Introduction

The fetus is an ideal tissue-engineering subject, both as donor and host. The unique characteristics of fetal cells, combined with the developmental and long-term impacts of implanting tissue constructs into a fetus, add new perspectives to tissue engineering, significantly expanding its reach. Perhaps surprisingly, however, it was only a little over ten years ago that the concept widely referred to as fetal tissue engineering was first proposed and proven viable experimentally. This notion involves the procurement of fetal cells, preferably through minimally invasive techniques, followed by their processing in the engineering of tissue constructs in vitro in parallel to the remainder of gestation, so that an infant or a fetus with a prenatally diagnosed birth defect could benefit from having autologous, expanded tissue readily available for surgical implantation in the perinatal period. A variety of prenatally diagnosable birth defects may be amenable to this approach. The following is a summarized review of the current status of fetal tissue engineering, along with other pertinent information.

Historical outline

The first attempts at utilizing fetal cells in a therapeutic setting took place almost a century ago, thus long before the modern era of transplantation. The first reported transplantation of human fetal tissue took place in 1922, when a fetal adrenal graft was transplanted into a patient with Addison’s disease [1]. This, along with a few other similar efforts involving different fetal cells and tissues over the following years, was unsuccessful. It is only over the past three decades that fetal tissue transplantation has resulted in somewhat favorable outcomes, albeit essentially anecdotally.