title: Current achievements and future perspectives in whole-organ bioengineering.
abstract: Irreversible end-stage organ failure represents one of the leading causes of death, and organ transplantation is currently the only curative solution. Donor organ shortage and adverse effects of immunosuppressive regimens are the major limiting factors for this definitive practice. Recent developments in bioengineering and regenerative medicine could provide a solid base for the future creation of implantable, bioengineered organs. Whole-organ detergent-perfusion protocols permit clinicians to gently remove all the cells and at the same time preserve the natural three-dimensional framework of the native organ. Several decellularized organs, including liver, kidney, and pancreas, have been created as a platform for further successful seeding. These scaffolds are composed of organ-specific extracellular matrix that contains growth factors important for cellular growth and function. Macro- and microvascular tree is entirely maintained and can be incorporated in the recipient's vascular system after the implant. This review will emphasize recent achievements in the whole-organ scaffolds and at the same time underline complications that the scientific community has to resolve before reaching a functional bioengineered organ.
authors.affiliation: IRCCS Policlinico San Matteo, Department of General Surgery, University of Pavia, Viale Golgi 19, Pavia, 27100, Italy. apeloso@wakehealth.edu.|Wake Forest Institute for Regenerative Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27157, USA. apeloso@wakehealth.edu.
authors.forename: Andrea
authors.initials: A
authors.lastname: Peloso
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27157, USA. adhal@wakehealth.edu.
authors.forename: Abritee
authors.initials: A
authors.lastname: Dhal
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27157, USA. jzambon@wakehealth.edu.
authors.forename: Joao P
authors.initials: JP
authors.lastname: Zambon
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27157, USA. pli@wakehealth.edu.|Department of General Surgery Affiliated Hospital of Nantong University, Nantong University, Nantong, Jiangsu, 226001, China. pli@wakehealth.edu.
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27157, USA. gorlando@wakehealth.edu.|Wake Forest School of Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27517, USA. gorlando@wakehealth.edu.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orlando
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27157, USA. aatala@wakehealth.edu.|Wake Forest School of Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27517, USA. aatala@wakehealth.edu.
authors.forename: Anthony
authors.initials: A
authors.lastname: Atala
authors.affiliation: Wake Forest Institute for Regenerative Medicine, Medical Centre Boulevard, Winston-Salem, NC, 27157, USA. ssoker@wakehealth.edu.
authors.forename: Shay
authors.initials: S
authors.lastname: Soker
mesh_terms: D057005:Bioengineering; D005109:Extracellular Matrix / Q000378:metabolism; D006321:Heart / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000166:cytology / Q000502:physiology; D008099:Liver / Q000166:cytology / Q000502:physiology; D008168:Lung / Q000166:cytology / Q000502:physiology; D009206:Myocardium / Q000166:cytology; D009940:Organoids / Q000166:cytology / Q000637:transplantation; D010179:Pancreas / Q000166:cytology / Q000502:physiology; D023822:Tissue Engineering; D054457:Tissue Scaffolds