The 20th century saw a revolution in the form of the concept of organ transplantation. However, despite technological advances, the chief concern of mismatch between demand and supply has not yet been addressed. It is quite plausible that the present century will witness yet another breakthrough in the organ transplantation scenario in the form of regenerative medicine and cell based therapy.
Forbes magazine, a few years ago, carried an article that said — stem cells will revolutionise organ transplants. Today, medical science is not far from reaching the goal. In fact, a recent study at Harvard University stated that animal organs can be stripped off their cells and refurbished with human stem cells and when transplanted may be able to replace damaged organs in the human body. However, achieving this goal is not as simple as in theory. Nonetheless, the possibility of utilising stem cells for organ transplantation is promising and researchers are working on the same to facilitate transition of the technology from bench to bed side.
What does regenerative medicine offer?
Although organ replacement is seemingly successful (kidney, liver, heart being the common organs transplanted), for decades now, the issue of donor organ shortage remains unanswered. A bee-line exists for transplantation surgeries with waiting periods that have been reported to be more than six months. Ultimately, many patients still die due to unavailability of organs at the required time. Additionally, several ethical issues related to medical tourism (for transplantation), monetary compensation for organ donation, organ trafficking crimes are widespread due to limited supply of organs.
The promising field of regenerative medicine and cell based therapy can be explored to augment organ function as well as repair and regenerate damaged organs by utilising the body’s own repair and healing mechanisms. This will aid to address the current needs of organ transplantation, namely inexhaustible source of tissues and immune-suppression free transplantation.
Another concern with conventional organ transplantation is the need for long term immunosuppressive agents in order to prevent rejection of donor graft rejection. Prolonged suppression of the immune system is not advisable and may lead to side effects. The advantage of cell based therapy lies in the fact that, along with the properties of self renewal, multi-differentiation potential and anti-inflammation, these cells are also potent immunomodulatory agents. What can be achieved through this form of therapy is safe and effective regeneration of organs and tissues, by utilising cells and growth factors from the patients’ own body.
The existing dogma of organ transplantation is being challenged by the advent of regenerative medicine. Stem cells present with unexplored properties in transplantation immunobiology can contribute significantly towards evolution of newer therapeutic avenues in organ replacement. Tissue engineering is another advanced modality which ties together concepts of stem cell biology, medicine and biomedical and chemical engineering. Research in this field is ongoing to develop heart, lungs and kidney in the lab and advancing the final engineered organ to clinical set-ups. While such a possibility may seem unrealistic at this stage, there is extensive ongoing research activity and soon we will witness a day when organ transplants are replaced by cell transplants.
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