Yagi Hiroshi, Kitagawa Yuko
Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Nihon Geka Gakkai Zasshi. 2012 Sep;113(5):419-23.
New methods to facilitate recovery from end-stage organ failure are needed since only limited treatment options are available in this context, including replacement therapy such as hemodialysis or organ transplantation. Recent progress in the field of tissue engineering has opened attractive approaches for clinical applications of regenerative medicine which could be an option in this regard. Of these, tissue decellularization technology, which retains all the necessary cues for cell maintenance and homeostasis, such as the three-dimensional structure of the organ and its extracellular matrix components, has recently been applied to whole organs. It has demonstrated efficacy in generating an engineered graft that is transplantable by vascular anastomosis. Several different therapeutic targets have been explored and applied clinically. However, the use of this technology in the context of the digestive organs is still under investigation, which is more difficult because of their complicated three-dimensional structure and complex functioning. We applied this technology to the liver and demonstrated its efficacy in recellularized hepatocyte function and three-dimensional structure that was anatomically feasible for transplantation. Recent progress in stem cell technology will facilitate this new method as a novel platform for functional organ grafting in patients with organ failure.
由于在终末期器官衰竭的情况下只有有限的治疗选择,包括诸如血液透析或器官移植等替代疗法,因此需要新的方法来促进从终末期器官衰竭中恢复。组织工程领域的最新进展为再生医学的临床应用开辟了有吸引力的途径,这在这方面可能是一种选择。其中,组织去细胞化技术保留了细胞维持和内环境稳定所需的所有必要线索,如器官的三维结构及其细胞外基质成分,最近已应用于整个器官。它已证明在生成可通过血管吻合移植的工程化移植物方面具有功效。已经探索了几种不同的治疗靶点并在临床上应用。然而,该技术在消化器官方面的应用仍在研究中,由于其复杂的三维结构和复杂的功能,这更具难度。我们将该技术应用于肝脏,并证明了其在重新细胞化的肝细胞功能和解剖学上可行的移植三维结构方面的功效。干细胞技术的最新进展将促进这种新方法成为器官衰竭患者功能性器官移植的新平台。