Organ transplantation faces two major challenges. First, we need to urgently identify a potentially inexhaustible source of organs. Second, we need to make immunosuppression-free transplantation possible. Many strategies have been implemented to increase the donor pool, yet the gap between the demand and the offer remains too wide and, as a consequence, the number of patients dying on the waiting list keeps rising. Tolerance has been pursued for decades, yet it remains an elusive goal outside liver transplantation, where the weaning off immunosuppression appears a safe option in selected cases. As the field of regenerative medicine has shown immense potential to address these challenges, transplant medicine should embrace the opportunity to join forces and partner with it. Regenerative medicine will enable organ-on-demand whereby patients will receive organs that will not be rejected and in a timely fashion. This will make registration in the waiting list and antirejection medications unnecessary and, as the new organs will be implanted immediately after fabrication, ischemia-reperfusion injury secondary to organ preservation will not be a problem anymore. The journey has just begun.
Elsevier, Organ Repair and Regeneration, 2021, Pages 273-284