Abstract:
Introduction: Post-thyroidectomy hypothyroidism is a common complication of total thyroid
removal, traditionally managed with lifelong hormone replacement therapy. Thyroid models
developed through tissue engineering represent innovative approaches to restore endocrine function.
This study summarizes recent advances in thyroid tissue engineering and compares the efficacy and
practical potential of various methods.
Materials and Methods: We conducted a narrative review using articles published between 2009-
2025, focusing on autologous thyroid transplants, stem cell-derived thyrocytes, organoids, hydrogel
scaffolds, and decellularized matrices. Preclinical and in vitro outcomes assessed included thyroid
hormone production (T3, T4, TSH), follicular architecture, vascularization, and long-term stability.
We synthesized the data descriptively to compare functional restoration and practical feasibility.
Results: Autologous thyroid cell sheets transplanted into pre-vascularized, retrievable Cell Pouch™
devices restored serum T3 and T4 to 95-100% of baseline in rat models within 4-7 weeks. Histology
attested 95% normal follicular architecture and angiogenesis in all grafts, with endocrine function
maintained till 20 weeks. Pluripotent stem cells differentiated into thyroid follicular cells expressed
NKX2-1 and PAX8 in >90% of cells. These cells secreted T4 at 80- 85% of what native tissue
produces in vitro, but in vivo endocrine rescue reached only 30-40% of normal serum T4.
Decellularized human thyroid scaffolds and hydrogel matrices increased cell survival by 70-80%,
maintained follicular organization in ~85% of constructs, and encouraged blood vessel growth.
Thyroid organoids from fetal and adult tissues proved over 90% efficiency in forming follicles and
produced hormones reaching 75-80% of normal T4 output. Comparative analysis indicates that
autologous transplantation in vascularized devices currently provides the strongest restoration of
thyroid function. Meanwhile, stem cell and organoid-based strategies have significant potential for
personalized regenerative therapies.
Conclusions: Tissue-engineered methods can restore post-thyroidectomy endocrine function, with
autologous thyroid cell transplantation in pre-vascularized devices demonstrating good efficiency in
preclinical studies. Stem cell-derived thyrocytes, organoids, and hydrogel scaffolds give
complementary platforms for functional restoration and future clinical applications. Further
exploration is necessary to optimize scalability, vascularization, immune compatibility, and long- term
safety for human implementation.
