Whole organ and tissue reconstruction in thoracic regenerative surgery.
Development of novel prognostic, diagnostic, and treatment options will provide major benefits for millions of patients with acute or chronic respiratory dysfunction, cardiac-related disorders, esophageal problems, or other diseases in the thorax. Allogeneic organ transplant is currently available. However, it remains a trap because of its dependency on a very limited supply of donated organs, which may be needed for both initial and subsequent transplants. Furthermore, it requires lifelong treatment with immunosuppressants, which are associated with adverse effects. Despite early clinical applications of bioengineered organs and tissues, routine implementation is still far off. For this review, we searched the PubMed, MEDLINE, and Ovid databases for the following keywords for each tissue or organ: tissue engineering, biological and synthetic scaffold/graft, acellular and decelluar(ized), reseeding, bioreactor, tissue replacement, and transplantation. We identified the current state-of-the-art practices in tissue engineering with a focus on advances during the past 5 years. We discuss advantages and disadvantages of biological and synthetic solutions and introduce novel strategies and technologies for the field. The ethical challenges of innovation in this area are also reviewed.
Advanced Center for Translational Regenerative Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
Mei Ling
ML
Lim
Philipp
P
Jungebluth
Fatemeh
F
Ajalloueian
Linda Helen
LH
Friedrich
Irina
I
Gilevich
Karl-Henrik
KH
Grinnemo
Elena
E
Gubareva
Johannes C
JC
Haag
Greg
G
Lemon
Sebastian
S
Sjöqvist
Arthur L
AL
Caplan
Paolo
P
Macchiarini
D019149:Bioreactors; D006348:Cardiac Surgical Procedures; D013505:Digestive System Surgical Procedures; D006801:Humans; D055633:Immune System Phenomena; D007830:Larynx / Q000601:surgery; D008168:Lung / Q000601:surgery; D016377:Organ Transplantation / Q000009:adverse effects* / Q000592:standards; D044968:Regenerative Medicine / Q000941:ethics / Q000379:methods* / Q000639:trends; D033581:Stem Cell Transplantation; D019616:Thoracic Surgical Procedures / Q000941:ethics / Q000379:methods* / Q000639:trends; D023822:Tissue Engineering / Q000941:ethics / Q000379:methods* / Q000639:trends; D054457:Tissue Scaffolds; D014132:Trachea / Q000601:surgery
3-dimensional; 3D; ECM; IL; MHC; MSC; NCD; SIS; TE; extracellular matrix; interleukin; major histocompatibility complex; mesenchymal stem cell; noncommunicable disease; small intestine submucosa; tissue engineering