Tissue engineering is a discipline that focuses on the regeneration of living tissues from a combination of cells, biomaterials, and signaling cues (1). The nature of this regenerative science is multidisciplinary, drawing knowledge from cellular and developmental biology, material science and engineering, drug delivery, and wound healing. There has been a tremendous growth in the number of scientific publications that relates to tissue engineering. A simple search in the PubMed database using the term “tissue engineering” shows that the number of publication has grown from less than one per year in the 1980s to 2087 in 2007. This tremendous growth is partly due to the increased interests in stem cells and their therapeutic potential, leading to a new era in regenerative science. Tissue engineering technology has been applied to many organ systems over the last two decades. Several tissue-engineered products are either in clinical use or in clinical trials. For example, skin substitutes made from human cells and collagen matrices have been used to treat patients with burn injury (2). Urinary bladder replacements made from autologous cells and biodegradable polymers to augment bladders of patients with myelomeningocele are in phase 2 clinical trials (3). These tissue-engineering based treatments bring new options and hope to a wide range of patients with tissue deficits.

The potential applications of tissue engineering to the pediatric population are diverse. Congenital anomalies that require surgical reconstruction of the tissue deficits occur in every organ system. For example, children with a cleft palate may require bone grafts for reconstruction, and bone regeneration using stem cells, biomaterials, and molecular signals can avoid the donor site morbidity (4,5). In the cardiovascular system, children with congenital heart disease may require shunts, patches, and valves for their repair, and the use of cells and biomaterials to produce cardiovascular tissue substitutes are being actively pursued (6,7). In the genitourinary systems, children with hypospadias, dysfunctional bladders, and dysplastic kidneys will often require multiple procedures for urologic reconstruction. Tissue deficits in these settings are being addressed with emerging tissue-engineered products (8–10). The application of tissue engineering is well suited to the pediatric population because children heal better and adapt faster than adults. It is also more challenging because the tissue-engineered organ needs to be designed to allow for the child's growth and development.

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