Tissue engineering

Imagine patients with peripheral arterial disease who do not have to face the prospect of amputation because they can receive a vascular graft created from their own cells. Or imagine children undergoing heart surgery who do not have to face a lifetime of operations or the risks from synthetic heart valves because they can receive a valve made from their own cells, which can grow with them. These scenarios may sound like science fiction, but they are becoming increasingly realistic options for treatment thanks to tissue engineering.

Every day healthcare professionals are faced with the devastating and expensive implications of the loss or failure of an organ or a tissue. Treatments include organ transplantation or the use of mechanical devices, all of which have well documented problems. Huge advances were made in the 20th century that allow the reconstitution of damaged and lost tissue through organ and tissue transplantation. But need for organs and availability of donors are acutely disparate.

In 2006 in the United States alone about 125 000 patients were on waiting lists for an organ transplant because of end stage organ failure, but only 27 000 transplants were performed, and more than 7000 people died while waiting.1 This provides the driving force for the evolution of surgery, the ultimate aim of which is to be able to engineer tissues and to induce their regeneration.

Tissue engineering, according to one of its pioneers, Joseph Vacanti, director of the Tissue Engineering and Organ Fabrication Laboratory at Massachusetts General Hospital in Boston, involves “combining engineering and the life sciences to produce living replacement structures including tissues and organs to help patients.” It has the potential to revolutionise the treatment of …