Organ transplantation has seen miraculous advances over the last 50 years, but the vast and growing shortage of donor organs limits patients’ access to these lifesaving treatments. Patients who are fortunate enough to receive a transplant face a lifelong battle with immune rejection of the transplanted organ. Technologies to preserve donor organs and other complex tissues during transplantation can impact these problems in many ways, with the potential to transform organ transplantation and many other areas of public health.
Advances in complex tissue preservation can impact organ transplantation by allowing for increasing donor utilization, limiting organ discard, allowing for matching for more organs and across large regions (ideally globally), reducing costs such as the short-notice plane and helicopter transportation often currently needed to arrange transplants within short preservation windows, making possible new immune tolerance induction therapies, enabling techniques for organ rehabilitation and conditioning for transplantation, reducing health disparities, and more.
The benefits of banking organs and other complex tissues also extend far beyond organ transplantation, affecting many broad areas of public health. As is clear from the strategic plan of the Multi-Agency Tissue Engineering Science (MATES) Interagency Working Group (see http://tissueengineering.gov), preservation and banking is a key bottleneck in bioengineering and is needed to enable a shelf-life for logistics, inventory, on-demand access and quality control. This was re-iterated by the Chair of MATES, Dr. Richard McFarland, at the White House Roundtable on May 28, 2015. Banked tissues can be stockpiled for national emergencies, military conflicts, and mass casualty events. Complex tissue preservation could greatly enhance the success of limb salvage, improve research and drug discovery, reduce the reliance on use of animals in scientific experiments, and protect the fertility of patients undergoing chemo and radiation therapy.
Challenge & Sub-Challenge Impact Statements
Cryopreservation techniques that help maintain structural integrity of cells/tissues could assist methods of cell mapping. Better cryopreservation could also improve the availability of well-preserved tissues for mapping experiments.
Related Challenge Topics: Cell Mapping
Cryopreservation can aid in creating and maintaining large stocks of starting materials for biomanufacturing and create large scale cell banks to reliably source different cells types for tissue engineering or emergency medicine (e.g. hematopoietic cells). Importantly, successful cryopreservation would improve the quality and yield of the cells and materials, thus boosting the quality of research, biomanufacturing, or transplant that rely on these sources.
Related Challenge Topic: Cell Sourcing
Cryopreservation would mitigate the time constraints related to immune tolerance induction procedures. Organs/tissue grafts could be preserved until tolerance is induced in the recipient and is ready for transplantation.
Related Challenge Topics: Immune Tolerance
Cryopreservation strategies for minimizing ischemia-reperfusion injury could be applied to minimize organ/graft injury upon integration with the vasculature.
Related Challenge Topics: Integration
Cryopreservation techniques could be used to manipulate cell metabolism (i.e. induce hypometabolic states) in tissues to enable delayed vascularization during engineering. An alternative strategy could cryopreserve small tissue components as building blocks that could later be integrated with vasculature constructs to form larger tissues.
Related Challenge Topics: Vascularization
Cryopreservation would improve the longevity/availability of tissues that would undergo gene editing treatment. Organs/tissues could be stored prior to and after gene editing while awaiting transplant and, with sufficient time, would allow for post-hoc confirmation testing to test for successful gene editing.
Related Challenge Topics: Gene Editing
Cryopreservation that maintains the structural integrity and function of tissues could aid research in general. Well preserved tissue structures would be beneficial in experiments studying the spatial-temporal effects of growth factors in organs/tissues. Secondarily, preservation of specific cell sources for growth factor production may be of interest.
Related Challenge Topics: Growth Factors
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