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Rainer Burgkart. 1 Department of Orthopedics, "Klinikum rechts der Isar, " Technical University Munich, Munich, Germany.
Alexandru Tron. 1 Department of Orthopedics, "Klinikum rechts der Isar, " Technical University Munich, Munich, Germany.
Peter Prodinger. 1 Department of Orthopedics, "Klinikum rechts der Isar, " Technical University Munich, Munich, Germany.
Mihaela Culmes. 2 Department of Vascular Surgery, "Klinikum rechts der Isar, " Technical University Munich, Munich, Germany.
Jutta Tuebel. 1 Department of Orthopedics, "Klinikum rechts der Isar, " Technical University Munich, Munich, Germany.
Martijn van Griensven. 3 Department of Trauma Surgery, "Klinikum rechts der Isar, " Technical University Munich, Munich, Germany.
Belma Saldamli. 1 Department of Orthopedics, "Klinikum rechts der Isar, " Technical University Munich, Munich, Germany.
Andreas Schmitt. 4 Department of Sports Orthopedics, "Klinikum rechts der Isar, " Technical University Munich, Munich, Germany.
Address correspondence to: Rainer Burgkart, MD, PhD, Department of Orthopedics, "Klinikum rechts der Isar", Technical University Munich, Ismaninger St. 22, Munich 81675, Germany, E-mail: [email protected]
Introduction
The main reason for the modest translation of tissue engineering methods into clinical practice is the yet unsolved problem of vascularization.1 It is known that the diffusion limit of oxygen in tissues is only 100 to 200 μm.2 Thus, an intact vascular network--or functional substitute--is the prerequisite to realize tissue constructs of more than 400 μm in diameter. In the last decade, many scientists in the field of tissue engineering have focused on solving the problem of vascularization. However, up to now, all approaches have failed to prove applicability for tissue engineering of large tissues or even whole organs in humans (for review see1 ).
In 2004, Mertsching and her group presented a promising idea. They decellularized intestinal segments that were harvested together with their vascular supply to generate a scaffold for tissue engineering with an inherent vascular network. They could provide proof-of-principle with successful decolonization of the vascular network with endothelial cells and survival of seeded stromal cells under dynamic culture conditions.3 Within the last 3 years, the decellularization method was translated to solid organs with great success.4 After decellularization and reseeding with cardiomyocytes, a perfused, pumping rat heart could be generated in vitro.5 Uygun et al. reported the generation and successful transplantation of a recellularized liver graft...