From stem cells and cadaveric matrix to engineered organs

The definitive treatment for end-stage heart failure, organ transplant, is limited by the supply of donor organs. Successful allograft recipients suffer significant adverse effects from chronic antirejection medications. Positive clinical treatment of injured myocardium with stem/progenitor cells has led to hope that one day autologous stem-cell-derived whole or partial donor organs can be generated. Advances in the ability to isolate (or generate) stem or progenitor cells that can give rise to beating cardiocyte-like cells and vascular components, and the advent of human iPS cell technology when combined with recent advances in the generation of perfusable complex tissue scaffolds has moved the field closer to creation of a transplantable heart. As cardiac tissue engineering matures, several other simpler cardiac tissues, such as patches for focal use and human cell test beds for drug screening and drug discovery, are emerging.