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New Perspectives in Liver Transplantation: From Regeneration to Bioengineering


New Perspectives in Liver Transplantation: From Regeneration to Bioengineering

Debora Bizzaro et al. Bioengineering (Basel).


Advanced liver diseases have very high morbidity and mortality due to associated complications, and liver transplantation represents the only current therapeutic option. However, due to worldwide donor shortages, new alternative approaches are mandatory for such patients. Regenerative medicine could be the more appropriate answer to this need. Advances in knowledge of physiology of liver regeneration, stem cells, and 3D scaffolds for tissue engineering have accelerated the race towards efficient therapies for liver failure. In this review, we propose an update on liver regeneration, cell-based regenerative medicine and bioengineering alternatives to liver transplantation.

Keywords: end-stage liver diseases; liver bioreactors; liver regeneration; liver tissue bioengineering; regenerative medicine.

Conflict of interest statement

The authors declare no conflict of interest.


Figure 1
Figure 1
Schematic representation of mechanisms of liver regeneration. (A) After liver damage in normal conditions, the principal ways to restore hepatic mass are hyperplasia and hypertrophy. (B) In the cirrhotic liver, the normal regeneration process is impaired and hepatic progenitor cells are involved in restoring liver functions.
Figure 2
Figure 2
Schematic representation of the principal cell sources available for cell therapy and liver bioengineering, with brief description of their pros and cons. HEPs: hepatocytes; HPCs: hepatic progenitor cells; MSCs: mesenchymal stem cells; HSCs: hematopoietic stem cells; EPCs: endothelial progenitors cells; iPSCs: induced pluripotent stem cells; ESCs: embryonic stem cells.
Figure 3
Figure 3
Main pros (green boxes) and cons (red boxes) of the principal liver bioengineering approaches. ECM: extracellular matrix.

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