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❒ 4 ❒ CONTORTIONS Tissue Engineering and the Topological Body Up until now, the question of the relationship between inert matter and life has above all focused on the problem of fabricating living matter from inert matter: the properties of life were located in the chemical composition of living substances . . . . However, a hiatus remains between the production of the substances used by life and the production of the living being itself: in order to affirm that one is approximating life, one would have to be capable of producing the topology of the living being, its particular type of space and the relationship it establishes between an interior and exterior milieu. The bodies of organic chemistry are not topologically distinct from the usual physical and energetic relations. However , the topological condition is perhaps primordial in the living being as such. There is no evidence that we can adequately conceptualize the living being within the framework of Euclidian relations. —Gilbert Simondon, L’individu et sa genèse physico-biologique THE FIELD OF REGENERATIVE MEDICINE, WHICH COMBINES STEM CELL SCIENCE and tissue engineering, has been hailed as a second-generation model of earlier biomedical technologies, such as prosthetics and organ transplantation. It has also been associated with a return to “mechanistic” or “architectural” theories of biology in which the engineering of forces and relations (stress, tension , compressibility, cell-surface interactions) predominates over the semiotics of code, message, and signal. Emerging out of a heritage of reconstructive medicine and in vitro cell and tissue culture, the aim of tissue engineering (TE) is to reconstruct threedimensional living organs and tissues in vitro, from the cellular level up, to then transplant them back into the patient’s body. Unlike reconstructive medicine TE does not simply transfer tissues through microsurgery techniques; it 103 also works to modulate their morphogenesis, in vitro and in vivo. The sources from which living cells can be cultured are multiple—so far, biologists have used the cells of aborted fetuses, frozen embryos, the abandoned foreskins of circumcised children, as well as other discarded tissues, but the most ambitious proposals seek to use therapeutic cloning as a source of autologous (selfto -self) donation of embryonic tissue. Once sourced, these cells are then cultured and multiplied in a three-dimensional form, often with the aid of some kind of scaffold, which may be made out of natural, synthetic, or biodegradable material (or some mixture of these). Thus far, biologists have had most success in developing structural substitutes such as skin (the first commercially available TE product), bone, cartilage, and heart valves, but experiments are also under way to construct more complex metabolic substitutes to compensate for liver and pancreas failure. Another area of study, which I am less concerned with here, involves the direct implantation of stem cells (neural, hematopoietic, and islet) into the body. The first experiments in tissue engineering date back to the early 1990s, but the field as a whole really took off as a result of advances in stem cell biology in the late 1990s. The successful culturing of pluripotent human embryonic stem (ES) cell lines, along with the discovery that adult stem cells were more ubiquitous and more plastic than had previously been thought, led to a deeper understanding of the body’s possibilities of transformation. The reconstruction of organs and tissues, it was thought, could be envisaged not only as a process of in vitro morphogenesis, but more ambitiously as one of reproducible embryogenesis .1 TE has been credited with the potential to overcome the intractable problems associated with organ transplantation and prosthetics—immune reactions, the scarcity of transplantable organs, the limited life span and wearand -tear of medical implants in the body. The fact that TE works with the regenerative possibilities of the body (its ability to recreate itself) would mean that organ scarcity and use-by dates would no longer be an issue. The use of autologous transfers, or even the manipulation of cell-surface interactions, it is predicted , will displace the problem of immunogenicity. In this sense TE is hailed as an upgraded version of these earlier biomedical technologies. But is there an essential continuity between TE and the organ technologies of the mid-twentieth century? Are they working with the same concept of animation , of bodily (re)generation and transformability? In this chapter I argue 104 Contortions ❒ that the techniques of reproducible morphogenesis exploited in TE differ in fundamental respects from the biomedical paradigm of organ transplantation and prosthetics. These differences are first of all...

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