Introduction
The demand for tissue and organ replacement following tissue damage (eg, severe burns) or diseases (eg, cardiomyopathy) is expanding, and, while the number of patients suffering from organ failure is also increasing, there is a significant shortage of organs available for transplantation. Partial lack of organ functionality and nonsevere tissue damage, although not immediately life-threatening and not requiring a transplant, also have important consequences on the patients' quality of life and constitute a source of high costs for a prolonged time. Overall, in the United States, defects and failure in organs or tissues cost more than $400 billion on a yearly basis.
To satisfy the constantly increasing need for donor organs, xenotransplantation strategies have been developed and explored in the past few years, with at times encouraging, at times disappointing results. A number of unresolved issues still keep xenotransplantation strategies far from clinical applications, including acute graft rejection, risk of virus contamination, and the difficulty of achieving a good functionality of organs in a xenogeneic environment.
All these limitations have been driving forces for researchers to strike alternative routes and one of them, tissue engineering, has now become one of the most forward-reaching fields of investigation. It might sound overly optimistic, but some observers argue that, in the not too far away future, tissue engineering technologies and their output will reach the importance presently held by gene technologies. From a more cautious point of view, the giant steps made in the fields of genomics and proteomics on one side and in stem-cell biology and manipulation on the other suggest that indeed new options for organ/tissue repair might soon be available for application in the clinic, at least for certain organs and diseases.
Does this mean that we will get to a stage where we will be able to order "spare parts" for our body as we do for our cars or appliances? At the moment, independently of all ethical consideration, substitution of body parts, different from the first attempts at tissue repair, remains a science fiction scenario.
Presentations held during the 27th International ACHEMA Congress on Chemical Engineering, Environmental Protection and Biotechnology, in Frankfurt am Main, Germany, at the session dedicated to "Tissue Engineering and Organ Repair," addressed these topics and offered an interesting view of the trends and directions in which this exciting field is moving, thus providing a few clues as to what is science and what is still science fiction.
The main fields of research, in which several clinical trials are being performed, are investigations of skin substitutes and bone/cartilage replacements. However, new treatment strategies for heart, liver, pancreas, and neurological diseases are also starting to yield preliminary, but promising, results.
© 2003 Medscape
Cite this: Tissue Regeneration and Organ Repair: Science or Science Fiction? - Medscape - Jul 14, 2003.
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