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Regenerative Medicine as Applied to General Surgery

Orlando, Giuseppe MD, PhD, MCF*,†; Wood, Kathryn J. DPhil#; De Coppi, Paolo MD, PhD**; Baptista, Pedro M. PharmD, PhD*; Binder, Kyle W. PhD*; Bitar, Khalil N. PhD††; Breuer, Christopher MD‡‡; Burnett, Luke PhD‡,§§; Christ, George PhD*; Farney, Alan MD, PhD; Figliuzzi, Marina BiolSciD‖‖; Holmes, James H. IV MD, FACS§; Koch, Kenneth MD; Macchiarini, Paolo MD, PhD¶¶; Sani, Sayed-Hadi Mirmalek PhD*; Opara, Emmanuel PhD*; Remuzzi, Andrea EngD; Rogers, Jeffrey MD; Saul, Justin M. PhD*,##; Seliktar, Dror PhD***; Shapira-Schweitzer, Keren PhD***; Smith, Tom PhD; Solomon, Daniel MD‡‡; Van Dyke, Mark PhD*,§§; Yoo, James J. MD, PhD*; Zhang, Yuanyuan MD, PhD*; Atala, Anthony MD*,¶; Stratta, Robert J. MD; Soker, Shay PhD*

doi: 10.1097/SLA.0b013e318243a4db

The present review illustrates the state of the art of regenerative medicine (RM) as applied to surgical diseases and demonstrates that this field has the potential to address some of the unmet needs in surgery. RM is a multidisciplinary field whose purpose is to regenerate in vivo or ex vivo human cells, tissues, or organs to restore or establish normal function through exploitation of the potential to regenerate, which is intrinsic to human cells, tissues, and organs. RM uses cells and/or specially designed biomaterials to reach its goals and RM-based therapies are already in use in several clinical trials in most fields of surgery. The main challenges for investigators are threefold: Creation of an appropriate microenvironment ex vivo that is able to sustain cell physiology and function in order to generate the desired cells or body parts; identification and appropriate manipulation of cells that have the potential to generate parenchymal, stromal and vascular components on demand, both in vivo and ex vivo; and production of smart materials that are able to drive cell fate.

This review illustrates the art of regenerative medicine as applied to surgery and demonstrates that this field has the potential to address some of the unmet needs in the treatment of surgical diseases.

*Wake Forest Institute for Regenerative Medicine, Winston Salem, NC

Transplant Surgery, Department of Surgery

Department of Orthopaedic Surgery

§Burn Center, Department of Surgery

Department of Gastroenterology, and

Department of Urology, Wake Forest University School of Medicine, Winston Salem, NC

#Transplantation Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom

**Institute of Child Health, Pediatric Surgery, University College London, London, United Kingdom

††Gastrointestinal molecular motor laboratory, Department of Pediatrics–Gastroenterology, University of Michigan Medical School, Ann Arbor, MI

‡‡Department of Surgery, Section of Pediatric Surgery, Yale University School of Medicine, New Haven, CT

§§Keranetics, Winston-Salem, NC

‖‖Biomedical Engineering Department, Mario Negri Institute for Pahrmacological Research, Bergamo, Italy

¶¶Laboratory of Regenerative Surgery, Karolinska Institutet, Stockholm, Sweden

##Virginia Tech–-Wake Forest University School of Biomedical Engineering and Sciences, Winston-Salem, NC

***Bruce Rappaport Faculty of Medicine and Faculty of Biomedical Engineering, Technion–-Israel Institute of Technology, Haifa, Israel.

Reprints: Giuseppe Orlando, MD, PhD, MCF, The Wake Forest Institute for Regenerative Medicine, Winston Salem, NC; and the University of Oxford, Nuffield Department of Surgical Sciences, Oxford, United Kingdom. E-mail:

Disclosure: No funding sources have been employed. Giuseppe Orlando, MD, PhD, is recipient of the Marie Curie International Outgoing Fellowship POIF-GA-2008-221850, financed by the European Commission under the 7th Framework Program for Research and Development. K.N.B. discloses the following grants: NIH NIDDK5-RC1-DK-087151 and R01-DK-071614. E.O. discloses the grant NIH RO1DK080897.

© 2012 Lippincott Williams & Wilkins, Inc.