and ongoing research explores their potential against malaria, influenza, HIV, and, notably, COVID-19. In 2020, scientists identified monoclonal antibodies capable of neutralizing the SARS-CoV-2 virus in cell cultures, highlighting their adaptability and promising future in combating emerging health challenges.

In Vitro Fertilization

On July 25, 1978, Louise Brown entered the world as the first baby conceived through in vitro fertilization (IVF), marking a historic achievement by British scientist Robert Edwards and gynaecologist Patrick Steptoe.

In Vitro Fertilization

On July 25, 1978, Louise Brown entered the world as the first baby conceived through in vitro fertilization (IVF), marking a historic achievement by British scientist Robert Edwards and gynaecologist Patrick Steptoe.

Historical Precedents

Though the concept of IVF had early attempts in the late 19th century and mid-20th century, it was Edwards and Steptoe's collaboration that brought success. In 1968, they pioneered IVF, achieving fertilization and cell division outside the body. The breakthrough eluded them until 1976, when the Browns, facing fertility challenges, sought their help.

Modern IVF Practices

Contemporary IVF involves fertility drugs to stimulate egg maturation, increasing the chances of viable embryos. Unused embryos, eggs, and sperm can be cryopreserved. Intracytoplasmic sperm injection (ICSI) addresses male infertility by directly injecting sperm into an egg. Despite initial opposition, IVF has become safer, more successful, and widely embraced in the quest for parenthood.

The IVF Milestone

In collaboration with embryologist Jean Purdy, Edwards and Steptoe successfully fertilized and implanted an eight-cell embryo into Lesley Brown's uterus in November 1977. The birth of Louise Brown was a medical triumph, although initially met with skepticism about the ethics of "test-tube babies."
As IVF demonstrated its efficacy, perceptions evolved. Initially considered unnatural, more than 4.5 million IVF babies were born by 2010 when Edwards received the Nobel Prize. Today, IVF is widely accepted, offering hope to various demographics, including same-sex couples, single women, and surrogates.

Advancements and Future Prospects

Though the concept of IVF had early attempts in the late 19th century and mid-20th century, it was Edwards and Steptoe’s collaboration that brought success. In 1968, they pioneered IVF, achieving fertilization and cell division outside the body. The breakthrough eluded them until 1976, when the Browns, facing fertility challenges, sought their help.

The IVF Milestone

In collaboration with embryologist Jean Purdy, Edwards and Steptoe successfully fertilized and implanted an eight-cell embryo into Lesley Brown’s uterus in November 1977. The birth of Louise Brown was a medical triumph, although initially met with skepticism about the ethics of “test-tube babies.”

As IVF demonstrated its efficacy, perceptions evolved. Initially considered unnatural, more than 4.5 million IVF babies were born by 2010 when Edwards received the Nobel Prize. Today, IVF is widely accepted, offering hope to various demographics, including same-sex couples, single women, and surrogates.

Modern IVF Practices

Contemporary IVF involves fertility drugs to stimulate egg maturation, increasing the chances of viable embryos. Unused embryos, eggs, and sperm can be cryopreserved. Intracytoplasmic sperm injection (ICSI) addresses male infertility by directly injecting sperm into an egg. Despite initial opposition, IVF has become safer, more successful, and widely embraced in the quest for parenthood.

Global Eradication of Disease

On May 8, 1980, a historic milestone was reached as the World Health Organization (WHO) declared smallpox eradicated, marking the first and only victory against a major human disease. Smallpox, a centuries-old scourge, had claimed millions of lives annually until British physician Edward Jenner discovered a vaccine in 1796.

Global Eradication of Disease

On May 8, 1980, a historic milestone was reached as the World Health Organization (WHO) declared smallpox eradicated, marking the first and only victory against a major human disease. Smallpox, a centuries-old scourge, had claimed millions of lives annually until British physician Edward Jenner discovered a vaccine in 1796.

Evolution of Vaccination

Vaccines played a pivotal role in reducing smallpox deaths. Edward Jenner’s discovery initiated widespread vaccination, providing individual immunity while benefiting entire communities. Despite initial setbacks, such as vaccine contamination in the 19th century, advancements like Sydney Copeman’s glycerine storage in the 1890s increased public trust. By 1953, smallpox had been eliminated in the US and Europe.

Overcoming Challenges

The extension of vaccination programs to tropical regions faced challenges due to the vaccine’s instability in warm conditions. Innovations by Leslie Collier, who freeze-dried the vaccine for extended storage, and Benjamin Rubin, the creator of the bifurcated needle, streamlined the vaccination process, allowing simple, pricked applications of powdered vaccine.

Strategic Eradication Campaign

In 1967, the WHO launched the Smallpox Eradication Programme, employing a strategic “ring” approach. This involved isolating infected individuals, tracking and vaccinating potential contacts, and creating immunized rings to contain outbreaks. Mass vaccinations were avoided, contributing to the program’s success.

In 1975, the last naturally contracted case occurred in Bangladesh, and in 1977, Somalia witnessed the final case of the minor variant. Both cases were quelled using the ring strategy, leading to the eradication of smallpox. This monumental achievement spurred the WHO’s efforts to combat other vaccine-preventable diseases, extending hope for the eradication of polio and Guinea worm disease. The success with smallpox showcased the potential for global immunization programs to triumph over deadly diseases.

Minimally Invasive Surgery

Keyhole surgery, a transformative approach to minimally invasive procedures, traces its roots to the early 20th century. The pivotal moment occurred in 1981 when German gynaecologist Kurt Semm conducted the first appendectomy using this groundbreaking technique. Initially met with skepticism, keyhole procedures, encompassing laparoscopic, arthroscopic, and thoracoscopic surgeries, gained widespread acceptance in the mid-1980s.

In 1910, Swedish surgeon Hans Jacobaeus pioneered diagnostic laparoscopy by inserting a cystoscope through the abdominal wall. Acknowledging the risks and potentials, progress was gradual until the 1930s when US internist John Ruddock popularized surgical laparoscopies. However, the real breakthrough came in the 1980s with technological advancements, notably the introduction of 3D videoscopic imaging. This innovation enhanced the safety and precision of keyhole surgery, enabling its application in various fields, including urology, where robot-assisted laparoscopy became prevalent.
Keyhole surgery boasts numerous advantages over open procedures: a minimal incision of 5-15mm (0.2-0.6 in), reduced pain and bleeding, often requiring only local anesthesia and swift patient recovery. Today, the majority of abdominal surgeries leverage keyhole techniques, marking a paradigm shift in surgical practices.

Minimally Invasive Surgery

Keyhole surgery, a transformative approach to minimally invasive procedures, traces its roots to the early 20th century. The pivotal moment occurred in 1981 when German gynaecologist Kurt Semm conducted the first appendectomy using this groundbreaking technique. Initially met with skepticism, keyhole procedures, encompassing laparoscopic, arthroscopic, and thoracoscopic surgeries, gained widespread acceptance in the mid-1980s.

In 1910, Swedish surgeon Hans Jacobaeus pioneered diagnostic laparoscopy by inserting a cystoscope through the abdominal wall. Acknowledging the risks and potentials, progress was gradual until the 1930s when US internist John Ruddock popularized surgical laparoscopies. However, the real breakthrough came in the 1980s with technological advancements, notably the introduction of 3D videoscopic imaging. This innovation enhanced the safety and precision of keyhole surgery, enabling its application in various fields, including urology, where robot-assisted laparoscopy became prevalent.

Keyhole surgery boasts numerous advantages over open procedures: a minimal incision of 5-15mm (0.2-0.6 in), reduced pain and bleeding, often requiring only local anesthesia and swift patient recovery. Today, the majority of abdominal surgeries leverage keyhole techniques, marking a paradigm shift in surgical practices.

Gene Therapy

Gene therapy is a medical approach focused on introducing healthy DNA into cells with defective DNA to remedy various disorders. In 1990, American geneticist William French Anderson achieved a breakthrough by successfully applying gene therapy to treat a girl with severe combined immunodeficiency (SCID). The girl lacked the enzyme ADA necessary for producing infection-fighting white blood cells. At that time, the available treatment options were limited, including enzyme injections, bone marrow transplants, or isolation in a sterile environment.

Anderson’s team extracted white blood cells from the girl, inserted the ADA gene using a viral vector, and reintroduced the modified cells into her bloodstream. Remarkably, within six months, her white blood cell count normalized. While this technique held promise, its limitation of not integrating new DNA into its natural position within the host’s genome led to disruptions in cell functioning, causing leukemia in some later recipients.

Subsequent advancements in genetic research have addressed these challenges, enabling the precise placement of introduced DNA and the development of “in-body” gene editing techniques. While these advancements offer potential cures for a spectrum of genetic conditions, they also evoke ethical considerations regarding the definition of disability and the potential misuse of gene editing for human enhancement. Presently, gene therapy remains a risky intervention, reserved for cases where no alternative cure exists.

Laser Eye Surgery

The utilization of lasers as a surgical tool spans various medical domains, including ophthalmology, where they are employed for tasks ranging from retinal repairs to vision correction. However, the refinement of femtosecond laser technology between 1995 and 1997 by American biomedical engineers Tibor Juhasz and Ron Kurtz marked a pivotal advancement, rendering laser eye surgery notably safer, more precise, and predictable.

Since the mid-1990s, ophthalmic surgeons have embraced the LASIK technique to address both long- and short-sightedness. Initially, this involved a microkeratome precision blade for creating a corneal flap and a laser for reshaping the cornea. However, an evolving trend increasingly incorporates femtosecond lasers for the entire procedure. These ultrafast lasers emit brief light pulses, disrupting eye tissue with exceptional precision, eliminating the need for a blade.

Femtosecond technology is revolutionizing cataract surgery, a procedure performed around 30 million times annually to address clouded areas on the eye lens, a leading cause of global blindness. In femtosecond laser-assisted cataract surgery, the laser orchestrates minimal corneal incisions and a circular opening in the lens capsule. This allows the breakdown of the cataract and the insertion of an artificial lens implant. The corneal incisions then heal naturally.

Laser Eye Surgery

The utilization of lasers as a surgical tool spans various medical domains, including ophthalmology, where they are employed for tasks ranging from retinal repairs to vision correction. However, the refinement of femtosecond laser technology between 1995 and 1997 by American biomedical engineers Tibor Juhasz and Ron Kurtz marked a pivotal advancement, rendering laser eye surgery notably safer, more precise, and predictable.

Since the mid-1990s, ophthalmic surgeons have embraced the LASIK technique to address both long- and short-sightedness. Initially, this involved a microkeratome precision blade for creating a corneal flap and a laser for reshaping the cornea. However, an evolving trend increasingly incorporates femtosecond lasers for the entire procedure. These ultrafast lasers emit brief light pulses, disrupting eye tissue with exceptional precision, eliminating the need for a blade.

Femtosecond technology is revolutionizing cataract surgery, a procedure performed around 30 million times annually to address clouded areas on the eye lens, a leading cause of global blindness. In femtosecond laser-assisted cataract surgery, the laser orchestrates minimal corneal incisions and a circular opening in the lens capsule. This allows the breakdown of the cataract and the insertion of an artificial lens implant. The corneal incisions then heal naturally.

Stem Cell Research

In 1998, American cell biologist James Thomson and his Wisconsin-based team achieved a groundbreaking milestone by isolating human embryonic stem cells (ESCs) from donated embryos, providing a significant leap in creating diverse cell types. Stem cells, versatile cells capable of giving rise to various specialized cell types, present the prospect of nearly limitless applications in the body. Embryonic stem cells, specifically pluripotent, possess the capacity to transform into almost any specialized cell, offering unparalleled value for researchers. In contrast, adult stem cells, primarily multipotent, exhibit limited variety in the cell types they can generate.

Clinical use of adult stem cells dates back to the 1960s when bone marrow transplants were initiated as a treatment for various blood cancers. In this procedure, haematopoietic stem cells (HSCs), responsible for all blood cell types, are extracted from the patient’s or a compatible donor’s pelvic marrow. After eradicating cancerous blood cells through radiation, the HSCs are reintroduced into the bloodstream.

Thomson’s embryonic stem cell research faced opposition from the Catholic Church and contentious debates surrounding the moral implications of extracting cells from unused embryos. Although there were regulatory restrictions, subsequent advancements, such as Shinya Yamanaka’s discovery in 2006, enabled the genetic alteration of multipotent stem cells, transforming them into pluripotent cells. This breakthrough expanded the potential sources of stem cells beyond embryos.

Controversy persists in stem cell research, with ethical considerations surrounding the right to life of embryos and the moral duty to develop treatments for severe diseases. Directed differentiation, a process converting pluripotent stem cells into specific cell types, facilitates the growth of tissues like heart muscle, brain, and retinal cells. Reprogrammed stem cells are crucial in clinical trials targeting heart disease, neurological conditions, retinal disease, and type 1 diabetes.

In summary, the evolution of stem cell research encompasses ethical dilemmas, scientific breakthroughs, and ongoing exploration of their therapeutic potential.

Stem Cell Research

In 1998, American cell biologist James Thomson and his Wisconsin-based team achieved a groundbreaking milestone by isolating human embryonic stem cells (ESCs) from donated embryos, providing a significant leap in creating diverse cell types. Stem cells, versatile cells capable of giving rise to various specialized cell types, present the prospect of nearly limitless applications in the body. Embryonic stem cells, specifically pluripotent, possess the capacity to transform into almost any specialized cell, offering unparalleled value for researchers. In contrast, adult stem cells, primarily multipotent, exhibit limited variety in the cell types they can generate.

Clinical use of adult stem cells dates back to the 1960s when bone marrow transplants were initiated as a treatment for various blood cancers. In this procedure, haematopoietic stem cells (HSCs), responsible for all blood cell types, are extracted from the patient’s or a compatible donor’s pelvic marrow. After eradicating cancerous blood cells through radiation, the HSCs are reintroduced into the bloodstream.

Thomson’s embryonic stem cell research faced opposition from the Catholic Church and contentious debates surrounding the moral implications of extracting cells from unused embryos. Although there were regulatory restrictions, subsequent advancements, such as Shinya Yamanaka’s discovery in 2006, enabled the genetic alteration of multipotent stem cells, transforming them into pluripotent cells. This breakthrough expanded the potential sources of stem cells beyond embryos.

Controversy persists in stem cell research, with ethical considerations surrounding the right to life of embryos and the moral duty to develop treatments for severe diseases. Directed differentiation, a process converting pluripotent stem cells into specific cell types, facilitates the growth of tissues like heart muscle, brain, and retinal cells. Reprogrammed stem cells are crucial in clinical trials targeting heart disease, neurological conditions, retinal disease, and type 1 diabetes.

In summary, the evolution of stem cell research encompasses ethical dilemmas, scientific breakthroughs, and ongoing exploration of their therapeutic potential.

Nanomedicine

Nanomedicine involves manipulating materials at an atomic scale to monitor, repair, build, and control bodily systems. Nanostructures, measuring less than 100 nanometres (nm) in at least one dimension, have applications ranging from food packaging to electronics. However, it wasn’t until 1999, with the publication of American nanotechnologist Robert Freitas’s Nanomedicine, that the idea of using nanotechnology in medicine gained widespread attention.
One area of exploration within nanomedicine is the study of quantum dots (QDs) as biomarkers for diagnosis and treatment. Quantum dots are nanoparticles, tiny crystals (less than 20nm across) made of semiconducting materials. These crystals, sensitive to light, emit photons when excited by specific wavelengths. Depending on their size, quantum dots emit red, orange, blue, or green light.

While most QDs are composed of potentially toxic materials like zinc sulphide, they are coated with polymers to shield the body. This coating mimics receptors on body cells, allowing QDs to bind to them. Coated QDs serve as biomarkers, highlighting the presence of target cells, such as cancer cells before symptoms manifest. Additionally, scientists are exploring the use of QDs to precisely deliver drugs to specific cells, minimizing damage to healthy cells.

Robotics and Telesurgery

The development of medical robots traces back to the 1980s when UK-based medical robotics engineer Brian Davies introduced a robot named PROBOT with some autonomous functions. In 1991, PROBOT was utilized in a clinical trial for prostate surgery. Subsequently, AESOP, designed in the US, emerged, demonstrating the ability to manipulate an endoscope inside the body during surgical procedures. In 1998, the ZEUS system achieved a milestone by performing the first robotic coronary artery bypass surgery. By the time Marescaux utilized it, ZEUS could manipulate 28 different surgical implements.

There are three primary types of robotic surgery systems. Shared-control robots provide support to a surgeon’s hand and manipulate instruments but lack autonomy. Telesurgical robots, exemplified by ZEUS, are remotely controlled from a console, with the robot’s arms acting as scalpels, scissors, graspers, and cameras. Supervisory-controlled robots exhibit the highest level of autonomy: a surgeon inputs data and the robot executes controlled motions to perform the surgery. Presently limited to simple operations, the future holds the potential for sophisticated autonomous robotic surgeons capable of undertaking complex procedures.

Robotics and Telesurgery

The development of medical robots traces back to the 1980s when UK-based medical robotics engineer Brian Davies introduced a robot named PROBOT with some autonomous functions. In 1991, PROBOT was utilized in a clinical trial for prostate surgery. Subsequently, AESOP, designed in the US, emerged, demonstrating the ability to manipulate an endoscope inside the body during surgical procedures. In 1998, the ZEUS system achieved a milestone by performing the first robotic coronary artery bypass surgery. By the time Marescaux utilized it, ZEUS could manipulate 28 different surgical implements.

There are three primary types of robotic surgery systems. Shared-control robots provide support to a surgeon’s hand and manipulate instruments but lack autonomy. Telesurgical robots, exemplified by ZEUS, are remotely controlled from a console, with the robot’s arms acting as scalpels, scissors, graspers, and cameras. Supervisory-controlled robots exhibit the highest level of autonomy: a surgeon inputs data and the robot executes controlled motions to perform the surgery. Presently limited to simple operations, the future holds the potential for sophisticated autonomous robotic surgeons capable of undertaking complex procedures.

Regenerative Medicine

The field of organ transplantation faces challenges, notably limited organ availability and issues related to tissue rejection. Addressing these obstacles, the emerging field of regenerative medicine focuses on “regenerating” human cells and tissues, offering the potential for customized organ growth.

A pivotal moment came in 2006 when Japanese researcher Shinya Yamanaka discovered that multipotent stem cells, that have the capacity to develop into various specialized cell types within a specific organ, could be reprogrammed into pluripotent cells. This breakthrough involved reversing the development of multipotent cells, transforming them into immature cells with the capacity to evolve into diverse body cell types.

Building upon Yamanaka’s findings, researchers at Heriot-Watt University in Edinburgh, Scotland, achieved a significant milestone in 2015. They developed a 3D printing process capable of printing human stem cells derived from a donor’s own tissue. This innovation opened avenues for creating laboratory-grown human tissue applicable to transplantation and pharmaceutical research.

In 2019, Brazilian researchers took a notable step by reprogramming human blood cells to generate hepatic organoids, essentially “mini livers” mimicking normal liver functions. While currently limited to miniature livers, this technique holds promise for producing entire organs suitable for transplantation.

Regenerative Medicine

The field of organ transplantation faces challenges, notably limited organ availability and issues related to tissue rejection. Addressing these obstacles, the emerging field of regenerative medicine focuses on “regenerating” human cells and tissues, offering the potential for customized organ growth.

A pivotal moment came in 2006 when Japanese researcher Shinya Yamanaka discovered that multipotent stem cells, that have the capacity to develop into various specialized cell types within a specific organ, could be reprogrammed into pluripotent cells. This breakthrough involved reversing the development of multipotent cells, transforming them into immature cells with the capacity to evolve into diverse body cell types.

Building upon Yamanaka’s findings, researchers at Heriot-Watt University in Edinburgh, Scotland, achieved a significant milestone in 2015. They developed a 3D printing process capable of printing human stem cells derived from a donor’s own tissue. This innovation opened avenues for creating laboratory-grown human tissue applicable to transplantation and pharmaceutical research.
In 2019, Brazilian researchers took a notable step by reprogramming human blood cells to generate hepatic organoids, essentially “mini livers” mimicking normal liver functions. While currently limited to miniature livers, this technique holds promise for producing entire organs suitable for transplantation.

Face Transplants

Plastic surgery, with roots dating back to ancient Egypt around 1600 BCE, evolved significantly with the advent of microsurgery techniques in the 1970s. This innovation allowed intricate reattachments of skin and body parts, complete with nerves and blood supply. In 1994, a landmark achievement—successfully reattaching the face of a nine-year-old girl in India—emboldened plastic surgeons to explore face transplants.

The inaugural partial face transplant occurred in 2005 when French surgeon Bernard Devauchelle reconstructed a woman’s face. Subsequently, French plastic surgeon Laurent Lantieri claimed the first full face transplant in 2008 on a 30-year-old man. Although Spanish doctors asserted a more intricate face transplant in 2010, Lantieri remained a trailblazer, leading eight of the world’s 42 face transplants by 2020. This included a second operation on the 2008 patient in 2018 after rejection of the initial transplant.

Face transplants hinge on “free tissue transfer,” where a donor’s tissue, with its blood supply temporarily cut off, is reconnected to the recipient’s blood supply. Surgeons benefit from 3D printing, creating models of both donor and recipient for guidance. In a 2017 case in the US, augmented reality computer visualizations aided surgeons in a facial transplant. However, the long-term success remains uncertain, and the use of immunosuppressive drugs to prevent rejection poses an increased risk of severe infections.