J.Jpn. Surg. Soc.. 119(4): 387-394, 2018

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Feature topic

3D RESPIRATORY ORGAN CONSTRUCTION AND APPLICATION IN THE FIELD OF SURGERY: THE REGENERATED LUNG AND TRACHEA

In the field of surgery, the trachea and lungs are key respiratory organs that we hope to be able to fabricate. Many approaches to fabricating the trachea have been attempted using artificial materials based on polypropylene and polytetrafluoroethylene, biomaterials including the aorta, and bioengineered tracheas including decellularized scaffolds; clinical applications are already in progress. Given the clinical usage of Good Manufacturing Practice-compliant standard materials and forthcoming clinical trials, commodification in the near future is expected. However, due to repetitive inflation and deflation, the lung is a highly dynamic organ, and thus its 3D organ fabrication presents significant difficulties exceeding those of other organs. There are currently very few reports on organoids, and the only recognized method is based on the use of decellularized scaffolds. However, fabricated lungs currently last only a few hours. Extracellular matrix damage and thrombosis from insufficient recellularization are considered to be contributing factors. From the development of stem cell research, various kinds of cells including ES cells, iPS cells, and mesenchymal cells have been used. With this increase in the selection of available cell types and improvement of regeneration processes such as differentiation and maturation methodologies, progress in organ fabrication is expected. Although studies to fabricate human organs from xenogeneic organs by recellularization on xenogeneic scaffolds are in progress, clinical application of this technology remains a long way off.

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