Soft-tissue loss resulting from trauma or oncologic resection is a significant problem worldwide. Surgical reconstruction using adipose tissue has long been the gold-standard solution. However, these surgeries are often highly morbid, not always feasible in patients with insufficient adipose, and can have unpredictable results. Engineered soft-tissue replacements present a promising alternative. Many cell types, such as adipose-derived stem cells, have been recognized as a viable starting platform upon which new avenues in tissue engineering can be built. Additionally, efforts to develop scaffolds that can mimic the native extracellular matrix have been made with varying success. However, the suboptimal vascularization of engineered replacements is still a major limiting factor for achieving clinical translation. The current research explores the integration of all these techniques, including the use of growth factors, bioactive molecules, and advanced microsurgical techniques to enhance the vascularization process. This translational review covers the clinically standard methods of soft-tissue reconstruction and dives into emerging engineering techniques to develop vascularized adipose alternatives.

Type 1 diabetes results from autoimmune destruction of pancreatic β-cells, and while whole-organ pancreas and islet transplantation can restore endogenous insulin secretion, both are limited by donor scarcity, early inflammatory injury, hypoxia, and the need for lifelong immunosuppression. Pancreatic tissue engineering has therefore emerged as a strategy to generate scalable, transplantable constructs capable of reestablishing physiological glucose regulation. However, as native islets depend on a robust microvascular network for oxygen delivery, nutrients and coordinated hormone secretion, insufficient vascularization remains the dominant cause of engineered graft failure. This review provides an overview of (a) the current state of pancreas transplant, (b) strategies for vascularized and immunoprotective pancreatic constructs, (c) cell differentiation strategies beyond of pancreatic β-cells, (d) translational progress in animal and human clinical trials, (e) key challenges in clinical translation, (f) ethical and regulatory considerations, and (g) future directions for tissue engineered pancreatic constructs. Our goal is to provide the reader with a translational overview that spans biology, tissue engineering, and clinical translation. Impact statement: This translational review provides a concise review of tissue engineering efforts to date within the context of engineered pancreatic constructs. Our paper systematically and logically discusses current developments, challenges, and novel approaches in pancreatic tissue engineering. It provides a digestible starting point for understanding the various approaches and the implications of successful tissue engineering strategies that can be used to develop transplantable pancreatic constructs.