Table 1.

Future directions for the use of decellularized scaffolds to bioengineer functional organs

Area	Specific questions	Impact
Scaffold decellularization methods	• Systematic direct comparisons between methods. • Identification of best method for each organ. • Standardization.	Production of high-quality decellularized scaffolds in a reproducible way.
Stem cells	• Isolation from patients • Expansion in culture to large numbers. • Differentiation into specific phenotypes with high efficiency and purity.	Repopulation of scaffolds to bioengineer functional organs in a bioreactor system.
Tissue preservation	• Long-term preservation of decellularized scaffolds (i.e. weeks to months). • Short-term ex vivo preservation of regenerated organs (i.e. days).	Creation of a stock of decellularized scaffolds that can be used on demand. Preservation of bioengineered organs before transplantation.
Transplantation in large animal model	• Functional evaluation • Evaluation of mid- and long-term fate of scaffolds and regenerated organs.	Assessment of outcomes of interest at a human-relevant scale.
Immunologic response	• Type of immunologic response to decellularized scaffolds and regenerated organs, if any. • Evaluation of the feasibility of using decellularized scaffolds from different species in organ bioengineering (“xenoscaffolds”).	Determination of the need for any sort of immunosuppression after transplantation of bioengineered organs. Expansion of the tissue source pool to overcome donor shortage.