Biological reactors as artificial organs

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Artificial organ design generally attempts to provide a substitute for the most basic physiologic functions; for example, an artificial kidney can balance electrolytes and remove excess solutes and water. However, artificial organs are only a compromise and do not completely duplicate natural functions. If we measure success in survival years or compare the condition of the patient on an artificial kidney with his condition before renal failure, we see that the substitute is far from ideal. When present concepts of the artificial kidney are examined, it is obvious that all fall short of duplicating the total function of the natural kidney in (1) adaptation to individual needs through continuous purification, (2) selective transport mechanisms, (3) in situ use, and (4) aiding other physiologic processes. Most artificial organs associated with metabolic or catabolic functions have limitations which prevent their continuous use in situ. New concepts must be explored to achieve any major improvement in substituting organ function.

General concept

At present, we do not understand complete organ function nor the inadequacies of the substitutes now in use. Because a comprehensive knowledge of all uremic toxins is lacking, we do not know whether these toxins are being adequately removed.1 Realizing the shortcomings of present technology, we should reconsider the workings of nature and their application to our specific purpose. The use of living microorganisms as substitutes for normal physiologic functions was thus conceived, and this study was undertaken to apply the concept to renal support.

Microorganisms are biological reactors serving as an. . .



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