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Willacy O, Juul N, Taouzlak L, Chamorro CI, Ajallouiean F, Fossum M. A perioperative layered autologous tissue expansion graft for hollow organ repair. Heliyon 2024; 10:e25275. [PMID: 38322882 PMCID: PMC10845913 DOI: 10.1016/j.heliyon.2024.e25275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/03/2024] [Accepted: 01/24/2024] [Indexed: 02/08/2024] Open
Abstract
Tissue engineering has not been widely adopted in clinical settings for several reasons, including technical challenges, high costs, and regulatory complexity. Here, we introduce the Perioperative Layered Autologous Tissue Expansion graft (PLATE graft), a composite biomaterial and collagen-reinforced construct with autologous epithelium on one side and smooth muscle tissue on the other. Designed to mimic the structure and function of natural hollow organs, the PLATE graft is unique in that it can be produced in a standard operating theatre and is cost-effective. In this proof-of-principle study, we test its regenerative performance in eight different organs, present biomechanical and permeability tests, and finally explore its in vivo performance in live rabbits.
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Affiliation(s)
- Oliver Willacy
- Laboratory of Tissue Engineering, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Division of Pediatric Surgery, Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Nikolai Juul
- Laboratory of Tissue Engineering, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Division of Pediatric Surgery, Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Loai Taouzlak
- Department of Health Technology, Technical University of Denmark, 2800: Kgs, Lyngby, Denmark
| | - Clara I. Chamorro
- Laboratory of Tissue Engineering, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Fatemeh Ajallouiean
- Department of Health Technology, Technical University of Denmark, 2800: Kgs, Lyngby, Denmark
- The Danish National Research Foundation and Villum Foundation's Center for Intelligent Drug Delivery and Sensing Using Microcontainers and Nanomechanics (IDUN), Department of Health Technology, Technical University of Denmark, Ørsted Plads, 2800: Kgs, Lyngby, Denmark
| | - Magdalena Fossum
- Laboratory of Tissue Engineering, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Division of Pediatric Surgery, Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Laboratory of Tissue Engineering, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Juul N, Ajalloueian F, Willacy O, Chamorro CI, Fossum M. Advancing autologous urothelial micrografting and composite tubular grafts for future single-staged urogenital reconstructions. Sci Rep 2023; 13:15584. [PMID: 37730755 PMCID: PMC10511703 DOI: 10.1038/s41598-023-42092-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023] Open
Abstract
Urogenital reconstructive surgery can be impeded by lack of tissue. Further developments within the discipline of tissue engineering may be part of a solution to improve clinical outcomes. In this study, we aimed to design an accessible and easily assembled tubular graft with autologous tissue, which could be constructed and implanted as a single-staged surgical procedure within the premises of an ordinary operating room. The ultimate goals would be to optimize current treatment-options for long-term urinary diversion. Therefore, we evaluated the optimal composition of a collagen-based scaffold with urothelial micrografts in vitro, and followingly implanted the construct in vivo as a bladder conduit. The scaffold was evaluated in relation to cell regeneration, permeability, and biomechanical properties. After establishing an optimized scaffold in vitro, consisting of high-density collagen with submerged autologous micrografts and reinforced with a mesh and stent, the construct was successfully implanted in an in vivo minipig model. The construct assemblance and surgical implantation proved feasible within the timeframe of a routine surgical intervention, and the animal quickly recovered postoperatively. Three weeks post-implantation, the conduit demonstrated good host-integration with a multilayered luminal urothelium. Our findings have encouraged us to support its use in more extensive preclinical large-animal studies.
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Affiliation(s)
- Nikolai Juul
- Laboratory of Tissue Engineering, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Division of Pediatric Surgery, Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Fatemeh Ajalloueian
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Oliver Willacy
- Laboratory of Tissue Engineering, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Division of Pediatric Surgery, Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Clara Ibel Chamorro
- Laboratory of Tissue Engineering, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Laboratory of Tissue Engineering, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Magdalena Fossum
- Laboratory of Tissue Engineering, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Division of Pediatric Surgery, Department of Surgery and Transplantation, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Laboratory of Tissue Engineering, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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Exploring the Concept of In Vivo Guided Tissue Engineering by a Single-Stage Surgical Procedure in a Rodent Model. Int J Mol Sci 2022; 23:ijms232012703. [PMID: 36293558 PMCID: PMC9604108 DOI: 10.3390/ijms232012703] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/09/2022] [Accepted: 10/15/2022] [Indexed: 11/17/2022] Open
Abstract
In severe malformations with a lack of native tissues, treatment options are limited. We aimed at expanding tissue in vivo using the body as a bioreactor and developing a sustainable single-staged procedure for autologous tissue reconstruction in malformation surgery. Autologous micro-epithelium from skin was integrated with plastically compressed collagen and a degradable knitted fabric mesh. Sixty-three scaffolds were implanted in nine rats for histological and mechanical analyses, up to 4 weeks after transplantation. Tissue integration, cell expansion, proliferation, inflammation, strength, and elasticity were evaluated over time in vivo and validated in vitro in a bladder wound healing model. After 5 days in vivo, we observed keratinocyte proliferation on top of the transplant, remodeling of the collagen, and neovascularization within the transplant. At 4 weeks, all transplants were fully integrated with the surrounding tissue. Tensile strength and elasticity were retained during the whole study period. In the in vitro models, a multilayered epithelium covered the defect after 4 weeks. Autologous micro-epithelial transplants allowed for cell expansion and reorganization in vivo without conventional pre-operative in vitro cell propagation. The method was easy to perform and did not require handling outside the operating theater.
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A tissue-engineered urinary conduit in a porcine urinary diversion model. Sci Rep 2021; 11:16754. [PMID: 34408168 PMCID: PMC8373918 DOI: 10.1038/s41598-021-94613-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/01/2021] [Indexed: 12/25/2022] Open
Abstract
The use of an ileal segment is a standard method for urinary diversion after radical cystectomy. Unfortunately, utilization of this method can lead to numerous surgical and metabolic complications. This study aimed to assess the tissue-engineered artificial conduit for urinary diversion in a porcine model. Tissue-engineered tubular polypropylene mesh scaffolds were used for the right ureter incontinent urostomy model. Eighteen male pigs were divided into three equal groups: Group 1 (control ureterocutaneostomy), Group 2 (the right ureter-artificial conduit-skin anastomoses), and Group 3 (4 weeks before urostomy reconstruction, the artificial conduit was implanted between abdomen muscles). Follow-up was 6 months. Computed tomography, ultrasound examination, and pyelogram were used to confirm the patency of created diversions. Morphological and histological analyses were used to evaluate the tissue-engineered urinary diversion. All animals survived the experimental procedures and follow-up. The longest average patency was observed in the 3rd Group (15.8 weeks) compared to the 2nd Group (10 weeks) and the 1st Group (5.8 weeks). The implant's remnants created a retroperitoneal post-inflammation tunnel confirmed by computed tomography and histological evaluation, which constitutes urostomy. The simultaneous urinary diversion using a tissue-engineered scaffold connected directly with the skin is inappropriate for clinical application.
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Adamowicz J, Van Breda SV, Kloskowski T, Juszczak K, Pokrywczynska M, Drewa T. Constructing artificial urinary conduits: current capabilities and future potential. Expert Rev Med Devices 2018; 16:135-144. [PMID: 30588868 DOI: 10.1080/17434440.2019.1562901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Intestinal segments are currently used in reconstructive urology to create urinary diversion after cystectomy. Ileal conduit (IC) is the dominant type of urinary diversion. Nevertheless, IC is not an ideal solution as the procedure still requires entero-enterostomy to restore the bowel continuity. This step is a source of relevant complications that might prolong recovery time. Fabrication of artificial urinary conduit is a tempting idea to introduce an alternative form of urinary diversion which might improve cystectomy outcomes. AREAS COVERED The aim of this review is to discuss available research data about artificial urinary conduit and identify major challenges for future studies. EXPERT OPINION Fabrication of artificial urinary conduit is in range of current tissue engineering technology but there are still many challenges to overcome. There is an urgent need for studies to be conducted on large animal models with long follow up to expose the limitation of experimental strategies and to gather data for translational research.
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Affiliation(s)
- Jan Adamowicz
- a Chair of Urology, Department of Regenerative Medicine, Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz , Poland
| | - Shane V Van Breda
- b Department of Biomedicine , University Hospital Basel , Basel , Switzerland
| | - Tomasz Kloskowski
- a Chair of Urology, Department of Regenerative Medicine, Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz , Poland
| | - Kajetan Juszczak
- c Department of Urology , Memorial Rydygier Hospital , Cracow , Poland
| | - Marta Pokrywczynska
- a Chair of Urology, Department of Regenerative Medicine, Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz , Poland
| | - Tomasz Drewa
- a Chair of Urology, Department of Regenerative Medicine, Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz , Poland
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Expansion of Submucosal Bladder Wall Tissue In Vitro and In Vivo. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5415012. [PMID: 27777947 PMCID: PMC5062021 DOI: 10.1155/2016/5415012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/10/2016] [Accepted: 08/30/2016] [Indexed: 11/17/2022]
Abstract
In order to develop autologous tissue engineering of the whole wall in the urinary excretory system, we studied the regenerative capacity of the muscular bladder wall. Smooth muscle cell expansion on minced detrusor muscle in vitro and in vivo with or without urothelial tissue was studied. Porcine minced detrusor muscle and urothelium were cultured in vitro under standard culture conditions for evaluation of the explant technique and in collagen for tissue sectioning and histology. Autografts of minced detrusor muscle with or without minced urothelium were expanded on 3D cylinder moulds by grafting into the subcutaneous fat of the pig abdominal wall. Moulds without autografts were used as controls. Tissue harvesting, mincing, and transplantation were performed as a one-step procedure. Cells from minced detrusor muscle specimens migrated and expanded in vitro on culture plastic and in collagen. In vivo studies with minced detrusor autografts demonstrated expansion and regeneration in all specimens. Minced urothelium autografts showed multilayered transitional urothelium when transplanted alone but not in cotransplantation with detrusor muscle; thus, minced bladder mucosa was not favored by cografting with minced detrusor. No regeneration of smooth muscle or epithelium was seen in controls.
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Sloff M, Simaioforidis V, Tiemessen DM, Janke HP, Kortmann BBM, Roelofs LAJ, Geutjes PJ, Oosterwijk E, Feitz WFJ. Tubular Constructs as Artificial Urinary Conduits. J Urol 2016; 196:1279-86. [PMID: 27185613 DOI: 10.1016/j.juro.2016.04.092] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE A readily available artificial urinary conduit might be substituted for autologous bowel in standard urinary diversions and minimize bowel associated complications. However, the use of large constructs remains challenging as host cellular ingrowth and/or vascularization is limited. We investigated large, reinforced, collagen based tubular constructs in a urinary diversion porcine model and compared subcutaneously pre-implanted constructs to cell seeded and basic constructs. MATERIALS AND METHODS Reinforced tubular constructs were prepared from type I collagen and biodegradable Vicryl® meshes through standard freezing, lyophilization and cross-linking techniques. Artificial urinary conduits were created in 17 female Landrace pigs, including 7 with a basic untreated construct, 5 with a construct seeded with autologous urothelial and smooth muscle cells, and 5 with a free graft formed by subcutaneous pre-implantation of a basic construct. All pigs were evaluated after 1 month. RESULTS The survival rate was 94%. At evaluation 1 basic and 1 cell seeded conduit were occluded. Urinary flow was maintained in all conduits created with pre-implanted constructs. Pre-implantation of the basic construct resulted in a vascularized tissue tube, which could be used as a free graft to create an artificial conduit. The outcome was favorable compared to that of the other conduits. Urinary drainage was better, hydroureteronephrosis was limited and tissue regeneration was improved. CONCLUSIONS Subcutaneous pre-implantation of a basic reinforced tubular construct resulted in a vascularized autologous tube, which may potentially replace bowel in standard urinary diversions. To our knowledge we introduce a straightforward 2-step procedure to create artificial urinary conduits in a large animal model.
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Affiliation(s)
- Marije Sloff
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Vasileios Simaioforidis
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dorien M Tiemessen
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Heinz P Janke
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Barbara B M Kortmann
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Luc A J Roelofs
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul J Geutjes
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Egbert Oosterwijk
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wout F J Feitz
- Department of Urology, Radboud Institute for Molecular Life Sciences and Amalia's Children Hospital, Radboud University Medical Center, Nijmegen, The Netherlands
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8
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Chamorro CI, Zeiai S, Reinfeldt Engberg G, Fossum M. Minced Tissue in Compressed Collagen: A Cell-containing Biotransplant for Single-staged Reconstructive Repair. J Vis Exp 2016:53061. [PMID: 26967119 DOI: 10.3791/53061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Conventional techniques for cell expansion and transplantation of autologous cells for tissue engineering purposes can take place in specially equipped human cell culture facilities. These methods include isolation of cells in single cell suspension and several laborious and time-consuming events before transplantation back to the patient. Previous studies suggest that the body itself could be used as a bioreactor for cell expansion and regeneration of tissue in order to minimize ex vivo manipulations of tissues and cells before transplanting to the patient. The aim of this study was to demonstrate a method for tissue harvesting, isolation of continuous epithelium, mincing of the epithelium into small pieces and incorporating them into a three-layered biomaterial. The three-layered biomaterial then served as a delivery vehicle, to allow surgical handling, exchange of nutrition across the transplant, and a controlled degradation. The biomaterial consisted of two outer layers of collagen and a core of a mechanically stable and slowly degradable polymer. The minced epithelium was incorporated into one of the collagen layers before transplantation. By mincing the epithelial tissue into small pieces, the pieces could be spread and thereby the propagation of cells was stimulated. After the initial take of the transplants, cell expansion and reorganization would take place and extracellular matrix mature to allow ingrowth of capillaries and nerves and further maturation of the extracellular matrix. The technique minimizes ex vivo manipulations and allow cell harvesting, preparation of autograft, and transplantation to the patient as a simple one-stage intervention. In the future, tissue expansion could be initiated around a 3D mold inside the body itself, according to the specific needs of the patient. Additionally, the technique could be performed in an ordinary surgical setting without the need for sophisticated cell culturing facilities.
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Affiliation(s)
- Clara I Chamorro
- Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institutet
| | - Said Zeiai
- Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institutet; Department of Pediatric Surgery, Urology Section, Astrid Lindgren Children's Hospital, Karolinska University Hospital
| | - Gisela Reinfeldt Engberg
- Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institutet; Department of Pediatric Surgery, Urology Section, Astrid Lindgren Children's Hospital, Karolinska University Hospital
| | - Magdalena Fossum
- Department of Women's and Children's Health, Center for Molecular Medicine, Karolinska Institutet; Department of Pediatric Surgery, Urology Section, Astrid Lindgren Children's Hospital, Karolinska University Hospital;
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Saksena R, Gao C, Wicox M, de Mel A. Tubular organ epithelialisation. J Tissue Eng 2016; 7:2041731416683950. [PMID: 28228931 PMCID: PMC5308438 DOI: 10.1177/2041731416683950] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 11/21/2016] [Indexed: 12/11/2022] Open
Abstract
Hollow, tubular organs including oesophagus, trachea, stomach, intestine, bladder and urethra may require repair or replacement due to disease. Current treatment is considered an unmet clinical need, and tissue engineering strategies aim to overcome these by fabricating synthetic constructs as tissue replacements. Smart, functionalised synthetic materials can act as a scaffold base of an organ and multiple cell types, including stem cells can be used to repopulate these scaffolds to replace or repair the damaged or diseased organs. Epithelial cells have not yet completely shown to have efficacious cell-scaffold interactions or good functionality in artificial organs, thus limiting the success of tissue-engineered grafts. Epithelial cells play an essential part of respective organs to maintain their function. Without successful epithelialisation, hollow organs are liable to stenosis, collapse, extensive fibrosis and infection that limit patency. It is clear that the source of cells and physicochemical properties of scaffolds determine the successful epithelialisation. This article presents a review of tissue engineering studies on oesophagus, trachea, stomach, small intestine, bladder and urethral constructs conducted to actualise epithelialised grafts.
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Affiliation(s)
- Rhea Saksena
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Chuanyu Gao
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Mathew Wicox
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Achala de Mel
- Division of Surgery and Interventional Science, University College London, London, UK
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Reinfeldt Engberg G, Lundberg J, Chamorro CI, Nordenskjöld A, Fossum M. Transplantation of autologous minced bladder mucosa for a one-step reconstruction of a tissue engineered bladder conduit. BIOMED RESEARCH INTERNATIONAL 2013; 2013:212734. [PMID: 24288669 PMCID: PMC3833032 DOI: 10.1155/2013/212734] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/12/2013] [Accepted: 09/18/2013] [Indexed: 11/18/2022]
Abstract
Surgical intervention is sometimes needed to create a conduit from the abdominal wall to the bladder for self-catheterization. We developed a method for tissue engineering a conduit for bladder emptying without in vitro cell culturing as a one-step procedure. In a porcine animal model bladder, wall tissue was excised and the mucosa was minced to small particles. The particles were attached to a tube in a 1 : 3 expansion rate with fibrin glue and transplanted back by attaching the tube to the bladder and through the abdominal wall. Sham served as controls. After 4-5 weeks, conduits were assessed in respect to macroscopic and microscopic appearance in 6 pigs. Two pigs underwent radiology before termination. Gross examination revealed a patent conduit with an opening to the bladder. Histology and immunostaining showed a multilayered transitional uroepithelium in all cases. Up to 89% of the luminal surface area was neoepithelialized but with a loose attachment to the submucosa. No epithelium was found in control animals. CT imaging revealed a patent channel that could be used for filling and emptying the bladder. Animals that experienced surgical complications did not form conduits. Minced autologous bladder mucosa can be transplanted around a tubular mold to create a conduit to the urinary bladder without in vitro culturing.
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Affiliation(s)
- Gisela Reinfeldt Engberg
- Department of Women's and Children's Health and Center of Molecular Medicine, Karolinska Institutet, Q3:03 Astrid Lindgren Children's Hospital, 171 76 Stockholm, Sweden
- Pediatric Surgery, Unit of Urology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Johan Lundberg
- Department of Clinical Neuroscience, Karolinska Institutet and Department of Neuroradiology, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Clara Ibel Chamorro
- Department of Women's and Children's Health and Center of Molecular Medicine, Karolinska Institutet, Q3:03 Astrid Lindgren Children's Hospital, 171 76 Stockholm, Sweden
| | - Agneta Nordenskjöld
- Department of Women's and Children's Health and Center of Molecular Medicine, Karolinska Institutet, Q3:03 Astrid Lindgren Children's Hospital, 171 76 Stockholm, Sweden
- Pediatric Surgery, Unit of Urology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden
| | - Magdalena Fossum
- Department of Women's and Children's Health and Center of Molecular Medicine, Karolinska Institutet, Q3:03 Astrid Lindgren Children's Hospital, 171 76 Stockholm, Sweden
- Pediatric Surgery, Unit of Urology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, 171 76 Stockholm, Sweden
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Ajalloueian F, Zeiai S, Rojas R, Fossum M, Hilborn J. One-Stage Tissue Engineering of Bladder Wall Patches for an Easy-To-Use Approach at the Surgical Table. Tissue Eng Part C Methods 2013; 19:688-96. [DOI: 10.1089/ten.tec.2012.0633] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Fatemeh Ajalloueian
- Textile Department, Isfahan University of Technology, Isfahan, Iran
- Ångström Laboratory, Division of Polymer Chemistry, Department of Chemistry, Uppsala University, Uppsala, Sweden
| | - Said Zeiai
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Paediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Ramiro Rojas
- Ångström Laboratory, Division of Polymer Chemistry, Department of Chemistry, Uppsala University, Uppsala, Sweden
| | - Magdalena Fossum
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Paediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Jöns Hilborn
- Ångström Laboratory, Division of Polymer Chemistry, Department of Chemistry, Uppsala University, Uppsala, Sweden
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12
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Geutjes P, Roelofs L, Hoogenkamp H, Walraven M, Kortmann B, de Gier R, Farag F, Tiemessen D, Sloff M, Oosterwijk E, van Kuppevelt T, Daamen W, Feitz W. Tissue engineered tubular construct for urinary diversion in a preclinical porcine model. J Urol 2012; 188:653-60. [PMID: 22704444 DOI: 10.1016/j.juro.2012.03.119] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Indexed: 11/17/2022]
Abstract
PURPOSE The ileal conduit has been considered the gold standard urinary diversion for patients with bladder cancer and pediatric patients. Complications are mainly related to the use of gastrointestinal tissue. Tissue engineering may be the technical platform on which to develop alternatives to gastrointestinal tissue. We developed a collagen-polymer conduit and evaluated its applicability for urinary diversion in pigs. MATERIALS AND METHODS Tubular constructs 12 cm long and 15 mm in diameter were prepared from bovine type I collagen and Vypro® II synthetic polymer mesh. Characterized tubes were sterilized, seeded with and without primary porcine bladder urothelial cells, and implanted as an incontinent urostomy using the right ureter in 10 female Landrace pigs. At 1 month the newly formed tissue structure was functionally and microscopically evaluated by loopogram and immunohistochemistry, respectively. RESULTS The survival rate was 80% with 1 related and 1 unrelated death. By 1 month the collagen was resorbed and a retroperitoneal tunnel had formed that withstood 40 cm H(2)O water pressure. In 5 cases the tunnel functioned as a urostomy. Histological analysis revealed a moderate immune response, neovascularization and urothelial cells in the construct lumen. The polymer mesh provoked fibroblast deposition and tissue contraction. No major differences were observed between cellular and acellular constructs. CONCLUSIONS After implanting the tubular constructs a retroperitoneal tunnel was formed that functioned as a urinary conduit in most cases. Improved large tubular scaffolds may generate alternatives to gastrointestinal tissue for urinary diversion.
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Affiliation(s)
- Paul Geutjes
- Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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