From in vitro evaluation to human postmortem pre-validation of a radiopaque and resorbable internal biliary stent for liver transplantation applications

Advances in functional coatings on biliary stents

Biliary stenting is an important interventional method for the prevention and treatment of biliary tract diseases. However, complications, such as postoperative biliary infection and restenosis, frequently occur due to the extensive scope of the biliary system and the complex composition of bile. The combination of coating technology and biliary stents is expected to bring new approaches to the solution of these problems. The cutting-edge advance on functional coatings on biliary stents is reviewed from seven perspectives: anticorrosion, -bacterial, -tumor, stone-dissolving, X-ray visibility, antistent migration and functional composite coatings. The development trend is also discussed. Overall, the performance of the numerous functional coatings for various purposes is generally up to expectations, but the balance between the medications' effectiveness and their safety needs to be further adjusted. Many contemporary investigations have advanced to the level of animal experiments, offering crucial fundamental assurance for broader human studies. The combination of biliary stents and functional coatings is an innovative idea with great potential for future development.

Emerging Trends in Biliary Stents: A Materials and Manufacturing Perspective

Biliary stent technology has come a long way since its inception. There have been significant advancements in materials used, designs, and deployment strategies. Options have expanded from thermoplastic and metallic...

Long-term in vivo performances of polylactide/iron oxide nanoparticles core-shell fibrous nanocomposites as MRI-visible magneto-scaffolds

There is a growing interest in magnetic nanocomposites in biomaterials science. In particular, nanocomposites that combine poly(lactide) (PLA) nanofibers and superparamagnetic iron oxide nanoparticles (SPIONs), which can be obtained by either electrospinning of a SPION suspension in PLA or by precipitating SPIONs at the surface of PLA, are well documented in the literature. However, these two classical processes yield nanocomposites with altered materials properties, and their long-term in vivo fate and performances have in most cases only been evaluated over short periods of time. Recently, we reported a new strategy to prepare well-defined PLA@SPION nanofibers with a quasi-monolayer of SPIONs anchored at the surface of PLA electrospun fibers. Herein, we report on a 6-month in vivo rat implantation study with the aim of evaluating the long-term magnetic resonance imaging (MRI) properties of this new class of magnetic nanocomposites, as well as their tissue integration and degradation. Using clinically relevant T2-weighted MRI conditions, we show that the PLA@SPION nanocomposites are clearly visible up to 6 months. We also evaluate here by histological analyses the slow degradation of the PLA@SPIONs, as well as their biocompatibility. Overall, these results make these nanocomposites attractive for the development of magnetic biomaterials for biomedical applications.

Case report: Trans-papillary free stenting of the cystic duct and of the common bile duct in a double biliary ducts anastomoses of a right lobe living donor transplantation

Background

One of the major issues related to the living donor liver transplantation recipient outcome is still the high rate of biliary complication, especially when multiple biliary ducts are present and multiple anastomoses have to be performed.

Case presentation and conclusion

We report a case of adult-to-adult right lobe living donor liver transplantation performed for a recipient affected by alcohol-related cirrhosis with MELD score of 17. End-stage liver disease was complicated by refractory ascites, portal hypertension, small esophageal varices and portal gastropathy, hypersplenism, and abundant right pleural effusion. Here in the attached video we described the adult-to-adult LDLT procedures, where a right lobe with two biliary ducts draining respectively the right anterior and the right posterior segments has been transplanted. LDLT required a biliary reconstruction using the native cystic and common bile ducts stented trans-papillary with two 5- French 6 cm long soft silastic catheter. None major complications were detected during post-operative clinical courses. Actually, the donor and the recipient are alive and well. The technique we describe in the video, allow to keep the biliary anastomoses protected and patent without having the risk of creating cholestasis and the need of invasive additional procedure. No living donor right lobe transplantation should be refused because of the presence of multiple biliary ducts.