3D Bio-Printing

Sue Coatney
NetApp

Biren Gandhi
Cisco

Beom Soo Park

AMAT

Dmitry Dzilno
AMAT

Emmanuel Munguia Tapia

Samsung

Gowri Kamarthy
Lam

Ikhlaq Sidhu
UC Berkeley

College of Engineering
University of California, Berkeley
Fung Technical Report No. 2013.04.17
http://www.funginstitute.berkeley.edu/sites/default/files/3D_Bio-Printing.pdf

April 17, 2013

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The Coleman Fung Institute for Engineering Leadership,

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Abstract: 3D printing is the process of creating a 3D object from a digital model by using additive manufacturing, in which an object is made by adding material layer by layer and fusing it together. This approach
contrasts with traditional manufacturing, in which an object is formed by removing excess material. This
report will focus on 3D printing in the medical field and discuss the current state of technology, disruptive
changes, societal impacts, affected industries, the value net analysis and the opportunities for new businesses.
Currently, 3D printing is being used for dental fabrication and prosthetics manufacturing. In addition,
researchers are actively exploring the potential of printing bones, tissues and organs for replacement. It is
projected that in the next decade there will be significant advancements in this area, which will result in
adoption and commercialization of these technologies. According to the United Network for Organ Sharing (UNOS), more than 113,000 patients in the U.S. are currently waiting for an organ transplant. As a result
of this technology, there will be fewer number of people waiting for organ replacement and the mortality
rate for organ replacements either from the wait time or from issues relating to recipients compatibility
with transplanted organ will be greatly reduced.
As these technologies advance, several regulatory and societal factors will need to be addressed. For
example, since the tissue or organ will have to be matched to the recipient, FDA approvals will be necessary. Societal factors, such as athletes enhancing their performance with additional 3D-printed muscle
tissue, would have to be considered and regulated. Another major shift would be longer life expectancy,
which would impact retirement, savings, social security, and Medicare.
The industries that will be impacted positively with this technology include computer-aided design companies, hospitals and insurance companies saving on expenses related to transplant logistics, stem cell
storage and harvesting. The industries that will be negatively impacted include dialysis centers, companies
that manufacture pacemakers and heart valves, organ-replacement logistics and transportation.
In summary, 3D bio-printing will have a huge impact on society and peoples lives, along with tremendous
business opportunities.

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Introduction of 3-D Bio-Printing

A 3D printed object is printed in layers, and then the layers are joined or fused together. 3D printing
is currently prohibitively expensive, so it is not yet a viable replacement for high-yield
manufacturing. However, 3-D printing is very effective at designing prototypes or replacing custom
parts. For example, BMW is currently creating car part prototypes using 3D printing. 3D printing is
also being used for rapid prototyping in research labs and industries as well as in industrial design,
engineering, architecture, construction, automotive, jewelry, dentistry, medicine, civil engineering,
automotive, aerospace, and education.

Hypothesis
3D printing is evolving quickly from rapid prototyping to having wider industrial application,
particularly for custom or unique parts. In the medical field, this will have a disruptive impact on
bone, tissue, and organ replacement, as they are bio-printed instead of sought for in compatible
donors. As a result, there will be a drastic positive shift in quality of life with corresponding impacts
in business, government, and society.
We emphasize that 3D printing is likely to affect many facets of society, but this paper focuses
primarily on the medical field.

3D Bio-Printing Technology [17]

3D printing is increasingly permitting the direct digital manufacture (DDM) of a wide variety of
plastic and metal items. While this in itself may trigger a manufacturing revolution, far more
startling is the recent development of bio-printers. These artificially construct living tissue by
outputting layer upon layer of living cells. Currently, all bio-printers are experimental. However, in
the future, bio-printers they could revolutionize medical practice as yet another element of the New
Industrial Convergence.
Bio-printers may be constructed in various configurations. However, all bio-printers output cells
from a bio-print head that moves left and right, back and forth, and up and down, in order to place
the cells exactly where required. Over a period of several hours, this permits an organic object to be
built up by accumulating a great number of very thin layers.
In addition to outputting cells, most bio-printers also output a dissolvable gel to support and protect
cells during printing. A possible design for a future bio-printer appears below and in the sidebar,
here shown in the final stages of printing out a replacement human heart.

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Bio-printing Pioneers
Several experimental bio-printers have already been built. For example, Professor Makoto Nakamura
realized in 2002 that the droplets of ink in a standard inkjet printer are about the same size as
human cells. He therefore decided to adapt the technology, and by 2008 had created a working bioprinter that can print out bio-tubing similar to a blood vessel. In time, Professor Nakamura hopes to
be able to print entire replacement human organs ready for transplant. One can learn more about
this groundbreaking work here or read this message from Professor Nakamura.
Another bio-printing pioneer is the company Organovo. This company was set up by a research
group lead by professor Gabor Forgacs of the University of Missouri. In March 2008, it managed to
bio-print functional blood vessels and cardiac tissue using cells obtained from a chicken. Their work
relied on a prototype bio-printer with three print heads. The first two of these output cardiac and
endothelial cells, while the third dispensed a collagen scaffold (which is now termed 'bio-paper') to
support the cells during printing.
Since 2008, Organovo has worked with a company called Invetech to create a commercial bio-printer
called the NovoGen MMX. This bio-printer is loaded with bio-ink spheroids that contain an
aggregate of tens of thousands of cells. To create its output, the NovoGen first lays down a single
layer of a water-based bio-paper made from collagen, gelatin or other hydrogels. Bio-ink spheroids
are then injected into this water-based material. As illustrated below, more layers are subsequently
added to build up the final object. Amazingly, Nature then takes over and the bio-ink spheroids
slowly fuse together. As this occurs, the bio-paper dissolves away or is otherwise removed, thereby
leaving a final bio-printed body part or tissue.

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As Organovo have demonstrated, their bio-ink printing process it is not necessary to print all of the
details of an organ with a bio-printer, as once the relevant cells are placed in roughly the right place,
Nature completes the job. This point is powerfully illustrated by the fact that the cells contained in a
bio-ink spheroid are capable of rearranging themselves after printing. For example, experimental
blood vessels have been bio-printed using bio-ink spheroids comprised of an aggregate mix of
endothelial, smooth muscle and fibroblast cells. Once placed in position by the bio-print head, the
endothelial cells migrate to the inside of the bio-printed blood vessel, the smooth muscle cells move
to the middle, and the fibroblasts migrate to the outside with no technological intervention.
In more complex bio-printed materials, intricate capillaries and other internal structures also form
naturally after printing has taken place. The process may sound almost magical, but as professor
Forgacs explains, it is no different than how cells of an embryo know how to configure themselves
into complicated organs. Nature has been evolving this amazing capability for millions of years. Once
in the right places, appropriate cell types somehow just know what to do.
In December 2010, Organovo create the first blood vessels to be bio-printed using cells cultured from
a single person. The company has also successfully grafted bio-printed nerves into rats, and
anticipates human trials of bio-printed tissues by 2015. The company expects that the first
commercial application of its bio-printers will be to produce simple human tissue structures for
toxicology tests. These will enable medical researchers to test drugs on bio-printed models of the
liver and other organs, thereby reducing the need to test drugs on animals.
Once the human trials are complete, Organovo hopes that its bio-printers will be used to produce
blood vessel grafts for use in heart bypass surgery. The company intends to develop a wider range of
tissue-on-demand and organs-on-demand technologies. To this end, researchers are now working on
tiny mechanical devices that can artificially exercise and hence strengthen bio-printed muscle tissue
before it is implanted into a patient.
Organovo anticipates that its first artificial human organ will be a kidney, one of the more
functionally straightforward parts of the body. The first bio-printed kidney may in fact not even need
to look just like its natural counterpart. Rather, it need only be capable of cleaning waste products
from the blood. You can read more about the work of Organovo and Professor Forgac's in this article
from Nature.

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Regenerative Scaffolds and Bones

Another research team with the long-term goal of producing human organs on-demand created the
Envisiontec Bioplotter. Like Organovo's NovoGen MMX, the Bioplotter prints bio-ink 'tissue
spheroids' and supportive scaffold materials including fibrin and collagen hydrogels. However, the
Bioplotter can also print a wider range of biomaterials, including biodegradable polymers and
ceramics that may be used to support and form artificial organs and to serve as bio-printed
substitutes for bone.
A team led by Jeremy Mao at the Tissue Engineering and Regenerative Medicine Lab at Columbia
University is working on the application of bio-printing in dental and bone repairs. A bio-printed,
mesh-like 3D scaffold in the shape of an incisor has already been successfully implanted into the
jawbone of a rat by using tiny, interconnecting micro channels that contain stem cell-recruiting
substances. Just nine weeks after implantation, these triggered the growth of fresh periodontal
ligaments and newly formed alveolar bone. In time, this research may enable people to be fitted with
living, bio-printed teeth, or scaffolds that will cause the body to grow new teeth all by itself. You can
read more about this development in this article from The Engineer.
In another experiment, Mao's team implanted bio-printed scaffolds in the place of the hipbones of
several rabbits. These were then infused with growth factors. As reported in The Lancet, every rabbit
grew new and fully functional joints around the mesh over a four-month period. Some even began to
walk or place weight on their new joints only a few weeks after surgery. Over the next decade, human
patients may therefore be fitted with bio-printed scaffolds that will trigger the grown of replacement
bones. In a similar development, a team from Washington State University has also recently reported
on four years of work using 3D printers to create a bone-like material that may in the future be used
to repair damage to human bones.
In Situ Bio-printing
The aforementioned progress will in time permit organs to be bio-printed in a lab from a culture of a
patient's own cells. Such developments could spark a medical revolution. Researchers are
already trying to go further by developing techniques that will enable cells to be printed directly onto
or into the human body in situ. Doctors may therefore be able to scan wounds and spray on layers of
cells to heal patients almost instantaneously.

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A team of bio-printing researchers lead by Anthony Alata at the Wake Forrest School of Medicine has
already developed a skin printer. In initial experiments, the team has taken 3D scans of test injuries
inflicted on some mice and has used the data to control a bio-print head that has sprayed skin cells, a
coagulant and collagen onto the wounds. The results are also very promising: the wounds healed in
just two or three weeks, compared to the control group mices recovery time of five or six weeks.
Funding for skin-printing is coming in part from the US military, which is keen to develop in situ
bio-printing to help heal wounds on the battlefield. At present, the work is still in a pre-clinical
phase. Alata is making progress in this research by using pigs, but trials using human burn victims
could be as little as five years away.
Bio-printers have vast and phenomenal potential to change and save lives. In perhaps a few decades,
it may be possible for robotic surgical arms tipped with bio-print heads to enter the body, repair
damage at the cellular level, and then repair the point of entry on their way out. Patients would still
need to rest and recuperate for a few days to allow bio-printed materials to fully fuse into mature and
living tissue. However, most patients could potentially recover from very major surgery in less than a
week.
Cosmetic Applications
Along with allowing keyhole bio-printers to repair organs inside a patient during an operation, in
situ bio-printing could have cosmetic applications: for example, face printers. Face printers would
evaporate existing flesh while simultaneously replacing it with new cells to exact patient
specifications. People could therefore download a face scan from the Internet and have it applied to
their heads. Alternatively, some teenagers may have their own face scanned, then reapplied every few
years to achieve the appearance of perpetual youth.

The idea of having the cells of your face slowly burnt away by a laser and reprinted to order may
sound like a nightmare that nobody would ever choose to endure. However, as we all know, many
people today go under the knife to achieve far less cosmetically. When the technology is available to

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create them, face printers let alone printers capable of printing new muscles without the hassle of
exercise are very likely to find a market.
Bio-printing Implications
As bio-printers enter medical application, replacement organs will be output to individual patient
specifications. As every item printed will be created from a culture of a patient's own cells, the risk of
transplant organ rejection should be very low.
Together with developments in nanotechnology and genetic engineering, bio-printing may also prove
a powerful tool for those in pursuit of life extension. Mainstream bio-printing will also inevitably
drive further the New Industrial Convergence, with doctors, engineers and computer scientists all
increasingly learning to manipulate living tissue at its most basic cellular level [17].

Technology Progression
3D printing technology for medical applications is presently an active topic of research. For instance,
there are early stage laboratory prototypes demonstrating on how to print medication, new skin,
cartilage and bones (like skull fragments), replacement tissue (such as blood vessels and heart
tissue), and even complete replacement organs (such as kidneys and embryonic stem cells.) The
subsections below briefly describe practical progress made in each of these areas.
Printing medication. A team of researchers at the University of Glasgow, led by Cronin Lee [13]
created a 3D printing application that prints laboratory equipment specific to the experiment they
wish to run. Cronin indicates that this technology is the first step towards technology that could
allow people print their own medicine at home. With a custom-built 3D printer and chemical inks,
users would download the appropriate molecules to perform molecular assembly on the fly.
Printing skin. The last 25 years have seen great advances in creating tissue-engineered skin, which
could replace skin damaged from burns, skin diseases and other causes. Recently, scientists have
added 3D printed skin to their repertoire. Lothar Koch [5] of the Laser Center Hannover in Germany
and colleagues laser-printed skin cells, as reported September 2010 in the journal Tissue
Engineering Part C: Methods.
Printing cartilages and bones. 3D cell-printing efforts have also begun focusing on reproducing
the skeletal system. In 2011, researchers in Washington State University [8] used a 3D printer to
create a bone-like material and structure that acts as a scaffold upon which new bone can grow.
Similarly, Lothar Koch [5] of the Laser Center Hannover in Germany and colleagues have developed
laser printing to create grafts from stem cells that could develop into bone and cartilage. Their work
was published in January 2011 in the journal Tissue Engineering Part C: Methods. In May of this
year, CNET reported that 75 percent of an American patient's skull was surgically replaced with a
custom-made implant produced by a 3D printer from Oxford Performance Materials [7].

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Printing replacement tissue. Printing replacement tissue to patch or fix existing organs is
another active area of research. For example, researchers developed a "heart patch" made of 3Dprinted cells that could repair damaged hearts. Ralf Gaebel of the University of Rostock, Germany,
and his colleagues [10] made such a patch using a computerized laser-based printing technique. They
implanted these heart patches into the hearts of rats that had suffered heart attacks. The patched
hearts showed improvement in function, the scientists reported in December 2011 in the journal
Biomaterials. Gabor Forgacs from the University of Missouri in Columbia and colleagues [12]
printed blood vessels and sheets of cardiac tissue that "beat" like a real heart. Their work was
published in March 2008 in the journal Tissue Engineering. Forgacs and others started a company
called Organovo to bring these products to market. A group at the German Fraunhofer Institute [11]
created blood vessels by printing artificial biological molecules with a 3D inkjet printer and zapping
them into shape with a laser.
Printing replacement organs. In a stirring talk from TED2011, Anthony Atala [6] described his
research in the development of an organ-printing 3D printer. Atala introduced a product of a similar
technology a bladder grown by borrowed cells. He believes this technology could be a solution to
the present crisis of the shortages in donated organs.
Printing human embryonic stem cells. Stem cells can now be printed, at least in the lab. In a
study published February 5, 2013 in the journal Science, researchers from the University of
Edinburgh [9] describe a valve-based cell printer that prints living human embryonic stem cells. The
cells could be used to create tissue upon which to test drugs or grow replacement organs, the
scientists report.
Studying cancer with printed cells. Printing cells could lead to better ways of studying diseases
in the lab. Researchers are already using automated systems to print ovarian cancer cells onto a gel
in a lab dish where the cells could be grown and studied. The printing approach could enable
scientists to study cancerous cells in a more systematic environment, and use them to test
treatments. The study, led by biomedical engineer Utkan Demirci of Harvard University Medical
School and Brigham and Women's Hospital, was published February 2011 in Biotechnology
Journal.

Research into 3D bio printing is still in its early stages, but it is occurring today in laboratories
around the world. We believe, by analyzing existing trends, that some of these technologies will be
adopted within the next three to five years. Namely, (1) specific organ tissue replacement for
important organs such heart and kidney, (2) personalized replacement 3D printed joints with custom
fit, and (3) 3D printed organ replacement will become available. For the next five to 10 years,
technological adoption will become widespread and commercialized as the technology continues to
mature. 3D technology may become commercialized in this order: (1) Replacement 3D printed
organs commonly available at affordable cost, (2) Liver, Kidney replacement companies achieve
maturity, (3) 3D printed tissue replacement for all body organs available, and (4) 3D printed
medicine [12] widely available.

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The diagram below summarizes our beliefs in how 3D printing technology will evolve from todays
laboratory research and early prototypes into adoption (within three to five years), and eventually
into widespread commercialization as the technology matures (in five to 10 years).

Research (today)
-Printing medication
-Printing new skin
-Printing cargilage and bones
-Printing replacement tissue
-Printing replacement organs
-Printing stem cells

Adoption (3-5 years)

-Speci?ic organ tissue
replacement for important
organs such heart and kidney.
- Personalized replacement 3D
printed joints (hip, knee) with
custom ?it
- Life saving 3D printed organ
replacement (high cost)

Commercialization (5-10 years)

- Replacement 3D printed
organs commonly available at
affordable cost
- Liver, kidney replacement
companies achieve maturity
-3D printed tissue replacement
for all body organs available
-Printing medication [12] at
home widely available

Regulatory and Societal Factors

The ability to 3D bio-print bones, tissue and organs will inevitably have regulatory and societal
impacts. The FDA, which has the charter of both promoting and protecting the publics health, will
play a critical role in how 3D bio-printing is used within the United States. The FDA will need to
approve the process of 3D bio-printing for any bone, tissue, or organ transplants, as well as the
process of implanting these replacement parts into humans and any follow-up care. As every person
has unique DNA and consequently will have unique bone, tissue and organs, there may be additional
regulatory approvals required. These additional hoops every patient will be subject to could stifle the
adoption of the technology.
Another societal factor to consider is performance-enhancing tissue augmentations. Should a
marathon runner, for example, be allowed to have additional muscles bio-printed to enhance their
performance? Should a swimmer be permitted to artificially improve his or her lung capacity?
Should athletes who do so be banned from competing, and how should we detect it? This is also an
issue for soldiers since a superior army could be engineered using bio-printing technology.
These potential enhancements, enabled by 3D bio-printing, could gradually become accepted as
normal as time goes on. One must ask whether bio-printing needs to be regulated or controlled, and
how a good body modification differs from a bad one. Otherwise, society might let technology
move forward without regulation down a path towards potentially irreversible and adverse societal
impacts.

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There are also end-of-life issues that need consideration. If body parts can be easily replaced, will
people opt to stay perpetually young through replacement instead of aging normally? Such a choice
could have dire consequences on population growth, Social Security, and retirement planning.
Furthermore, although it sounds far-fetched now, it may soon be possible to replace the brains of
people who have suffered from strokes or Alzheimers.
One must also inquire after the affordability of 3D bio-printing procedures. If only those who can
afford these procedures receive them, it could lead to significant magnification of the social divide
between those who can and cannot afford the procedures.
Finally, if or when the technology for printing medications at home becomes available, there will be a
need to regulate what types of medications users are allowed to print. People could easily print
recreational or illegal drugs, or misuse prescription drugs that are not intended for them.

Industries Impacted
Numerous industries will feel the effects of 3D bio-printing technology. While some industries will
benefit, others will be negatively impacted.

Positively-Impacted Industries
Ultimately, the patients who are cured by 3D bio-printing technology are the big winners. However,
several industry segments, described in this section, will see significant benefit as well.
Health insurance companies and government-funded health assistance services (like Medicare or
British Healthcare) will save on recurring costs for chronic health issues. Dialysis treatment costs
$55,000-$75,000 per patient per year. In 2007, Medicare spent $8.6 billion in dialysis costs for
335,000 patients [2]. Likewise, treatments for diabetes costs around $6,000 per year per patient, for
a total cost of $245 billion per year in the United States [1].
Hospitals and insurance companies will also benefit financially from 3D bio-printing as they will no
longer need to spend money on transplant logistics. In addition, both hospitals and surgical supply
companies will benefit as customers flock to the hospitals that have organ transplant capabilities.
Since organ printing relies on the patients stem cells, stem-cell harvesting and storage businesses
will experience a positive boost. Even people who are concerned about what the future might bring
will have stem cells harvested and banked so that they are ready to meet a future potential need.
Computer-assisted design (CAD) software companies such as Rhino and AutoCAD [14] will benefit
from this new expanding market, since designs for replacement organs will need to be created
digitally. Likewise, companies that provide secure storage and movement of the large CAD designs
will also benefit. For example, AutoDesk currently has revenues of $2B. Assuming a 10 percent jump
due to an increased demand for images of replacement organs, AutoDesk will experience a revenue
increase of $200 million annually.

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Negatively-Impacted Industries
The kidney dialysis industry will be significantly affected once replacement kidneys can be 3-D
printed. There are currently two major players in the United States dialysis industry: Fresenius, with
revenues of $3.4B/quarter, and DaVita, with revenues of $2.3B/quarter. The total revenues of this
industry are $22.8B/year. When replacement kidneys become readily available, both companies will
see a significant drop in their revenues.
Diabetes supply companies currently have a market of patients buying blood sugar testing supplies,
insulin, pills and insulin pumps. Were 3D bio-printing to become a commercialized reality, patients
could get a replacement pancreas printed instead. Companies like OneTouch, which is a leading
manufacturer of blood sugar monitors and testing supplies, are at risk. OneTouch is owned by
Johnson & Johnson, which had annual revenue of $2.7B in 2011.
Companies that sell pacemakers and new heart valves are also at risk as replacement hearts become
readily available. For example, Medtronics Cardiac and Vascular Group had annual revenue of
$8.48B and Medtronic Pacing Systems contributed $1.97B to that total. While not all patients would
opt for a bio-printed heart replacement, there is still considerable risk to their revenue stream. [3]
The final industry segment that will be negatively impacted is organ replacement logistics (UNOS)
and transportation.

Value Net Analysis

The products of 3D bio-printing will ultimately be sold not only to patients, but also to hospitals,
medical practices and medical insurance companies. Hospitals that offer bio-printing will see an
influx of patients in their facilities. Health insurance companies are also included in the customer
segment, as they will need to make cost tradeoffs between ongoing patient expenses and the onetime cost of replacing whatever organ is unhealthy.
Suppliers of the 3D bio-printing industry are inkjet printer manufacturers, including Cube, HP,
Cannon, and Stratasys. It is important to note that all of todays inkjet printers will continue to work
as is. They only require that the print nozzles be modified for the new bio-material. The creation of a
new kind of printer designed specifically for 3D bio-printing is an opportunity area.
Partners include current companies that are engaging in 3D printing (not bio-printing), like Cubify,
Cimatron, Perception, 3D Systems, and Stratasys.
The only company that is currently engaging in 3D bio-printing as a business is Organovo, which is
currently operating at a loss despite increasing revenues [4].

Opportunities
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As a rapidly growing ecosystem full of life-saving applications, 3D bio-printing presents

unprecedented business opportunities. Foundational elements of 3D printing technology are the
design model, the printer and the material. Each one of the foundational elements offers a wide array
of business opportunities.
Autodesk Inc.s AutoCAD and similar software companies are championing creation of software
design models compatible for use in 3D printing [14]. At the same time, many medical equipment
makers in the areas of MRI scanning and X-rays are playing close attention to body scans and
generating custom organ design models for bio-printing. Dentists could start utilizing patients
unique teeth layout and bone scans to create friendlier implants and prosthetics. Scanning and
securely storing such scans and making them available at a later stage could itself become an
industry.
A wide majority of todays research in 3D printing repurposes the printing heads and nozzles of
traditional printers. Affordable, medical-grade and reliable 3D printers would surely be a new
dimension for incumbent printer manufactures and could bring out new opportunities for niche
players. A whole new outsourcing industry could emerge based on 3D printing of customized
prosthetics, dentistry and other less-sensitive body parts that can be tailor-made for individual
patients, similar to todays plastic and metal manufacturing industry.
Plastic and metal have been initial materials for rapid prototyping of 3D printing technology in
industrial and automotive verticals. However, 3D bio-printing presents unique challenges as it
requires a variety of synthetic materials suitable for manufacturing tissues, bones, cartilage and
organs. A great deal of research in materials is either attempting to identify such elements, or using
stem cells in conjunction with other synthetic materials. Organovos MMX bio-printer has already
discovered a way of printing live tissue from silicon gel base and stem cells [14]. Other companies are
trying other approaches, including harvesting small batches of stem cells to serve as organic
material. With this approach, researchers hope to minimize or eliminate the rejection rate of organ
implants.
Along with these foundational elements of design, printing and material, there are many affiliated
ecosystems that offer new business opportunities. For example, human organs may be printed in
advance in case of an emergency. There may be opportunities for organ lockers, a system that
provides secure storage and transportation for customers organs. When the cost of 3D scanners and
printers become affordable for personal use, customers might want scanning kiosks.

Summary
3D printing technology is quickly maturing, evolving and expanding beyond the industrial rapid
prototyping stage. It is no longer restricted to lab or research projects a commercial ecosystem is
growing around various domains of application. Healthcare and surgical fields are especially crucial
sectors in the future of 3D printing technology.
The possibility of printing medication [13], new skin, cartilage or bones [15,16] is only the start.
Soon, numerous other bio-printing capabilities will emerge, all the way to printing tissue and

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replacement organs. Providing customized hip or knee joints fitting individual needs is no longer a
dream. Producing tissues or organs from stem cells has already become a reality in labs. It is not
unrealistic to imagine a time in which a majority of peoples organs can be customized and printed in
advance, stored in secure facilities and installed on demand at a later stage.
These advances in 3D printing technology bring out some critical social and regulatory challenges as
well. How far one can go in replacing body parts to increase life span? What is the fine line
separating organ replacement and cloning? How will government benefits and insurance agencies
react to increased longevity? And what are the effects of social divide created through availability of
technology at an affordable cost? All of these questions will soon become critical.
Of course, along with these challenges come tremendous business opportunities. The basic premise
of 3D printing technology relies upon three foundational elements the design, the printer and the
material. Companies that have an early lead in any of those areas could very well set the future
direction and growth of the 3D print ecosystem. In addition to tools and process-related companies,
companies will jump at the chance to fill the demand for body part scanning, secure storage and
transport of organs, surgical procedures for installing organs, and etc. These industries will provide
exponential growth opportunities as a result of the 3D bio-printing technology evolution.
To summarize, 3D bio printing is going to have a huge impact on society and will offer
unprecedented business opportunities in an exploding ecosystem.

References
[1] Diabetes yearly cost in the US: http://www.medicalnewstoday.com/articles/257363.php
[2] US Dialysis information: http://usatoday30.usatoday.com/news/health/2009-08-23dialysis_N.htm
[3] Medtronic 2012 revenue: http://annualreport.medtronic.com/business-overview/index.htm
[4] Organovo Financial Data:
http://markets.ft.com/research//Markets/Tearsheets/Financials?s=ONVO:QXR&subview=Income
Statement&period=a
[5] Lothar Koch, Stefanie Kuhn, Heiko Sorg, Martin Gruene, Sabrina Schlie, Ralf Gaebel, Bianca
Polchow, Kerstin Reimers, Stephanie Stoelting, Nan Ma, Peter M. Vogt, Gustav Steinhoff, and Boris
Chichkov. Tissue Engineering Part C: Methods. October 2010, 16(5): 847-854.
doi:10.1089/ten.tec.2009.0397.
[6] 7 talks on the wonders of 3D printing:
http://www.ted.com/talks/anthony_atala_printing_a_human_kidney.html
[7] 3D-printed implant replaces 75 percent of patient's skull: http://news.cnet.com/830117938_105-57573305-1/3d-printed-implant-replaces-75-percent-of-patients-skull/
[8] WSU researchers make bone-like material using 3D printer:
http://www.3ders.org/articles/20111130-bone-like-material-using-3d-printer.html
[9] Breakthrough: Scientists use 3D printer to produce stem cells:
http://www.3ders.org/articles/20130205-scientists-use-3d-printer-to-produce-human-embryonicstem-cells.html
[10] Patterning human stem cells and endothelial cells with laser printing for cardiac regeneration.

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Insights in Engineering Leadership White Paper

Ralf Gaebel, Nan Ma, Jun Liu, Jianjun Guan, Lothar Koch, Christian Klopsch, Martin Gruene, Anita
Toelk, Weiwei Wang, Peter Mark, Feng Wang, Boris Chichkov, Wenzhong Li, Gustav Steinhoff
Reference- and Translation Center for Cardiac Stem Cell Therapy, Department of Cardiac Surgery,
University of Rostock, 18057 Rostock, Germany., Biomaterials. 2011 Dec ;32 (35):9218-30 21911255
[11] Scientists created artificial blood vessels on a 3D printer:
http://www.3ders.org/Blog%20Posts/scientists-created-artificial-blood-vessels-on-a-3dprinter.html
[12] How to print out a blood vessel:
http://www.nature.com/news/2008/080320/full/news.2008.675.html
[13] Lee Cronin: Print your own medicine:
http://www.ted.com/talks/lee_cronin_print_your_own_medicine.html?utm_source=newsletter_d
aily&utm_campaign=daily&utm_medium=email&utm_content=button__2013-02-07
[14] Autodesk Developing CAD Software to Design, 3-D Print Living Tissue:
http://www.wired.com/design/2012/12/autodesk-3-d-print-tissue/
[15] 3D bio-printers to print skin and body parts:
http://phys.org/news/2011-02-3d-bio-printers-skin-body.html
[16] Bio-printing blog (possibilities of printing kidney, liver or heart):
http://bioprinter.blogspot.com/
[17] Explaining the Future: BIO-PRINTING by Christopher Barnatt
http://www.explainingthefuture.com/bioprinting.html

Biographies
Biren Gandhi:
Currently working as a Principal Architect with Cisco, Biren is spearheading crucial web/mobile
technology initiatives for WebEx Social an Enterprise Collaboration Software offered both onpremise and in the cloud to Fortune 1000 customers. Driven by his passion for practical
innovation, Biren has led a series of Workplace Innovation Network (WIN) initiatives at Cisco to
cultivate grassroots technical leadership. Prior to joining Cisco, he was divisional CTO of several
gaming studios at Zynga and a Sr. Architect at Facebook before that. In between his roles at
Facebook and Zynga, Biren co-founded a startup called AdMunity, a highly engaging collaborative
social platform for the advertising community. He loves sharing interesting, action-oriented articles
on innovation, leadership and organizational culture at http://thoughts.birengandhi.com/. Biren is
actively engaged with a number of nonprofit initiatives in San Francisco and the Bay Area, and
regularly participates in their annual Walk-a-thons.
LinkedIn: linkedin.com/in/birengandhi
Facebook: facebook.com/birengandhi
Twitter: twitter.com/birengandhi
Emmanuel Munguia Tapia: Dr. Emmanuel Munguia Tapia is the leader of the context awareness
project at the advanced software platforms lab in Samsung Research America in San Jose, California.
He directs a group of 15 researchers and four software engineers who focus on developing algorithms

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Insights in Engineering Leadership White Paper

to infer human activity, location and context from sensory, social, location, and interaction data
collected by mobile devices applying data mining, machine learning, and pattern classification
techniques. Dr. Munguia Tapia previously worked for Nokia Research, Oracle America, Mitsubishi
Electric Research, and Intel Research. Dr. Munguia Tapia received his PhD and MS degrees from the
Massachusetts Institute of Technology (MIT) for his work on context awareness, and ubiquitous and
wearable computing. His BS degree (with honors) is from the Instituto Politecnico Nacional (IPN),
Mexico. He was named one of the best graduating engineers by the Mexican National Association of
Schools of Engineering (ANFEI) and received the Presea Lazaro Cardenas Award, one of the highest
recognitions of academic excellence given by the President of Mexico.
Sue Coatney: Sue Coatney is the Technical Director in the Data Protection Group at NetApp. Sue
has architectural responsibility for Synchronous Data Replication where data is replicated to a
backup site. Sue has also worked extensively in High Availability and Clustering solutions on Data
ONTAP at NetApp. Prior to NetApp, Sue worked at Hewlett-Packard on the MPE-XL on device
drivers and backup solutions, and on the HP-ServiceGuard solution, which provided High
Availability solutions for the HP-UX operating system.
Beom Soo Park: Beom Soo Park has a masters degree in laser applications and a Ph.D in the
study of synthetic diamond manufacturing and application using a CVD process. He works on
PECVD systems and processes at Applied Materials.
Gowri Kamarthy: Gowri has a Ph.D in Chemical Engineering from the University of California at
Berkeley, CA. She currently works at Lam in the Etch Product Group.
Dmitry Dzilno: Dmitry is the Senior Director of Engineering Managing Applied Controls
Engineering (ACE) organization at Applied Materials, Inc. ACEs primary charter is to provide
Control System, Electrical Interconnect and AC power distribution solutions to the company
products for the Silicon Systems Group. Dmitry joined Applied Materials in 1996 as Technical
Support Supervisor and has held positions of increasing responsibility in Common Software
Organization and Foundation Engineering. Throughout his career at Applied Materials, Dmitry
helped to drive the innovation agenda by introducing and adopting cutting-edge industrial control
system architecture and technologies for process control. In 2004, Dmitry completed the Applied
System Engineering course with credits from the Cornell University AGU program. Prior to Applied
Materials, Dmitry founded and successfully ran two small companies that operated in the area of
service and medical electronics.

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Copyright 2013, by the author(s).

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Acknowledgement: This paper was created in an open classroom
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public relations of any firm affiliated with any of the authors.

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