Over 1.2 million Australians live with a heart condition. Coronary heart disease is the leading cause of death in Australia, killing 48 people every day. A heart attack occurs every 10 minutes.
“One in every four heart attacks causes irreversible damage,” explains Dr Carmine Gentile, leader of the Cardiovascular Regeneration Group at UTS. “That means every 40 minutes, a heart attack patient is left with a failing heart.”
In these cases, a heart transplant is often the best long-term treatment. But there’s a significant gap between supply and demand – only 100 heart transplants are performed in Australia each year, compared to around 13,000 patients in need. Even then, the lucky few who receive a transplant face the significant risk of transplant rejection, and must take immunosuppressants for the rest of their life. Others die within the first years after receiving a transplant.
“We want to help these patients,” says Dr Gentile.
In a world first, Dr Gentile is using 3D printing technology to create miniature human heart tissues, using personalised bioinks. “We have developed a technology that can 3D model and bioprint personalised hearts for transplantation, using the patient’s own stem cells so that there’s no risk of rejection,” he says. “This will also improve quality of life for patients and their families, and reduce number of deaths post-transplant.”
Roughly the size of half a fingernail, the miniature heart tissue not only gives researchers the ability to develop targeted treatments and therapies without the need for animal testing, it could also be used to regenerate damaged tissue after a heart attack.
“First, we 3D model the entire heart, based on hospital scans. Then, we 3D model the area requiring transplantation, as well as a heart patch to cover the damaged area,” explains Dr Gentile. “This information is then used by the bioprinter to create a beating heart tissue, from the bioink which contains the patient’s stem cells.”
Bringing bioprinting to Australia
Dr Gentile’s journey began in Italy, where he was born. He was training to become a pharmacist, when he developed a strong interest in biomedical research. “UTS is my home now, but I started my journey at the University of Pisa, a city famous for the Leaning Tower and Galileo,” he says. “Back then, I was studying how blood vessels could be mimicked in a test tube using bioreactors. It was a short project, but it led to a lifelong interest.”
After a short chapter working as a pharmacist, he was offered a research position in Charleston, South Carolina – a small city where researchers were innovating the field of bioprinting. “I was working in the lab 24/7 and had the opportunity to explore multiple scenarios for my research,” says Dr Gentile. “I had access to world-class facilities, experts and new technologies.”
In 2013, he was invited to continue his research in Australia.
“I had the opportunity to establish my own research group in this country. Bioprinting was still only just emerging as a technology in the US, and few Australians had heard of it,” says Dr Gentile. But this also meant that he faced some significant barriers – one being that there were no bioprinters in Australia.
“I needed to demonstrate the technology I developed was safe – but I had limited tools to test it,” explains Dr Gentile. He was invited to Harvard Medical School to test his approach, and while there he secured the funds to purchase Australia’s first bioprinter.
“Back then, not many companies were able to manufacture such a specialised tool. We partnered with a company in Spain to build our first customised bioprinter.”
From lab bench to bedside
Today, Dr Gentile’s goal is to bioprint heart tissues that can be safely transplanted into patients – but there’s still a long way to go. “We know patients are in urgent need of a safe alternative to a heart transplant. We’re working hard to further develop our technology and make sure it can be available in the shortest time possible,” he says.
Dr Gentile has brought together a unique multi-disciplinary team at UTS, and is collaborating with clinicians, including surgeons and cardiologists, to help ensure the technology works in a clinical setting.
He is also partnering with the bioprinting and pharmaceutical industries, so that when the technology does become available, it can reach as many patients as possible.
“We are working as a team. It’s the only possible way to achieve our goal,” says Dr Gentile.
“Our studies are driven by our passion, and I’m really pleased by the support my team at UTS has received. We are trying our best to advance the field, and make our technologies widely available.”