Challenges in Creating Whole Organs
Despite years of investigation, the successful development of 3-D matrix scaffolds that will successfully support a recellularized, functional organ has many barriers to overcome, according to Stephen Badylak, M.D., Ph.D., a professor in the department of surgery at the University of Pittsburgh.
Dr. Badylak believes that the extracellular matrix (ECM) represents an ideal support scaffold for regenerative medicine applications. “Recent advancements in decellularization and recellularization techniques and promising preclinical studies suggest that organ engineering is a very real possibility in the foreseeable future,” he stated.
Yet Dr. Badylak enumerated many formidable challenges, including the appropriate choice of candidate species from which the donor organ can be harvested, optimal methods of removing and reintroducing cells into the ECM, and selection of the most appropriate cell populations.
He cautioned that none of the whole-organ grafts produced to date have been used to replace or support function in vivo for more than a few hours, aside from skin grafts.
The formation of fibrotic tissue and scarring is a significant problem in the engineering of artificial organs. In the case of skin, in which vascularization has not sufficiently occurred, extensive scarring can profoundly compromise the quality of life for patients.
For this reason, Dr. Badylak suggests that protocols in which vascularization is promoted would improve the outlook for all types of whole-organ engineering. Sounding a cautionary note, Dr. Badylak stated, “it is important not to claim victory prematurely and create overly optimistic expectations until indisputable success in animal models of organ failure is demonstrated.”