Bioreactors for tissue engineering--a new role for perfusionists?

Tissue engineering is an exciting new area of medicine with rapid growth and expansion over the last decade. It has the potential to have a profound impact on the practice of medicine and influence the economic development in the industry of biotechnology. In almost every specialty of medicine, the ability to generate replacement cells and develop tissues will change the focus from artificial organs and transplantation to growing replacement organs from the patient's own stem cells. Once these organs are at a size that requires perfusion to maintain oxygen and nutrient delivery, then automated perfusion systems termed "bioreactors" will be necessary to sustain the organ until harvesting. The design of these "bioreactors" will have a crucial role in the maintenance of cellular function throughout the growth period. The perfusion schemes necessary to determine the optimal conditions have not been well elucidated and will undergo extensive research over the next decade. The key to progress in this endeavor will development of long-term perfusion techniques and identifying the ideal pressures, flow rates, type of flow (pulsatile/nonpulsatile), and perfusate solution. Perfusionists are considered experts in the field of whole body perfusion, and it is possible that they can participate in the development and operation of these "bioreactors." Additional education of perfusionists in the area of tissue engineering is necessary in order for them to become integral parts of this exciting new area of medicine.