title: Organ-level tissue engineering using bioreactor systems and stem cells: implications for transplant surgery.
abstract: Vascularized composite allotransplantation (VCA) enables surgeons to address complex problems that exceed the possibilities of traditional autologous reconstruction. However, logistical and immunologic challenges currently limit the widespread application of VCA. Recent breakthroughs in the field of stem cells and tissue engineering have direct implications for the advancement of VCA. Specifically, the use of bioreactors may prolong ex vivo allograft survival and enable allograft modulations that mitigate immunogenicity and enhance graft function. Additionally, novel approaches utilizing bioreactor systems for stem cell seeding of vascularized bioscaffolds provide a blueprint for the de novo generation of complex tissues. These promising bioreactor-based strategies have the potential to expand the reconstructive applications of VCA, and could one day allow the fabrication of customized complex tissue grafts.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Rennert
authors.forename: Michael
authors.initials: M
authors.lastname: Sorkin
authors.forename: Victor W
authors.initials: VW
authors.lastname: Wong
authors.affiliation: Stanford University School of Medicine, Department of Surgery, 257 Campus Drive West, Hagey building GK-201, Stanford, CA 94305-5148, USA. ggurtner@stanford.edu.
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Gurtner
mesh_terms: D064591:Allografts / Q000098:blood supply; D019149:Bioreactors; D001808:Blood Vessels / Q000637:transplantation; D006801:Humans; D013234:Stem Cells / Q000502:physiology; D046509:Tissue Culture Techniques; D023822:Tissue Engineering