Whole Organ and Tissue Reconstruction in Thoracic Regenerative Surgery

Abstract

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.

Stem Cell Therapeutics of Acute Liver Diseases, Transplantation, and Regeneration

“…Now it become possible to use bio-engineered organs and tissues, though its replacement is very difficult to proceed and practiced for disables [182]. It will lead to the development of strategies to treat age-onset diseases and facilitate stem-cell-based therapies in older individuals [183]. Further, there is an utmost need to have new reagents that could activate recruiting of intrinsic and extrinsic factors to induce or inject or implant progenitor cells into the damaged sites for repairing [184].…”

Current status of tracheal tissue engineering

“…Stem cells, which have the ability to self-renew and differentiation, play a critical role in tissue engineering processing of the scaffolds [9,10]. Airway scaffolds can be seeded by two main kind of cell types: Chondrocytes and epithelial cells.…”

“…Engineering of a new tissue requires; (i) cells for seeding, (ii) a matrix/scaffold on which to seed the cells and (iii) a bioreactor [7][8][9].…”

Coming to terms with tissue engineering and regenerative medicine in the lung

“…An important consideration (as with allogeneic transplants) is the immunological response of the transplant recipient to the bioengineered lung (102,131,189,190). Regardless of the materials used to engineer a lung, generalized immunosuppression will likely be the initial approach to minimizing rejection, although techniques to enhance acceptance of a bioengineered lung containing specific types of scaffold materials and cell types are obviously a major research focus [e.g., biocompatible materials, novel (ideally personalized) sources for stem cells, and cell differentiation techniques].…”