A long-standing limitation in tissue engineering has been the dogmatic reliance on synthetic scaffolds for building tissues with significant mechanical functions despite their deleterious effects (inflammation, scarring, infection, etc.). Tissue engineering by self-assembly (TESA) is a novel approach that relies on the cell's ability to produce natural extracellular matrix TESA can be used to produce structures that have physiological strength and are not recognized as foreign in vivo. We have developed a tissue-engineered blood vessel that has shown great promise as an arteriovenous shunt. Here, we review our journey from bench-top to bedside and discuss future applications of the TESA approach.

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DOI: 10.1016/S1369-7021(11)70117-1