Tissue Engineering and Organ Transplantation in Plastic Surgery: Cutting-Edge Developments

Introduction:

There is an increasing demand for biological parts to be replaced in the medical field. Novel tissue engineering and organ transplantation procedures have made it possible to meet the needs of regenerative medicine. Due to the ongoing recent developments and innovations in plastic surgery, it has the potential and is at the cutting edge of transitioning from traditional clinical procedures to a whole new arena of reconstructive clinical research. Plastic surgeons have attempted and even succeeded in embracing the science behind regenerative medicine. This article will focus on the recent developments in the field of biomedical engineering, organ engineering, stem cell therapy, and molecular advancements that have led to exciting and innovative areas in plastic surgery.

What Is the Role of Tissue Engineering in Plastic Surgery?

Plastic surgery involves the development of functional biologic replacements (substitutes). Hence, the field of tissue engineering applies the principles of life sciences and engineering to introduce cutting-edge novel developments in the field of plastic surgery. So, plastic surgeons are using this amazing technique of tissue engineering to improve patient experience enormously. Knee cartilage and artificial skin are prominent examples of tissue-engineered plastic body parts. Tissue engineering is a wonderful technology that has evolved rapidly in the past few decades.

The human body lacks the ability to regenerate organs or tissues. So, tissue engineering plays a pivotal role in the reconstructive and regenerative fields of plastic surgery as it helps in the restoration, replacement, or repair of tissues and organs.

Stem cells can repair different tissues in the body by growing and differentiating into multiple types of cells. Tissue engineering, therefore, helps to alleviate surgical morbidity in plastic surgery by integrating bio-artificial components in the patient’s tissues to replace damaged body cells and tissues.

Hence, in other words, tissue engineering has a prominent purpose of manufacturing vascularized, physiologically compatible components to repair complicated defects.

Plastic surgeons also work on the same principle by safely gathering adipose tissues present in the subcutaneous tissue. These adipose tissues are an excellent source of adult stem cells. There are three types of multipotent stem cells interspersed between the mature adipose fat cells in the stromal matrix. These include:

1. Preadipocytes.

2. Endothelial cells.

3. Precursor stromal cells.

All these multipotent stem cells have the potential to grow into different tissues. They can be used to treat various diseases in the field of regenerative plastic surgery.

What Are the Different Types of Tissue Engineering Applications Used in Plastic Surgery?

There are three main types of tissue engineering used in regenerative plastic surgery. These include:

• Reparative Stem Cell Technology - These stem cells are generated by reprogramming cells genetically. These stem cells have the potential to shape any stromal matrix, including collagen and adipose matrix.

• Tissue Scaffolds - They are made up of biomaterials, and they have the ability to mimic extracellular matrices in native tissues. Hence, it is essential to provide a proper framework for different tissues and cells.

• Growth Factors - Growth factors are an important component of tissue engineering. For instance, VEGF (vascular endothelial growth factor) helps increase blood circulation and develop the desired tissues in plastic surgery.

These techniques play a critical role in reconstructive plastic surgery.

What Are the Recent Advancements in Tissue Engineering and Organ Transplantation in Plastic Surgery?

• Tissue Engineered Reconstruction - It is a genetically engineered product that makes use of biomaterials, engineered products, stromal cell populations, and physicochemical factors. This solution can be used to replace, repair, or maintain several types of body tissues.

The benefits of using this biogenetically engineered solution are -

1. It is biocompatible.

2. Good functionality.

3. Immunological issues are not involved.

4. There is no morbidity at the donor site.

5. High-quality retention, resistance, and mechanical stability.

The disadvantages of tissue-engineered solution include:

1. High cost.

2. Limited use.

3. Lack of blood supply to the wound edges (diabetic foot ulcer is an example of this).

4. It might have a tumorigenic potency.

5. Difficulty engineering mature tissues.

Some of the biomaterials used for plastic surgery purposes include Hyaluronic acid, collagen, and PMMA (polymethyl methacrylate). They have the advantage of easy accessibility and easy customization. Some of the disadvantages of these biomaterials include foreign body reactions and repetitive injections due to biomaterial absorption.

• Autologous Reconstruction - In this type of reconstruction, a plastic surgeon takes the tissue from a different part of the body to form lost tissues. For instance, in order to recreate a breast, the plastic surgeon usually uses skin of the lower abdomen and adipose tissues from the host’s body itself.

It is a complex procedure with several benefits like -

1. Biocompatible.

2. Immune concerns are very low.

3. Ethical concerns not present.

The disadvantages of this procedure are -

1. Large donor site morbidity.

2. Complex procedure.

3. Costly.

• Implant Based Reconstruction - Artificially prepared materials are used by a plastic surgeon in implant based reconstruction. They are designed to imitate the original tissue.

Advantages -

1. Cost-efficient.

2. Minimizes the risk for disease transmission.

3. Maintains structural integrity.

Disadvantages -

1. Chances of infection.

2. May induce an inflammatory reaction.

3. May not support biological growth in the body.

• Organ Transplantation - It is also known as allogeneic reconstruction. In this procedure, cells, tissues, or organs are transplanted from a non-identical donor to a recipient. Presently, cadaveric transplants are in huge demand. These organs are called allografts.

Advantages -

1. No signs of donor site morbidity.

2. Healthy tissue is obtained.

3. Good donor cell viability.

4. A larger quantity of healthy tissue can be obtained.

Disadvantages -

1. Risk of disease transmission.

2. An immune response is usually triggered.

3. Chances of rejection of the organ transplanted.

4. Tissue typing and tissue matching are required.

5. Ethical restrictions.

Conclusion:

Plastic surgery regeneration and reconstructive procedures involving tissue engineering and organ transplantation techniques are in trend these days. With rapidly emerging newer technologies, these techniques are trying to improve the patient experience. Tissue engineering and organ transplantation have enormously reduced patient mortality and morbidity. However, proper coordination is required among plastic surgeons, researchers, and the healthcare industry. Mankind will benefit by using these cutting-edge technologies. More research should be carried out in this field.