Throughout the history of mankind injuries of all kinds and their consequences have been an important cause of ill-health, lost of working ability and decrease of the quality of life of people. And if earlier, Ukrainian doctors faced mainly with community-acquired and occupational injuries, over the past year as a result of military events in Donbass, Ukraine, more than ever, has met an urgent problem of the treatment and rehabilitation of patients who received firearm injuries.

The most dramatic in traumatology and orthopedics is the issue of prosthetics of lost limbs and other body parts. Therefore Association of cryobanks of umbilical cord blood and other human tissues and cells analyzed the global progress of cellular technologies in the treatment of traumatic injuries, as well as prospects for the development of this innovative field of medicine.

Currently, the world transplantology achieved sensational success in transplantation of organs and body parts. Thus, according to the International Registry on Hand and Composite Tissue Transplantation (Institute of Hand Surgery, Calgary, Italy), from 1998 to 2014 66 transplants of upper limb were performed, 22 transplants of one limb and 22 transplant of two limbs.

Since 2005, 20 transplants of face were performed worldwide (cheeks, nose, lips, perioral tissues), as patients could not eat, drink and talk. In one case, the transplantation of the face and two upper limbs was done. The duration of observation of these patients was 15 years after transplantation of arms and 8 years after face transplant. After upper limb transplant, protective sensitivity was noted in all patients and tactile sensitivity — in 90% of patients. Also the functions of the upper extremities, associated with daily physical activity were restored. After face transplant, patients can eat, drink, talk, and aesthetic aspects were solved as well as the problem of social adaptation (from the report of Prof. Denisov at the conference «Transplantation: Past, Present and Future», Kiev, 2014).

Unfortunately, scientists are still far from growing «to order» a full limb or an eye, but this idea from the plot for the science-fiction movie has reincarnated into the everyday work of biologists of the developed countries of the world, who are actively working to solve these problems. It is known that 500 mg of mesenchymal stem cells produce 3 kg of bone tissue.

Mesenchymal stem cells of the placenta are of particular interest for biomedical engineering of osteochondral constructs due to the extremely high potential for osteogenic differentiation. The positive results of the application of mesenchymal stem cells of the placenta in the reconstruction of the knee injury in rabbits were reported. Also, not a single case of successful recovery of high-level athletes from injuries thanks to the stem cells therapy is known. Currently osteochondral conduits grown from stem cells, are being tested in international clinical trials. In Ukraine, protocols of culturing of placental mesenchymal stem cells in the direction of osteogenic and chondrogenic differentiation are worked out by the Institute of Cell Therapy (Kiev).

Also in our time 3D-printers were created, allowing to grow skin in a place of a burn or significant damage. In this area Ukrainian scientists have succeeded a lot — Donetsk Institute of Emergency and Reconstructive Surgery n.a. VK Gusak of AMSU and the Institute of Cell Therapy (Kiev), both institutions are full members of the Association of cryobanks.

Institute of Emergency and Reconstructive Surgery n.a. VK Gusak of AMSU is known worldwide for its achievements in growing skin grafts from stem cells for the treatment of burns and frostbites. And the scientists from the Institute of Cell Therapy (Kiev) developed methods for treatment of burn wounds with the use of biologics, containing stem cells from umbilical cord blood and placental tissue. The use of stem cells and placental tissue in the treatment of burns can reduce treatment time before the autodermoplasty, stimulates granulation and epithelialization, reduces the activity of inflammatory reactions and symptoms of intoxication.

Japanese scientists have managed to grow a full eye in the orbit of the frog. The first report on the cultivation of a cornea from stem cells, developed at the University of Tokyo (Japan) is dated 2007. Scientists from the University of California (USA) have grown the 8-layer retina from stem cells. It should be noted that the method of creation of cornea from collagen was worked out and is being successfully applied in the Research Institute of Eye Diseases and Tissue Therapy n.a. VP Filatov (Odessa). Moreover, the scientists of this institute created corneal implants containing a system of continuous release of drugs.

Japanese scientists from 1 cell have received a tooth identical to the natural one, which was implanted to a mouse. And doctors at Johns Hopkins University, using cartilage from the chest, skin and blood vessels from other parts of the body, created artificial ear on the arm of a patient, and then transplanted it into the right place.

In 2008, an Italian surgeon Paolo Macchiarini world’s first transplanted a grown from her own stem cells trachea to 30-year-old woman. According to The Lancet journal, 5 years after surgery, the patient, a mother of two children, feels good, and notes the high quality of life with a tissue-engineered organ. Currently several tens of such operations were carried out.

Technology of growing of vessels using stem cells on decellurised or polymer scaffolds is widely used in various countries around the world. Tens of implantations of tissue-engineered vessels were performed. In Ukraine, the Institute of Cell Therapy (Kiev) has developed a method of vessels recovery through the use of cord blood stem cells. This method as well as the technology of pancreonecrosis treatment based on the application of cord blood stem cells, also developed by the Institute of Cell Therapy, were officially approved by Ministry of Health of Ukraine in 2012.

Obtaining of adequate blood substitutes is not less urgent task of disaster medicine and military surgery. Scientists have repeatedly reported about obtaining of blood cells (red and white blood cells, platelets) from stem cells, and in Paris (France) for the first time in the world medicine artificial blood derived from stem cells was successfully tested on volunteers.

At Yale University (USA), scientists grew rat lungs and transplanted them to the animals. These lungs were functioning in rats from 45 minutes to two hours. In 2014, at the University of Yokohama (Japan) a mini-liver was created from induced pluripotent stem cells derived from human skin, this organ for two months supported a life of a mouse.

Thus, this is from cellular technologies we will expect the next generation of medical prostheses in the next few decades.