Diseases desperate grown
By desperate appliance are relieved,
Or not at all.

William Shakespeare Hamlet Act IV, Scene 3
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Decellularisation and Recellularisation
A new approach to overcome organ scarcity by in vitro generation of organoids is decellularisation and recellularisation of tissues or whole organs. This concept is based on the idea of composing biologic scaffolds by removing cellular and antigen-presenting components from tissues or organs, obtaining the organs’ extracellular matrix. The extracellular matrix represents the secreted products of resident cells and preserves the complex architecture and three-dimensional structure of the organ and thus generates a biomatrix ideally suited for reseeding with cells.
Liver Cell Transplantation
Liver transplantation (LTx) is the gold standard for treatment of end-stage liver diseases and liver-based metabolic disorders, but availability is restricted by the shortage of donor organs. Liver cell transplantation (LCT) was developed to enable treatment of multiple patients with cells obtained from one donor organ and to provide alternatives in cases with contraindications for major surgery, i.e., LTx. While initial clinical studies demonstrated the safety and efficacy of LCT, success remained limited since LCT could not achieve the outcomes required for it to be established as a standard medical treatment. As part of further clinical studies on improvement of LCT, strategies for non-invasive monitoring of transplanted cells are under investigation.
Mixed and Virtual Reality in Surgery
The term, Virtual Reality is used for immersive experiences, which could be based on real-world content, purely synthetic content or a hybrid of both. Mixed Reality, i.e. the real and digital worlds integrated and enhanced with holograms, might be mandatory when interacting with the real world, i.e. during surgery. Ideally, Mixed Reality integrates your real and digital worlds seamlessly, enables intuitive and natural interactions and provides digital content is wherever needed.
We are working on preoperative surgical planning in visceral surgery (VR, MR), use of Mixed Reality systems in the operating room (MR assisted surgery, tele-consulting & mentoring) and training of surgical technicians via 360° videos and immersive 3D spaces.
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NeoHybrid Liver Graft
The neo-hybrid Liver Graft, an in vivo tissue engineered liver graft using autologous hepatocytes and hepatic progenitors cells, is a novel approach that might reduce the need for immunosuppression, improve long-term outcome after liver transplantation (LTx) and possibly induce host tolerance to allografts. Adult liver cells and autologous hepatic progenitors will be isolated from the diseased liver, explanted during standard orthotopic LTx, and retransplanted to the recipient via the spleen. The allogeneic liver graft is serving as a biological matrix for the engraftment of the autologous cells. Once these cells have engrafted, it is postulated that the autologous cells will repopulate the allogeneic graft liver as they have a selective advantage over the donor tissue due to their autologous origin.
microRNA and the Liver
After liver surgery, the lost functional mass is replaced in a process of compensatory growth in which quiescent hepatocytes reenter the cell cycle. However, the regulation of liver regeneration is not completely understood. Recent reports indicate an essential role for small noncoding microRNAs (miRNAs) in the regulation of hepatic development, carcinogenesis, and early regeneration.
miRNAs are the most abundant class of small, endogenous noncoding RNAs. miRNAs inhibit protein synthesis by blocking translation via complementary binding of messenger RNA (mRNA) or by suppressing translation and the subsequent degradation of target mRNA. miRNAs act in a variety of cellular processes such as development, organ homeostasis, and cancer.
Artificial and Bioartificial Liver Support
Liver failure remains a life-threatening syndrome. With the growing disparity between the number of suitable donor organs and patients waiting for transplantation, efforts have been made to optimize the allocation of organs, to find alternatives to cadaveric liver transplantation and to develop extracorporeal methods to support or replace the function of the failing organ. Over the past 20 years many liver support concepts have been developed and evaluated. Despite these efforts, none of the devices — neither, cell-based nor cell-free — were able to fully meet clinical demands. These limited results generate questions: Are the concepts evaluated inadequately? Are the concepts right but their scale too small and performances too low?
We thank the Deutsche Forschungsgemeinschaft (German Research Fondation, DFG), the Bundesministerium für Bildung und Forschung (Federal Ministry of Education and Research, BMBF), the European Region Development Fund (EFRE), the Charité Clinical Scientist program and the Fiebig-Stiftung for their financial support.
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Experimental Surgery and Regenerative Medicine