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World J Transplant. Mar 18, 2023; 13(3): 86-95
Published online Mar 18, 2023. doi: 10.5500/wjt.v13.i3.86
Transitioning of renal transplant pathology from allograft to xenograft and tissue engineering pathology: Are we prepared?
Muhammed Mubarak
Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Author contributions: Mubarak M is the sole author of the manuscript, and he conceived and designed the study, performed the research, participated in primary and final drafting, and has read and approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammed Mubarak, FCPS, Professor, Department of Histopathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Sindh, Pakistan. drmubaraksiut@yahoo.com
Received: September 20, 2022
Peer-review started: September 20, 2022
First decision: December 13, 2022
Revised: December 21, 2022
Accepted: January 9, 2023
Article in press: January 9, 2023
Published online: March 18, 2023
Processing time: 177 Days and 16.6 Hours
Abstract

Currently, the most feasible and widely practiced option for patients with end-stage organ failure is the transplantation of part of or whole organs, either from deceased or living donors. However, organ shortage has posed and is still posing a big challenge in this field. Newer options being explored are xenografts and engineered/bioengineered tissues/organs. Already small steps have been taken in this direction and sooner or later, these will become a norm in this field. However, these developments will pose different challenges for the diagnosis and management of problems as compared with traditional allografts. The approach to pathologic diagnosis of dysfunction in these settings will likely be significantly different. Thus, there is a need to increase awareness and prepare transplant diagnosticians to meet this future challenge in the field of xenotransplantation/ regenerative medicine. This review will focus on the current status of transplant pathology and how it will be changed in the future with the emerging scenario of routine xenotransplantation.

Keywords: Xenotransplantation; Bioengineered tissues; Pathology; Allograft; Xenograft

Core Tip: End-stage organ failure is a significant public health problem worldwide. Currently, treatment options are limited and organ shortage for allotransplantation is one of the biggest challenges. Alternative options being explored are xenografts and engineered/bioengineered tissues/organs. These developments will pose different challenges for the diagnosis and management of transplant pathologies as compared with traditional allografts. The approach to pathologic diagnosis of dysfunction in these settings will likely be significantly different. Thus, there is a need to increase awareness and prepare transplant pathologists to meet this imminent challenge in the field of xenotransplantation/regenerative medicine.