Sept. 20A5 saw the elec­tion of Cécile Legal­lais – a spe­cial­ist in health tech­nolo­gies – to pre­side over the Euro­pean Soci­ety for Arti­fi­cial Organs (ESAO). Her com­mit­ment to this learned soci­ety goes back some time now and here she now is at its head; ESAO, we recall is an asso­ci­a­tion devot­ed to devel­op­ment of research in organ replace­ment tech­nolo­gies. The actors here are sci­en­tists, clin­i­cal prac­ti­tion­ers, indus­tri­al­ists and academics. 

  Elect­ed in Sep­tem­ber 2015, Cécile Legal­lais, senior CNRS research sci­en­tists, post­ed to UTC, will sit in the Pres­i­den­t’s chair as of Sep­tem­ber 2017. ESAO is a learned soci­ety with between 450 and 550 mem­bers all involved in research work on arti­fi­cial replace­ment organs and it has the par­tic­u­lar fea­ture of pro­vid­ing for a two year lead-time between the elec­tion of a new Pres­i­dent and the lat­ter’s tak­ing office. This elec­tion under­scores Cécile Legal­lais’ high com­mit­ment for over 10 years as a Mem­ber of the Steer­ing Com­mit­tee, then as Sec­re­tary Gen­er­al of this asso­ci­a­tion, cre­at­ed in 1974. Cf. www.esao.org

Mul­ti­ple domains and actors

“The main objec­tive of ESAO is to devel­op and coor­di­nate research into arti­fi­cial organs in Europe”, recalls Cécile Legal­lais, insist­ing on the impor­tance of encour­ag­ing and enhanc­ing exchanges among clin­i­cal prac­ti­tion­ers and more the­o­ret­i­cal research sci­en­tist. To this pur­pose, the asso­ci­a­tion ESAO orga­nized a year­ly con­fer­ence so that mem­bers can ben­e­fit from a glob­al and trans­verse visions of the field. All sorts of spe­cial­ty attend and the par­tic­i­pants come from both the aca­d­e­m­ic and indus­tri­al worlds. Seen in terms of research pos­si­bil­i­ties, the field does cov­er a num­ber of sig­nif­i­cant dis­par­i­ties. “The actors in applied research are some­times dif­fi­cult to mobi­lize to devel­op new med­ical devices to meet today’s needs, more or less sat­is­fac­to­ri­ly met by exist­ing appa­ra­tus and equip­ment”, under­scores Cécile Legal­lais. As an exam­ple, if we reck­on that some 3 mil­lion patients with liv­er dis­or­ders today rely on exter­nal blood cleans­ing equip­ment (haemodial­y­sis), le lat­ter is nonethe­less very strin­gent in use, call­ing for reg­u­lar immo­bi­liza­tion last­ing sev­er­al hours each time. This kind of treat­ment is wor­ri­some process for patients, and yet research in this par­tic­u­lar social­i­ty is not pro­gress­ing. Asso­ciate busi­ness con­cerns are not always con­vinced by the poten­tial gain that could come from adopt­ing more recent tech­niques, in terms of benefits/risks.

Organs or arti­fi­cial functions

Today the tar­get is to com­pen­sate for the func­tions exe­cut­ed by our organs rather than design new arti­fi­cial organs that faith­ful­ly repro­duce the nat­ur­al organs”, explains Cécile Legal­lais. For the kid­neys, com­pen­sato­ry fil­ter­ing comes via exter­nal haemodial­y­sis equip­ment, where­as for the heart, we tend to use either an inter­nal or exter­nal pump rather than a com­plete heart. In France, only three Car­mat ‘com­plete heart pros­the­ses’ have been implant­ed so far. “And cer­tain organs such as our liv­er, have func­tions that are so com­plex that today we sim­ply can­not envi­sion design­ing a suit­able arti­fi­cial sub­sti­tute,” under­lines the research scientist. 

Mak­ing use of nat­ur­al, spe­cialised cells

One of the dif­fi­cul­ties met when implant­i­ng an arti­fi­cial replace­ment organ inside a patien­t’s body s that of the bio­com­pat­i­bil­i­ty of the mate­ri­als in con­tact and in par­tic­u­lar in join­ing up the body’s blood ves­sels to the device input/output tubes. “These are ques­tion now being inves­ti­gat­ed as is the fab­ri­ca­tion of tis­sue”, adds Cécile Legal­lais. Con­trol­ling mate­r­i­al struc­tures at both micro and nano­met­ric scales allows us to assem­ble ‘func­tion-inten­sive’ sur­faces that can serve as sup­ports on which bio­log­i­cal tis­sues can be grown. Tis­sue recon­struc­tion research is now enter­ing exper­i­men­tal phas­es. Work on cells and tis­sues opens up new hori­zons in bio-arti­fi­cial organs research. While, for a long peri­od, we were seek­ing to make new mechan­i­cal devices to com­pen­sate for a fail­ing organ and well-iden­ti­fied, spe­cif­ic func­tions, research sci­en­tists today are won­der­ing how they can make the most of the func­tion spe­cial­ized cells which nat­u­ral­ly ensured those func­tions under nor­mal conditions.