A Nature Biotechnology study from Great Ormond Street Hospital and UCL reports an autologous engineered esophageal segment that restored oral feeding and peristalsis in growing minipigs without immunosuppression. Researchers decellularized donor porcine scaffolds, repopulated them with autologous pericyte‑like myogenic precursors and fibroblasts, matured grafts in bioreactors, and implanted 2.5‑cm circumferential replacements. Five of eight pigs survived to six months with progressive neuromuscular regeneration and functional swallowing. The work models pediatric long‑gap esophageal atresia repair and demonstrates multicomponent conditioning (bioreactor, vascular wraps, biodegradable stents) that supports vascularization and muscle regeneration. Authors position the platform as a translational step toward personalized regenerative therapies for congenital esophageal defects and highlight remaining challenges in scale‑up, long‑term durability, and regulatory translation for pediatric use. Clarification: Decellularized scaffolds retain structural matrix while removing donor cells to reduce immune rejection; autologous cell repopulation aims to restore function.