Vascularized composite allotransplantation (VCA) enables surgeons to address complex problems that exceed
the possibilities of traditional autologous reconstruction. However, logistical and immunologic challenges currently limit
the widespread application of VCA. Recent breakthroughs in the field of stem cells and tissue engineering have direct implications
for the advancement of VCA. Specifically, the use of bioreactors may prolong ex vivo allograft survival and enable
allograft modulations that mitigate immunogenicity and enhance graft function. Additionally, novel approaches utilizing
bioreactor systems for stem cell seeding of vascularized bioscaffolds provide a blueprint for the de novo generation
of complex tissues. These promising bioreactor-based strategies have the potential to expand the reconstructive applications
of VCA, and could one day allow the fabrication of customized complex tissue grafts.
Keywords: Allograft, bioreactor, complex tissue engineering, stem cells, vascularized composite allotransplantation.
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