TY - JOUR
T1 - Challenges, highlights, and opportunities in cellular transplantation
T2 - A white paper of the current landscape
AU - the ASTS Cellular Transplantation Committee
AU - Parsons, Ronald F.
AU - Baquerizo, Angeles
AU - Kirchner, Varvara A.
AU - Malek, Sayeed
AU - Desai, Chirag S.
AU - Schenk, Austin
AU - Finger, Erik B.
AU - Brennan, Todd V.
AU - Parekh, Kalpaj R.
AU - MacConmara, Malcolm
AU - Brayman, Kenneth
AU - Fair, Jeffrey
AU - Wertheim, Jason A.
N1 - Publisher Copyright: © 2021 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2021/10
Y1 - 2021/10
N2 - Although cellular transplantation remains a relatively small field compared to solid organ transplantation, the prospects for advancement in basic science and clinical care remain bountiful. In this review, notable historical events and the current landscape of the field of cellular transplantation are reviewed with an emphasis on islets (allo- and xeno-), hepatocytes (including bioartificial liver), adoptive regulatory immunotherapy, and stem cells (SCs, specifically endogenous organ-specific and mesenchymal). Also, the nascent but rapidly evolving field of three-dimensional bioprinting is highlighted, including its major processing steps and latest achievements. To reach its full potential where cellular transplants are a more viable alternative than solid organ transplants, fundamental change in how the field is regulated and advanced is needed. Greater public and private investment in the development of cellular transplantation is required. Furthermore, consistent with the call of multiple national transplant societies for allo-islet transplants, the oversight of cellular transplants should mirror that of solid organ transplants and not be classified under the unsustainable, outdated model that requires licensing as a drug with the Food and Drug Administration. Cellular transplantation has the potential to bring profound benefit through progress in bioengineering and regenerative medicine, limiting immunosuppression-related toxicity, and providing markedly reduced surgical morbidity.
AB - Although cellular transplantation remains a relatively small field compared to solid organ transplantation, the prospects for advancement in basic science and clinical care remain bountiful. In this review, notable historical events and the current landscape of the field of cellular transplantation are reviewed with an emphasis on islets (allo- and xeno-), hepatocytes (including bioartificial liver), adoptive regulatory immunotherapy, and stem cells (SCs, specifically endogenous organ-specific and mesenchymal). Also, the nascent but rapidly evolving field of three-dimensional bioprinting is highlighted, including its major processing steps and latest achievements. To reach its full potential where cellular transplants are a more viable alternative than solid organ transplants, fundamental change in how the field is regulated and advanced is needed. Greater public and private investment in the development of cellular transplantation is required. Furthermore, consistent with the call of multiple national transplant societies for allo-islet transplants, the oversight of cellular transplants should mirror that of solid organ transplants and not be classified under the unsustainable, outdated model that requires licensing as a drug with the Food and Drug Administration. Cellular transplantation has the potential to bring profound benefit through progress in bioengineering and regenerative medicine, limiting immunosuppression-related toxicity, and providing markedly reduced surgical morbidity.
KW - basic (laboratory) research/science
KW - cellular transplantation (non-islet)
KW - clinical research/practice
KW - islet transplantation
KW - islets of Langerhans
KW - regenerative medicine
KW - stem cells
KW - tissue/organ engineering
KW - tolerance
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U2 - 10.1111/ajt.16740
DO - 10.1111/ajt.16740
M3 - Review article
C2 - 34212485
SN - 1600-6135
VL - 21
SP - 3225
EP - 3238
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 10
ER -