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Whole-organ re-engineering: a regenerative medicine approach in digestive surgery for organ replacement

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Abstract

Recovery from end-stage organ failure presents a challenge for the medical community, considering the limitations of extracorporeal assist devices and the shortage of donors when organ replacement is needed. There is a need for new methods to promote recovery from organ failure and regenerative medicine is an option that should be considered. Recent progress in the field of tissue engineering has opened avenues for potential clinical applications, including the use of microfluidic devices for diagnostic purposes, and bioreactors or cell/tissue-based therapies for transplantation. Early attempts to engineer tissues produced thin, planar constructs; however, recent approaches using synthetic scaffolds and decellularized tissue have achieved a more complex level of tissue organization in organs such as the urinary bladder and trachea, with some success in clinical trials. In this context, the concept of decellularization technology has been applied to produce whole organ-derived scaffolds by removing cellular content while retaining all the necessary vascular and structural cues of the native organ. In this review, we focus on organ decellularization as a new regenerative medicine approach for whole organs, which may be applied in the field of digestive surgery.

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Abbreviations

ES:

Embryonic stem

iPS:

Induced pluripotent stem

ECM:

Extracellular matrix

GAGs:

Glycosaminoglycans

EDTA:

Ethylenediaminetetraacetic acid

EGTA:

Ethylene glycol tetraacetic acid

BME:

Basement membrane extract

HLA:

Human leukocyte antigen

OPTN:

Organ procurement and transplantation network

SRTR:

Scientific registry of transplant recipients

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Acknowledgments

We thank Keio University for a special Grant-in-Aid for Innovative Collaborative Research Projects, a grant from the Japan Society for the Promotion of Science KAKENHI (23689059), Takeda Science Foundation to H.Y. and the National Institutes of Health (DK083556) to A.S.-G.

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  1. Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hiroshi Yagi & Yuko Kitagawa

  2. Department of Pathology, Center for Innovative Regenerative Therapies, Department of Surgery, Transplantation Section, Children’s Hospital of Pittsburgh and the Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    Alejandro Soto-Gutierrez

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  1. Hiroshi Yagi
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Correspondence to Alejandro Soto-Gutierrez or Yuko Kitagawa.

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Yagi, H., Soto-Gutierrez, A. & Kitagawa, Y. Whole-organ re-engineering: a regenerative medicine approach in digestive surgery for organ replacement. Surg Today 43, 587–594 (2013). https://doi.org/10.1007/s00595-012-0396-1

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