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Bartolf-Kopp M, Jungst T. The Past, Present, and Future of Tubular Melt Electrowritten Constructs to Mimic Small Diameter Blood Vessels - A Stable Process? Adv Healthc Mater 2024; 13:e2400426. [PMID: 38607966 DOI: 10.1002/adhm.202400426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/20/2024] [Indexed: 04/14/2024]
Abstract
Melt Electrowriting (MEW) is a continuously growing manufacturing platform. Its advantage is the consistent production of micro- to nanometer fibers, that stack intricately, forming complex geometrical shapes. MEW allows tuning of the mechanical properties of constructs via the geometry of deposited fibers. Due to this, MEW can create complex mechanics only seen in multi-material compounds and serve as guiding structures for cellular alignment. The advantage of MEW is also shown in combination with other biotechnological manufacturing methods to create multilayered constructs that increase mechanical approximation to native tissues, biocompatibility, and cellular response. These features make MEW constructs a perfect candidate for small-diameter vascular graft structures. Recently, studies have presented fascinating results in this regard, but is this truly the direction that tubular MEW will follow or are there also other options on the horizon? This perspective will explore the origins and developments of tubular MEW and present its growing importance in the field of artificial small-diameter vascular grafts with mechanical modulation and improved biomimicry and the impact of it in convergence with other manufacturing methods and how future technologies like AI may influence its progress.
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Affiliation(s)
- Michael Bartolf-Kopp
- Department for Functional Materials in Medicine and Dentistry, Institute of Biofabrication and Functional Materials, University of Würzburg and KeyLab Polymers for Medicine of the Bavarian Polymer Institute (BPI), Würzburg, Germany
| | - Tomasz Jungst
- Department for Functional Materials in Medicine and Dentistry, Institute of Biofabrication and Functional Materials, University of Würzburg and KeyLab Polymers for Medicine of the Bavarian Polymer Institute (BPI), Würzburg, Germany
- Department of Orthopedics, Regenerative Medicine Center Utrecht, University Medical Center Utrecht, Utrecht, Netherlands
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Cai YL, Nan F, Tang GT, Ma Y, Ren Y, Xiong XZ, Zhou RX, Li FY, Cheng NS, Jiang X. Fabrication of 3D printed PCL/PEG artificial bile ducts as supportive scaffolds to promote regeneration of extrahepatic bile ducts in a canine biliary defect model. J Mater Chem B 2023; 11:9443-9458. [PMID: 37727116 DOI: 10.1039/d3tb01250f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
In this study, a 3D porous poly(ε-caprolactone)/polyethylene glycol (PCL/PEG) composite artificial tubular bile duct was fabricated for extrahepatic bile duct regeneration. PCL/PEG composite scaffolds were fabricated by 3D printing, and the molecular structure, mechanical properties, thermal properties, morphology, and in vitro biocompatibility were characterized for further application as artificial bile ducts. A bile duct defect model was established in beagle dogs for in vivo implantation. The results demonstrated that the implanted PE1 ABD, serving as a supportive scaffold, effectively stimulated the regeneration of a new bile duct comprising CK19-positive and CK7-positive epithelial cells within 30 days. Remarkably, after 8 months, the newly formed bile duct exhibited an epithelial layer resembling the normal structure. Furthermore, the study revealed collagen deposition, biliary muscular formation, and the involvement of microvessels and fibroblasts in the regenerative process. In contrast, the anastomotic area without ABD implantation displayed only partial restoration of the epithelial layer, accompanied by fibroblast proliferation and subsequent bile duct fibrosis. These findings underscore the limited inherent repair capacity of the bile duct and underscore the beneficial role of the PE1 ABD artificial tubular bile duct in promoting biliary regeneration.
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Affiliation(s)
- Yu-Long Cai
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Fang Nan
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Guo-Tao Tang
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yuan Ma
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Yi Ren
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xian-Ze Xiong
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Rong-Xing Zhou
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Fu-Yu Li
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Nan-Sheng Cheng
- Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Xia Jiang
- Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
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3
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Development of an artificial portal vein using bioabsorbable polymers. Surg Today 2023; 53:261-268. [PMID: 35842849 DOI: 10.1007/s00595-022-02555-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/26/2022] [Indexed: 01/28/2023]
Abstract
PURPOSE During surgical resection of malignant tumors in the hepatobiliary pancreatic region, portal vein resection and reconstruction may be needed. However, there is no alternative to the portal vein. We therefore developed an artificial portal vein that could be used in the abdominal cavity. METHODS In the experiments, hybrid pigs (n = 8) were included. An artificial portal vein was created using a bioabsorbable polymer sheet (BAPS). Subsequently, the portal vein's anterior wall was excised into an elliptical shape. A BAPS in the form of a patch was implanted at the same site. At 2 weeks (n = 3) and 3 months (n = 5) after the implantation, the BAPS implantation site was resected and evaluated macroscopically and histopathologically. RESULTS Immediately after the implantation, blood leakage was not detected. Two weeks after implantation, the BAPS remained, and endothelial cells were observed. Thrombus formation was not observed. Three months after implantation, the BAPS had been completely absorbed and was indistinguishable from the surrounding portal vein. Stenosis and aneurysms were not observed. CONCLUSIONS BAPS can replace a defective portal vein from the early stage of implantation to BAPS absorption. These results suggest that it can be an alternative material to the portal vein in surgical reconstruction.
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Miyazawa M, Aikawa M, Takashima J, Kobayashi H, Ohnishi S, Ikada Y. Pitfalls and promises of bile duct alternatives: A narrative review. World J Gastroenterol 2022; 28:5707-5722. [PMID: 36338889 PMCID: PMC9627420 DOI: 10.3748/wjg.v28.i39.5707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/18/2022] [Accepted: 09/23/2022] [Indexed: 02/06/2023] Open
Abstract
Biliodigestive anastomosis between the extrahepatic bile duct and the intestine for bile duct disease is a gastrointestinal reconstruction that abolishes duodenal papilla function and frequently causes retrograde cholangitis. This chronic inflammation can cause liver dysfunction, liver abscess, and even bile duct cancer. Although research has been conducted for over 100 years to directly repair bile duct defects with alternatives, no bile duct substitute (BDS) has been developed. This narrative review confirms our understanding of why bile duct alternatives have not been developed and explains the clinical applicability of BDSs in the near future. We searched the PubMed electronic database to identify studies conducted to develop BDSs until December 2021 and identified studies in English. Two independent reviewers reviewed studies on large animals with 8 or more cases. Four types of BDSs prevail: Autologous tissue, non-bioabsorbable material, bioabsorbable material, and others (decellularized tissue, 3D-printed structures, etc.). In most studies, BDSs failed due to obstruction of the lumen or stenosis of the anastomosis with the native bile duct. BDS has not been developed primarily because control of bile duct wound healing and regeneration has not been elucidated. A BDS expected to be clinically applied in the near future incorporates a bioabsorbable material that allows for regeneration of the bile duct outside the BDS.
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Affiliation(s)
- Mitsuo Miyazawa
- Department of Surgery, Teikyo University Mizonokuch Hospital, Kanagawa 213-8507, Japan
| | - Masayasu Aikawa
- Department of Surgery, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
| | - Junpei Takashima
- Department of Surgery, Teikyo University Mizonokuch Hospital, Kanagawa 213-8507, Japan
| | - Hirotoshi Kobayashi
- Department of Surgery, Teikyo University Mizonokuch Hospital, Kanagawa 213-8507, Japan
| | - Shunsuke Ohnishi
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Yoshito Ikada
- Department of Bioenvironmental Medicine, Nara Medical University, Nara 634-8521, Japan
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Jiang X, Xiong X, Lin Y, Lu Y, Cheng J, Cheng N, Zhang J. A composite scaffold fabricated with an acellular matrix and biodegradable polyurethane for the in vivo regeneration of pig bile duct defects. Acta Biomater 2022; 150:238-253. [PMID: 35882348 DOI: 10.1016/j.actbio.2022.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/10/2022] [Accepted: 07/19/2022] [Indexed: 02/05/2023]
Abstract
Bile duct regeneration is urgently needed to restore the normal function of the damaged biliary system. In this study, an artificial bile duct (ABD) was fabricated for extrahepatic bile duct regeneration based on biodegradable polyurethane (BPU) and ureter acellular matrix (UAM) to endow it with favorable biocompatibility and eliminate bile leakage during in vivo bile duct regeneration. The mechanical properties, in vitro simulation of bile flow and cytocompatibility of BPU-UAM ABD were evaluated in vitro, and surgical implantation in the biliary defect site in minipigs was implemented to reveal the in vivo degradation of BPU-UAM and regeneration of the new bile duct. The results indicated that BPU-UAM ABD with a mechanical strength of 11.9 MPa has excellent cytocompatibility to support 3T3 fibroblast survival and proliferation in extraction medium and on the scaffolds. The in vivo implantation of BPU-UAM ABD revealed the change of collagen content throughout the new bile duct regeneration. Biliary epithelial cells were observed at day 70, and continuous biliary epithelial layer formation was observed after 100 days of implantation. Altogether, the BPU-UAM ABD fabricated in this study possesses excellent properties for application study in the regeneration of bile duct. STATEMENT OF SIGNIFICANCE: Extrahepatic bile duct defects carry considerable morbidity and mortality because they are the only pathway for bile to go down into the intestinal tract. At present, no artificial bile duct can promote biliary regeneration. In this study, BPU-UAM ABD was built based on biodegradable polyurethane and ureter acellular matrix to form a continuous compact layer of polyurethane in the internal wall of UAM and avoid bile leakage and experimental failure during in vivo implantation. Our work verified the effectiveness of the synthesized biodegradable polyurethane emulsion-modified urethral acellular matrix in bile regeneration and continuous biliary epithelial layer formation. This study provided a new approach for the curing of bile duct defects and inducing new bile tissue formation.
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Affiliation(s)
- Xia Jiang
- Regenerative Medicine Research Center, West China Hosp, Sichuan Univ, Chengdu 610041, Sichuan, China
| | - Xianze Xiong
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yixin Lin
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Yanrong Lu
- Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jingqiu Cheng
- Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Nansheng Cheng
- Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Jie Zhang
- Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
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Uemoto Y, Taura K, Nakamura D, Xuefeng L, Nam NH, Kimura Y, Yoshino K, Fuji H, Yoh T, Nishio T, Yamamoto G, Koyama Y, Seo S, Tsuruyama T, Iwaisako K, Uemoto S, Tabata Y, Hatano E. Bile duct regeneration with an artificial bile duct made of gelatin hydrogel non-woven fabrics. Tissue Eng Part A 2022; 28:737-748. [PMID: 35383474 DOI: 10.1089/ten.tea.2021.0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Although choledochojejunostomy is the standard technique for biliary reconstruction, there are various associated problems that need to be solved such as reflux cholangitis. Interposition with an artificial bile duct (ABD) to replace the resected bile duct maintains a physiological conduit for bile and may solve this problem. This study investigated the usefulness of an ABD made of gelatin hydrogel non-woven fabric (GHNF). GHNF was prepared by the solution blow spinning method. The migration and activity of murine fibroblast L929 cells were examined in GHNF sheets. L929 cells migrated into GHNF sheets, where they proliferated and synthesized collagen, suggesting GHNF is a promising scaffold for bile duct regeneration. ABDs made of GHNF were implanted in place of resected bile duct segments in rats. The rats were sacrificed at 2, 6, and 12 weeks post-implantation. The implantation site was histologically evaluated for bile duct regeneration. At postoperative 2 weeks, migrating cells were observed in the ABD pores. The implanted ABD was mostly degraded and replaced by collagen fibers at 6 weeks. Ki67-positive bile duct epithelial cells appeared within the implanted ABD. These were most abundant within the central part of the ABD after 6 weeks. The percentages of Ki67-positive cells were 31.7%±9.1% in the experimental group and 0.8%±0.6% in the sham operation group at 6 weeks (p<0.05), indicating that mature biliary epithelial cells at the stump proliferated to regenerate the biliary epithelium. Biliary epithelial cells had almost completely covered the bile duct lumen at 12 weeks (epithelialization ratios: 10.4%±6.9% at 2 weeks, 93.1%±5.1% at 6 weeks, 99.2%±1.6% at 12 weeks). The regenerated epithelium was positive for the bile duct epithelium marker cytokeratin 19. Bile duct regeneration was accompanied by angiogenesis, as evidenced by the appearance of CD31-positive vascular structures. Capillaries were induced 2 weeks after implantation. The number of capillaries reached a maximum at 6 weeks and decreased to the same level as that of normal bile ducts at 12 weeks. These results showed that an ABD of GHNF contributed to successful bile duct regeneration in rats by facilitating the cell migration required for extracellular matrix synthesis, angiogenesis, and epithelialization.
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Affiliation(s)
- Yusuke Uemoto
- Kyoto University, 12918, Surgery, Kyoto, Japan.,Kyoto University Institute for Frontier Life and Medical Sciences, 84090, Regeneration Science and Engineering, Kyoto, Kyoto, Japan;
| | | | | | - Li Xuefeng
- Kyoto University, 12918, Surgery, Kyoto, Japan;
| | | | | | - Kenji Yoshino
- Kyoto University, 12918, Surgery, Kyoto, Japan.,Nagahama City Hospital, 37078, Surgery, Nagahama, Shiga, Japan;
| | | | - Tomoaki Yoh
- Kyoto University, 12918, Surgery, Kyoto, Japan;
| | | | | | | | - Satoru Seo
- Kyoto University, 12918, Surgery, Kyoto, Japan;
| | - Tatsuaki Tsuruyama
- Kyoto University Hospital Clinical Bio Resource Center, 593766, Kyoto, Kyoto, Japan;
| | - Keiko Iwaisako
- Doshisha University - Kyotanabe Campus, 358002, Medical Life Systems, Kyotanabe, Kyoto, Japan;
| | - Shinji Uemoto
- Shiga University of Medical Science, 13051, Otsu, Shiga, Japan;
| | - Yasuhiko Tabata
- Kyoto University Institute for Frontier Life and Medical Sciences, 84090, Regeneration Science and Engineering, Kyoto, Kyoto, Japan;
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Buisson EM, Park S, Kim M, Kang K, Yoon S, Lee JE, Kim YW, Lee NK, Jeong MA, Kang B, Lee SB, Factor VM, Seo D, Kim H, Jeong J, Kim HJ, Choi D. Transplantation of patient-specific bile duct bioengineered with chemically reprogrammed and microtopographically differentiated cells. Bioeng Transl Med 2022; 7:e10252. [PMID: 35079629 PMCID: PMC8780056 DOI: 10.1002/btm2.10252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 01/01/2023] Open
Abstract
Cholangiopathy is a diverse spectrum of chronic progressive bile duct disorders with limited treatment options and dismal outcomes. Scaffold- and stem cell-based tissue engineering technologies hold great promise for reconstructive surgery and tissue repair. Here, we report a combined application of 3D scaffold fabrication and reprogramming of patient-specific human hepatocytes to produce implantable artificial tissues that imitate the mechanical and biological properties of native bile ducts. The human chemically derived hepatic progenitor cells (hCdHs) were generated using two small molecules A83-01 and CHIR99021 and seeded inside the tubular scaffold engineered as a synergistic combination of two layers. The inner electrospun fibrous layer was made of nanoscale-macroscale polycaprolactone fibers acting to promote the hCdHs attachment and differentiation, while the outer microporous foam layer served to increase mechanical stability. The two layers of fiber and foam were fused robustly together thus creating coordinated mechanical flexibility to exclude any possible breaking during surgery. The gene expression profiling and histochemical assessment confirmed that hCdHs acquired the biliary epithelial phenotype and filled the entire surface of the fibrous matrix after 2 weeks of growth in the cholangiocyte differentiation medium in vitro. The fabricated construct replaced the macroscopic part of the common bile duct (CBD) and re-stored the bile flow in a rabbit model of acute CBD injury. Animals that received the acellular scaffolds did not survive after the replacement surgery. Thus, the artificial bile duct constructs populated with patient-specific hepatic progenitor cells could provide a scalable and compatible platform for treating bile duct diseases.
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Affiliation(s)
- Elina Maria Buisson
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Suk‐Hee Park
- School of Mechanical EngineeringPusan National UniversityBusanRepublic of Korea
| | - Myounghoi Kim
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Kyojin Kang
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Sangtae Yoon
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Ji Eun Lee
- Digital Manufacturing Process GroupKorea Institute of Industrial TechnologySiheungsiGyeonggi‐doRepublic of Korea
| | - Young Won Kim
- Digital Manufacturing Process GroupKorea Institute of Industrial TechnologySiheungsiGyeonggi‐doRepublic of Korea
- Present address:
Current address: School of Mechanical EngineeringPurdue UniversityWest LafayetteIndianaUSA
| | - Nak Kyu Lee
- Digital Manufacturing Process GroupKorea Institute of Industrial TechnologySiheungsiGyeonggi‐doRepublic of Korea
| | - Mi Ae Jeong
- Department of Anesthesiology and pain medicineHanyang University College of MedicineSeoulRepublic of Korea
| | - Bo‐Kyeong Kang
- Department of RadiologyHanyang University, College of medicineSeoulRepublic of Korea
| | - Seung Bum Lee
- Laboratory of Radiation Exposure & TherapeuticsNational Radiation Emergency Medical Center, Korea Institute of Radiological & Medical ScienceSeoulRepublic of Korea
| | - Valentina M. Factor
- Laboratory of Molecular PharmacologyCenter for Cancer Research, National Cancer Institute, National Institutes of HealthBethesdaMarylandUSA
| | | | - Hyunsung Kim
- Department of PathologyHanyang University College of MedicineSeoulRepublic of Korea
| | - Jaemin Jeong
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Han Joon Kim
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
| | - Dongho Choi
- Department of SurgeryHanyang University College of MedicineSeoulRepublic of Korea
- HY Indang Center of Regenerative Medicine and Stem Cell ResearchHanyang UniversitySeoulRepublic of Korea
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8
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Sun Q, Shen Z, Liang X, He Y, Kong D, Midgley AC, Wang K. Progress and Current Limitations of Materials for Artificial Bile Duct Engineering. MATERIALS 2021; 14:ma14237468. [PMID: 34885623 PMCID: PMC8658964 DOI: 10.3390/ma14237468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 01/30/2023]
Abstract
Bile duct injury (BDI) and bile tract diseases are regarded as prominent challenges in hepatobiliary surgery due to the risk of severe complications. Hepatobiliary, pancreatic, and gastrointestinal surgery can inadvertently cause iatrogenic BDI. The commonly utilized clinical treatment of BDI is biliary-enteric anastomosis. However, removal of the Oddi sphincter, which serves as a valve control over the unidirectional flow of bile to the intestine, can result in complications such as reflux cholangitis, restenosis of the bile duct, and cholangiocarcinoma. Tissue engineering and biomaterials offer alternative approaches for BDI treatment. Reconstruction of mechanically functional and biomimetic structures to replace bile ducts aims to promote the ingrowth of bile duct cells and realize tissue regeneration of bile ducts. Current research on artificial bile ducts has remained within preclinical animal model experiments. As more research shows artificial bile duct replacements achieving effective mechanical and functional prevention of biliary peritonitis caused by bile leakage or obstructive jaundice after bile duct reconstruction, clinical translation of tissue-engineered bile ducts has become a theoretical possibility. This literature review provides a comprehensive collection of published works in relation to three tissue engineering approaches for biomimetic bile duct construction: mechanical support from scaffold materials, cell seeding methods, and the incorporation of biologically active factors to identify the advancements and current limitations of materials and methods for the development of effective artificial bile ducts that promote tissue regeneration.
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Affiliation(s)
- Qiqi Sun
- Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China; (Q.S.); (D.K.)
| | - Zefeng Shen
- Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; (Z.S.); (X.L.)
| | - Xiao Liang
- Department of General Surgery, Sir Run-Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; (Z.S.); (X.L.)
| | - Yingxu He
- School of Computing, National University of Singapore, Singapore 119077, Singapore;
| | - Deling Kong
- Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China; (Q.S.); (D.K.)
| | - Adam C. Midgley
- Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China; (Q.S.); (D.K.)
- Correspondence: (A.C.M.); (K.W.)
| | - Kai Wang
- Key Laboratory of Bioactive Materials for the Ministry of Education, College of Life Sciences, Nankai University, Tianjin 300071, China; (Q.S.); (D.K.)
- Correspondence: (A.C.M.); (K.W.)
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9
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Kar SK, Wells JM, Ellen ED, Te Pas MFW, Madsen O, Groenen MAM, Woelders H. Organoids: a promising new in vitro platform in livestock and veterinary research. Vet Res 2021; 52:43. [PMID: 33691792 PMCID: PMC7943711 DOI: 10.1186/s13567-021-00904-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/13/2021] [Indexed: 02/06/2023] Open
Abstract
Organoids are self-organizing, self-renewing three-dimensional cellular structures that resemble organs in structure and function. They can be derived from adult stem cells, embryonic stem cells, or induced pluripotent stem cells. They contain most of the relevant cell types with a topology and cell-to-cell interactions resembling that of the in vivo tissue. The widespread and increasing adoption of organoid-based technologies in human biomedical research is testament to their enormous potential in basic, translational- and applied-research. In a similar fashion there appear to be ample possibilities for research applications of organoids from livestock and companion animals. Furthermore, organoids as in vitro models offer a great possibility to reduce the use of experimental animals. Here, we provide an overview of studies on organoids in livestock and companion animal species, with focus on the methods developed for organoids from a variety of tissues/organs from various animal species and on the applications in veterinary research. Current limitations, and ongoing research to address these limitations, are discussed. Further, we elaborate on a number of fields of research in animal nutrition, host-microbe interactions, animal breeding and genomics, and animal biotechnology, in which organoids may have great potential as an in vitro research tool.
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Affiliation(s)
- Soumya K Kar
- Wageningen Livestock Research, Wageningen University & Research, Wageningen, The Netherlands.
| | - Jerry M Wells
- Host-Microbe Interactomics, Wageningen University & Research, Wageningen, The Netherlands
| | - Esther D Ellen
- Wageningen Livestock Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Marinus F W Te Pas
- Wageningen Livestock Research, Wageningen University & Research, Wageningen, The Netherlands
| | - Ole Madsen
- Animal Breeding and Genomics, Wageningen University & Research, Wageningen, The Netherlands
| | - Martien A M Groenen
- Animal Breeding and Genomics, Wageningen University & Research, Wageningen, The Netherlands
| | - Henri Woelders
- Wageningen Livestock Research, Wageningen University & Research, Wageningen, The Netherlands
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10
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Hamada T, Nakamura A, Soyama A, Sakai Y, Miyoshi T, Yamaguchi S, Hidaka M, Hara T, Kugiyama T, Takatsuki M, Kamiya A, Nakayama K, Eguchi S. Bile duct reconstruction using scaffold-free tubular constructs created by Bio-3D printer. Regen Ther 2021; 16:81-89. [PMID: 33732817 PMCID: PMC7921183 DOI: 10.1016/j.reth.2021.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/16/2021] [Accepted: 02/08/2021] [Indexed: 02/06/2023] Open
Abstract
Introduction Biliary strictures after bile duct injury or duct-to-duct biliary reconstruction are serious complications that markedly reduce patients’ quality of life because their treatment involves periodic stent replacements. This study aimed to create a scaffold-free tubular construct as an interposition graft to treat biliary complications. Methods Scaffold-free tubular constructs of allogeneic pig fibroblasts, that is, fibroblast tubes, were created using a Bio-3D Printer and implanted into pigs as interposition grafts for duct-to-duct biliary reconstruction. Results Although the fibroblast tube was weaker than the native bile duct, it was sufficiently strong to enable suturing. The pigs' serum hepatobiliary enzyme levels remained stable during the experimental period. Micro-computed tomography showed no biliary strictures, no biliary leakages, and no intrahepatic bile duct dilations. The tubular structure was retained in all resected specimens, and the fibroblasts persisted at the graft sites. Immunohistochemical analyses revealed angiogenesis in the fibroblast tube and absence of extensions of the biliary epithelium into the fibroblast tube's lumen. Conclusions This study's findings demonstrated successful reconstruction of the extrahepatic bile duct with a scaffold-free tubular construct created from pig fibroblasts using a novel Bio-3D Printer. This construct could provide a novel regenerative treatment for patients with hepatobiliary diseases.
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Key Words
- ALP, alkaline phosphatase
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- Artificial bile duct
- Bio-3D printer
- Cr, creatinine
- DMEM, Dulbecco's Modified Eagle's Medium
- EDTA, trypsin-ethylenediaminetetraacetic acid
- FBS, fetal bovine serum
- IBDI, iatrogenic bile duct injury
- KCL, potassium chloride
- LDLT, living donor liver transplantation
- PBS, phosphate-buffered saline
- QOL, quality of life
- Reconstruction
- Scaffold-free tubular construct
- T-Bil, total bilirubin
- γ-GTP, γ-glutamyl transpeptidase
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Affiliation(s)
- Takashi Hamada
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Anna Nakamura
- Department of Regenerative Medicine and Biomedical Engineering, Faculty of Medicine, Saga University, Japan
| | - Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Yusuke Sakai
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan.,Department of Chemical Engineering, Faculty of Engineering, Graduate School, Kyushu University, Japan
| | - Takayuki Miyoshi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Shun Yamaguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Takanobu Hara
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Tota Kugiyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Mitsuhisa Takatsuki
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Akihide Kamiya
- Department of Molecular Life Sciences, Tokai University School of Medicine, Japan
| | - Koichi Nakayama
- Department of Regenerative Medicine and Biomedical Engineering, Faculty of Medicine, Saga University, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
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11
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Shang H, Zeng JP, Wang SY, Xiao Y, Yang JH, Yu SQ, Liu XC, Jiang N, Shi XL, Jin S. Extrahepatic bile duct reconstruction in pigs with heterogenous animal-derived artificial bile ducts: A preliminary experience. World J Gastroenterol 2020; 26:7312-7324. [PMID: 33362386 PMCID: PMC7739164 DOI: 10.3748/wjg.v26.i46.7312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 11/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Extrahepatic biliary duct injury (BDI) remains a complicated issue for surgeons. Although several approaches have been explored to address this problem, the high incidence of complications affects postoperative recovery. As a nonimmunogenic scaffold, an animal-derived artificial bile duct (ada-BD) could replace the defect, providing good physiological conditions for the regeneration of autologous bile duct structures without changing the original anatomical and physiologic conditions.
AIM To evaluate the long-term feasibility of a novel heterogenous ada-BD for treating extrahepatic BDI in pigs.
METHODS Eight pigs were randomly divided into two groups in the study. The animal injury model was developed with an approximately 2 cm segmental defect of various parts of the common bile duct (CBD) for all pigs. A 2 cm long novel heterogenous animal-derived bile duct was used to repair this segmental defect (group A, ada-BD-to-duodenum anastomosis to repair the distal CBD defect; group B, ada-BD-to-CBD anastomosis to repair the intermedial CBD defect). The endpoint for observation was 6 mo (group A) and 12 mo (group B) after the operation. Liver function was regularly tested. Animals were euthanized at the above endpoints. Histological analysis was carried out to assess the efficacy of the repair.
RESULTS The median operative time was 2.45 h (2-3 h), with a median anastomosis time of 60.5 min (55-73 min). All experimental animals survived until the endpoints for observation. The liver function was almost regular. Histologic analysis indicated a marked biliary epithelial layer covering the neo-bile duct and regeneration of the submucosal connective tissue and smooth muscle without significant signs of immune rejection. In comparison, the submucosal connective tissue was more regular and thicker in group B than in group A, and there was superior integrity of the regeneration of the biliary epithelial layer. Despite the advantages of the regeneration of the bile duct smooth muscle observed in group A, the effect on the patency of the ada-BD grafts in group B was not confirmed by macroscopic assessment and cholangiography.
CONCLUSION This approach appears to be feasible for repairing a CBD defect with an ada-BD. A large sample study is needed to confirm the durability and safety of these preliminary results.
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Affiliation(s)
- Hao Shang
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Jian-Ping Zeng
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Si-Yuan Wang
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Ying Xiao
- Department of Pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Jiang-Hui Yang
- Department of Pathology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Shao-Qing Yu
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Xiang-Chen Liu
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
| | - Nan Jiang
- Institute for Precision Medicine Tsinghua University, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China
| | - Xia-Li Shi
- Department of Anesthesiology and Operation, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Shuo Jin
- Department of Hepatopancreatobiliary Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102200, China
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12
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Huang Y, Miyamoto D, Hidaka M, Adachi T, Gu WL, Eguchi S. Regenerative medicine for the hepatobiliary system: A review. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2020; 28:913-930. [PMID: 33314713 DOI: 10.1002/jhbp.882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/05/2020] [Accepted: 11/20/2020] [Indexed: 12/16/2022]
Abstract
Liver transplantation, the only proven treatment for end-stage liver disease and acute liver failure, is hampered by the scarcity of donors. Regenerative medicine provides an alternative therapeutic approach. Tremendous efforts dedicated to liver regenerative medicine include the delivery of transplantable cells, microtissues, and bioengineered whole livers via tissue engineering and the maintenance of partial liver function via extracorporeal support. This brief review summarizes the current status of regenerative medicine for the hepatobiliary system. For liver regenerative medicine, the focus is on strategies for expansion of transplantable hepatocytes, generation of hepatocyte-like cells, and therapeutic potential of engineered tissues in liver disease models. For biliary regenerative medicine, the discussion concentrates on the methods for generation of cholangiocyte-like cells and strategies in the treatment of biliary disease. Significant advances have been made in large-scale and long-term expansion of liver cells. The development of tissue engineering and stem cell induction technology holds great promise for the future treatment of hepatobiliary diseases. The application of regenerative medicine in liver still lacks extensive animal experiments. Therefore, a large number of preclinical studies are necessary to provide sufficient evidence for their therapeutic effectiveness. Much remains to be done for the treatment of hepatobiliary diseases with regenerative medicine.
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Affiliation(s)
- Yu Huang
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Department of Surgery, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangdong, China
| | - Daisuke Miyamoto
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masaaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiko Adachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Wei-Li Gu
- Department of Surgery, School of Medicine, Guangzhou First People's Hospital, South China University of Technology, Guangdong, China
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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13
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Xiang Y, Wang W, Gao Y, Zhang J, Zhang J, Bai Z, Zhang S, Yang Y. Production and Characterization of an Integrated Multi-Layer 3D Printed PLGA/GelMA Scaffold Aimed for Bile Duct Restoration and Detection. Front Bioeng Biotechnol 2020; 8:971. [PMID: 32984274 PMCID: PMC7479063 DOI: 10.3389/fbioe.2020.00971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 07/27/2020] [Indexed: 11/28/2022] Open
Abstract
We successfully fabricated artificial bile duct via 3D printing technique which was composed of poly (lactic-co-glycolic acid) (PLGA) and gelatin methacrylate (GelMA). The PLGA-inner layer provided sufficient strength to support the bile duct contraction, the GelMA-outer layer possessed good biocompatibility to provide a good living environment for the cells. Moreover, IKVAV laminin peptide (Ile-Lys-Val-Ala-Val) and ultrasmall superparamagnetic iron oxide (USPIO) were used to regulate scaffold cell adhesion and magnetic resonance imaging (MRI) detection, respectively. After BMSCs co-culture with IKVAV at a certain concentration, the survival rate and adhesion of BMSCs was increased obviously. Meanwhile, the fabricated scaffold exhibited the tensile modulus in the range of 17.19 - 29.05 MPa and the compressive modulus in the range of 0.042 - 0.066 MPa, which could meet the needs of human implantation. In an animal experiment in vivo pig bile duct regeneration, PLGA/GelMA/IKVAV/USPIO duct conduits could promote bile duct regeneration and enhance cytokeratin 19 (CK19) expression. In summary, the composite bile duct scaffold with excellent MRI imaging function and biocompatibility could be used to develop bioactive artificial bile ducts.
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Affiliation(s)
- Yang Xiang
- Department of Hepatobiliary Surgery, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
- Department of Urology Surgery, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Weijia Wang
- School of Metallurgy and Environment, Central South University, Changsha, China
| | - Yuanhui Gao
- Central Laboratory, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Jianquan Zhang
- Department of Hepatobiliary Surgery, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Jing Zhang
- Department of Obstetrics and Gynecology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Zhiming Bai
- Department of Urology Surgery, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Shufang Zhang
- Central Laboratory, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
| | - Yijun Yang
- Department of Hepatobiliary Surgery, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China
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14
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de Jong IEM, Sutton ME, van den Heuvel MC, Gouw ASH, Porte RJ. Evidence for Recipient-Derived Cells in Peribiliary Glands and Biliary Epithelium of the Large Donor Bile Ducts After Liver Transplantation. Front Cell Dev Biol 2020; 8:693. [PMID: 32850815 PMCID: PMC7419707 DOI: 10.3389/fcell.2020.00693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 07/08/2020] [Indexed: 12/04/2022] Open
Abstract
Introduction Chimerism after orthotopic liver transplantation (OLT) has largely been investigated in intrahepatic cellular constituents. However, little is known about chimerism in the extrahepatic and large intrahepatic bile ducts. Our aim was to evaluate the presence and extent of chimerism after OLT in the peribiliary glands (PBG) and the luminal epithelium of the large donor bile ducts. Methods For this study, we examined six extrahepatic and large intrahepatic bile ducts from livers that were re-transplanted. In all cases there was a sex-mismatch between donor and recipient (female donor organ and male recipient), which allowed to discriminate between donor- and recipient-derived cells. Specimens from female to female transplants were used as negative controls and male to male transplants as positive controls. Fluorescence in situ hybridization (FISH) for Y and X chromosomes was performed and the percentage of XY positive cells was determined among biliary epithelial cells. Immunohistochemistry was used to correlate chimerism with histological features. Results Cholangiocellular chimerism in all studied specimens ranged from 14 to 52%. The degree of chimerism was not associated with biliary damage. Marked chimerism was present at 5 days post-OLT. Ki-67-positivity was detected in 1–8% of the epithelial cells at the time of liver re-transplantation, and this correlated inversely with the degree of chimerism. Conclusion Recipient-derived cholangiocytes are present in the large bile ducts of the donor liver after OLT. The presence of chimerism in the large bile ducts suggests that recipient-derived cells may play a role in biliary regeneration following ischemia-induced injury during OLT.
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Affiliation(s)
- Iris E M de Jong
- Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Michael E Sutton
- Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.,Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Marius C van den Heuvel
- Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Annette S H Gouw
- Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Robert J Porte
- Section of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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15
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Li H, Yin Y, Xiang Y, Liu H, Guo R. A novel 3D printing PCL/GelMA scaffold containing USPIO for MRI-guided bile duct repair. ACTA ACUST UNITED AC 2020; 15:045004. [PMID: 32092713 DOI: 10.1088/1748-605x/ab797a] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Making artificial bile ducts in vitro for repairing and replacing diseased bile ducts is an important concept in tissue engineering. This study printed a tubular composite scaffold using polycaprolactone (PCL) through the current 3D printing method. It served as a matrix for the organoid cells of the bile duct to proliferation, migration, and differentiation. The PCL scaffold full of bile duct-like organ cells can achieve the effect of bionics, replacing the original bile duct to perform its proper function. In order to enrich the performance of the tubular scaffold, hydrogels were also used in this study. Applying a layer of gelatin methacryloyl (GelMA) hydrogel with an appropriate thickness on the outer layer of the PCL scaffold not only protects and supports the scaffold, but also improves the biocompatibility of the printed bile duct. In addition, ultrasmall superparamagnetic iron oxide (USPIO) nanoparticles dispersed in GelMA served as the contrast agent to monitor the repair of the lesion site and the degradation of the bile duct in real time by magnetic resonance imaging (MRI). In this study, a tubular composite scaffold that could reconstruct bile duct function and possess a real-time MRI imaging property was constructed by 3D printing. After 13 days of the co-culture of bone marrow derived stem cells (BMSCs), the survival rate of the BMSCs was greater than 95%, and the coverage of the BMSCs was as high as 90%. At the same time, the compression modulus of the stent could reach 17.41 kPa and the Young's modulus could reach 5.03 kPa. Thus, the mechanical properties of it can meet the needs of human implantation. USPIO can achieve MRI imaging in situ and nondestructively monitor the degradation of the stent in the body. In summary, PCL/GelMA/USPIO bile duct scaffolds are beneficial to the proliferation of cells on the scaffolds and can be used to construct biologically active artificial bile ducts.
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Affiliation(s)
- Hehong Li
- Department of Radiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, People's Republic of China
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16
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Agarwal T, Subramanian B, Maiti TK. Liver Tissue Engineering: Challenges and Opportunities. ACS Biomater Sci Eng 2019; 5:4167-4182. [PMID: 33417776 DOI: 10.1021/acsbiomaterials.9b00745] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Liver tissue engineering aims at the possibility of reproducing a fully functional organ for the treatment of acute and chronic liver disorders. Approaches in this field endeavor to replace organ transplantation (gold standard treatment for liver diseases in a clinical setting) with in vitro developed liver tissue constructs. However, the complexity of the liver microarchitecture and functionality along with the limited supply of cellular components of the liver pose numerous challenges. This review provides a comprehensive outlook onto how the physicochemical, mechanobiological, and spatiotemporal aspects of the substrates could be tuned to address current challenges in the field. We also highlight the strategic advancements made in the field so far for the development of artificial liver tissue. We further showcase the currently available prototypes in research and clinical trials, which shows the hope for the future of liver tissue engineering.
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17
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Buisson EM, Jeong J, Kim HJ, Choi D. Regenerative Medicine of the Bile Duct: Beyond the Myth. Int J Stem Cells 2019; 12:183-194. [PMID: 31022996 PMCID: PMC6657949 DOI: 10.15283/ijsc18055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/31/2018] [Accepted: 09/03/2018] [Indexed: 12/12/2022] Open
Abstract
Cholangiopathies are rare diseases of the bile duct with high mortality rates. The current treatment for cholangiopathies is liver transplantation, but there are significant obstacles including a shortage of donors and a high risk of complications. Currently, there is only one available medicine on the market targeting cholangiopathies, and the results have been inadequate in clinical therapy. To overcome these obstacles, many researchers have used human induced pluripotent stem cells (hPSC) as a source for cholangiocyte-like cell generation and have incorporated advances in bioprinting to create artificial bile ducts for implantation and transplantation. This has allowed the field to move dramatically forward in studies of biliary regenerative medicine. In this review, the authors provide an overview of cholangiocytes, the organogenesis of the bile duct, cholangiopathies, and the current treatment and advances that have been made that are opening new doors to the study of cholangiopathies.
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Affiliation(s)
- Elina Maria Buisson
- Department of Translational Medicine, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, Korea.,Department of Surgery, Hanyang University College of Medicine, Hanyang University, Seoul, Korea.,HY Indang Center of Regenerative Medicine and Stem Cell Research, Hanyang University, Hanyang University, Seoul, Korea
| | - Jaemin Jeong
- Department of Surgery, Hanyang University College of Medicine, Hanyang University, Seoul, Korea.,HY Indang Center of Regenerative Medicine and Stem Cell Research, Hanyang University, Hanyang University, Seoul, Korea
| | - Han Joon Kim
- Department of Surgery, Hanyang University College of Medicine, Hanyang University, Seoul, Korea
| | - Dongho Choi
- Department of Translational Medicine, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul, Korea.,Department of Surgery, Hanyang University College of Medicine, Hanyang University, Seoul, Korea.,HY Indang Center of Regenerative Medicine and Stem Cell Research, Hanyang University, Hanyang University, Seoul, Korea
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18
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Chen Y, Devalliere J, Bulutoglu B, Yarmush ML, Uygun BE. Repopulation of intrahepatic bile ducts in engineered rat liver grafts. TECHNOLOGY 2019; 7:46-55. [PMID: 31388515 PMCID: PMC6684151 DOI: 10.1142/s2339547819500043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Engineered liver grafts for transplantation with sufficient hepatic function have been developed both in small and large animal models using the whole liver engineering approach. However, repopulation of the bile ducts in the whole liver scaffolds has not been addressed yet. In this study, we show the feasibility of repopulating the bile ducts in decellularized rat livers. Biliary epithelial cells were introduced into the bile ducts of the decellularized liver scaffolds with or without hepatocytes in the parenchymal space. The recellularized grafts were cultured under perfusion for up to 2 days and histological analysis revealed that the biliary epithelial cells formed duct-like structures, with the viable hepatocyte mass residing in the parenchymal space, in an arrangement highly comparable to the native tissue. The grafts were viable and functional as confirmed by both albumin and urea assay results and the gene expression analysis of biliary epithelial cells in recellularized liver grafts. This study provides the proof-of-concept results for rat liver grafts co-populated with parenchymal and biliary epithelial cells.
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Affiliation(s)
- Yibin Chen
- Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Shriners Hospitals for Children, Boston, MA 02114, USA
| | - Julie Devalliere
- Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Shriners Hospitals for Children, Boston, MA 02114, USA
| | - Beyza Bulutoglu
- Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Shriners Hospitals for Children, Boston, MA 02114, USA
| | - Martin L Yarmush
- Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Shriners Hospitals for Children, Boston, MA 02114, USA
- Department of Biomedical Engineering, Rutgers University, Piscataway, NJ 08854, USA
| | - Basak E Uygun
- Center for Engineering in Medicine, Massachusetts General Hospital, Harvard Medical School, Shriners Hospitals for Children, Boston, MA 02114, USA
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19
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Lewis PL, Su J, Yan M, Meng F, Glaser SS, Alpini GD, Green RM, Sosa-Pineda B, Shah RN. Complex bile duct network formation within liver decellularized extracellular matrix hydrogels. Sci Rep 2018; 8:12220. [PMID: 30111800 PMCID: PMC6093899 DOI: 10.1038/s41598-018-30433-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 07/30/2018] [Indexed: 02/07/2023] Open
Abstract
The biliary tree is an essential component of transplantable human liver tissue. Despite recent advances in liver tissue engineering, attempts at re-creating the intrahepatic biliary tree have not progressed significantly. The finer branches of the biliary tree are structurally and functionally complex and heterogeneous and require harnessing innate developmental processes for their regrowth. Here we demonstrate the ability of decellularized liver extracellular matrix (dECM) hydrogels to induce the in vitro formation of complex biliary networks using encapsulated immortalized mouse small biliary epithelial cells (cholangiocytes). This phenomenon is not observed using immortalized mouse large cholangiocytes, or with purified collagen 1 gels or Matrigel. We also show phenotypic stability via immunostaining for specific cholangiocyte markers. Moreover, tight junction formation and maturation was observed to occur between cholangiocytes, exhibiting polarization and transporter activity. To better define the mechanism of duct formation, we utilized three fluorescently labeled, but otherwise identical populations of cholangiocytes. The cells, in a proximity dependent manner, either branch out clonally, radiating from a single nucleation point, or assemble into multi-colored structures arising from separate populations. These findings present liver dECM as a promising biomaterial for intrahepatic bile duct tissue engineering and as a tool to study duct remodeling in vitro.
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Affiliation(s)
- Phillip L. Lewis
- 0000 0001 2299 3507grid.16753.36Biomedical Engineering, Northwestern University, Evanston, IL, USA ,0000 0001 2299 3507grid.16753.36Simpson Querrey Institute, Northwestern University, Chicago, IL, USA
| | - Jimmy Su
- 0000 0001 2299 3507grid.16753.36Biomedical Engineering, Northwestern University, Evanston, IL, USA ,0000 0001 2299 3507grid.16753.36Simpson Querrey Institute, Northwestern University, Chicago, IL, USA
| | - Ming Yan
- 0000 0001 2299 3507grid.16753.36Biomedical Engineering, Northwestern University, Evanston, IL, USA ,0000 0001 2299 3507grid.16753.36Simpson Querrey Institute, Northwestern University, Chicago, IL, USA
| | - Fanyin Meng
- 0000 0004 0420 5847grid.413775.3Research Central Texas Veterans Health Care System, Temple, TX, USA ,grid.486749.0Baylor Scott & White Health Digestive Disease Research Center, Temple, TX, USA
| | - Shannon S. Glaser
- 0000 0004 0420 5847grid.413775.3Research Central Texas Veterans Health Care System, Temple, TX, USA ,grid.486749.0Baylor Scott & White Health Digestive Disease Research Center, Temple, TX, USA ,0000 0004 4687 2082grid.264756.4Medical Physiology, Texas A&M University College of Medicine, Temple, TX, USA
| | - Gianfranco D. Alpini
- 0000 0004 0420 5847grid.413775.3Research Central Texas Veterans Health Care System, Temple, TX, USA ,grid.486749.0Baylor Scott & White Health Digestive Disease Research Center, Temple, TX, USA ,0000 0004 4687 2082grid.264756.4Medical Physiology, Texas A&M University College of Medicine, Temple, TX, USA
| | - Richard M. Green
- 0000 0001 2299 3507grid.16753.36Division of Gastroenterology and Hepatology, Northwestern University, Chicago, IL, USA
| | - Beatriz Sosa-Pineda
- 0000 0001 2299 3507grid.16753.36Nephrology, Northwestern University, Chicago, IL, USA
| | - Ramille N. Shah
- 0000 0001 2299 3507grid.16753.36Simpson Querrey Institute, Northwestern University, Chicago, IL, USA ,0000 0001 2299 3507grid.16753.36Materials Science and Engineering, Northwestern University, Evanston, IL, USA ,0000 0001 2299 3507grid.16753.36Surgery (Transplant Division), Northwestern University, Chicago, IL, USA
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Nakashima S, Nakamura T, Miyagawa K, Yoshikawa T, Kin S, Kuriu Y, Nakase Y, Sakakura C, Otsuji E, Hagiwara A, Yamagishi H. In Situ Tissue Engineering of the Bile Duct Using Polypropylene Mesh-Collagen Tubes. Int J Artif Organs 2018; 30:75-85. [PMID: 17295195 DOI: 10.1177/039139880703000110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Multiple attempts have been made to replace biliary defects with a variety of materials. Recently, successful biliary reconstruction using the Gore-Tex vascular graft has been reported experimentally and clinically We designed a new artificial bile duct consisting of collagen sponge and polypropylene mesh. We presently evaluated the feasibility of using this prosthesis as a scaffold for bile duct tissue regeneration in a canine model. Our prosthesis, a sponge made from porcine dermal collagen, is reinforced with a polypropylene mesh cylinder. We used the prosthesis to reconstruct the middle portion of the common bile duct in seven beagle dogs to evaluate its efficacy. While one dog died of biliary stricture 8 months after operation, six survived without problems to scheduled time points for tissue evaluation at 1 to 12 months. All prostheses had become completely incorporated into the host. A confluent epithelial lining was observed within 3 months. In cholangiograms the prosthesis displayed long-term patency in the six dogs and provided satisfactory bile drainage for up to 12 months. Our graft thus shows promise for repair of biliary defects and should lead to development of a new treatment for biliary reconstruction.
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Affiliation(s)
- S Nakashima
- Department of Surgery and Regenerative Medicine, Division of Surgery and Physiology of Digestive System, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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Justin AW, Saeb-Parsy K, Markaki AE, Vallier L, Sampaziotis F. Advances in the generation of bioengineered bile ducts. Biochim Biophys Acta Mol Basis Dis 2017; 1864:1532-1538. [PMID: 29097260 DOI: 10.1016/j.bbadis.2017.10.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/25/2017] [Accepted: 10/26/2017] [Indexed: 12/17/2022]
Abstract
The generation of bioengineered biliary tissue could contribute to the management of some of the most impactful cholangiopathies associated with liver transplantation, such as biliary atresia or ischemic cholangiopathy. Recent advances in tissue engineering and in vitro cholangiocyte culture have made the achievement of this goal possible. Here we provide an overview of these developments and review the progress towards the generation and transplantation of bioengineered bile ducts. This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni and Peter Jansen.
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Affiliation(s)
| | - Kourosh Saeb-Parsy
- Department of Surgery, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Athina E Markaki
- Department of Engineering, University of Cambridge, Cambridge, UK
| | - Ludovic Vallier
- Wellcome Trust-Medical Research Council Stem Cell Institute, Cambridge Stem Cell Institute, Anne McLaren Laboratory, University of Cambridge, Cambridge, UK; Wellcome Trust Sanger Institute, Hinxton, UK; Department of Hepatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Fotios Sampaziotis
- Department of Surgery, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge, UK; Wellcome Trust-Medical Research Council Stem Cell Institute, Cambridge Stem Cell Institute, Anne McLaren Laboratory, University of Cambridge, Cambridge, UK; Department of Hepatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Buscemi S, Damiano G, Fazzotta S, Maffongelli A, Palumbo V, Ficarella S, Fiorica C, Cassata G, Licciardi M, Palumbo F, Gulotta L, Buscemi G, lo Monte A. Electrospun Polyhydroxyethyl-Aspartamide–Polylactic Acid Scaffold for Biliary Duct Repair: A Preliminary In Vivo Evaluation. Transplant Proc 2017; 49:711-715. [DOI: 10.1016/j.transproceed.2017.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Park SH, Kang BK, Lee JE, Chun SW, Jang K, Kim YH, Jeong MA, Kim Y, Kang K, Lee NK, Choi D, Kim HJ. Design and Fabrication of a Thin-Walled Free-Form Scaffold on the Basis of Medical Image Data and a 3D Printed Template: Its Potential Use in Bile Duct Regeneration. ACS APPLIED MATERIALS & INTERFACES 2017; 9:12290-12298. [PMID: 28322040 DOI: 10.1021/acsami.7b00849] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Three-dimensional (3D) printing, combined with medical imaging technologies, such as computed tomography and magnetic resonance imaging (MRI), has shown a great potential in patient-specific tissue regeneration. Here, we successfully fabricated an ultrathin tubular free-form structure with a wall thickness of several tens of micrometers that is capable of providing sufficient mechanical flexibility. Such a thin geometry cannot easily be achieved by 3D printing alone; therefore, it was realized through a serial combination of processes, including the 3D printing of a sacrificial template, the dip coating of the biomaterial, and the removal of the inner template. We demonstrated the feasibility of this novel tissue engineering construct by conducting bile duct surgery on rabbits. Moving from a rational design based on MRI data to a successful surgical procedure for reconstruction, we confirmed that the presented method of fabricating scaffolds has the potential for use in customized bile duct regeneration. In addition to the specific application presented here, the developed process and scaffold are expected to have universal applicability in other soft-tissue engineering fields, particularly those involving vascular, airway, and abdominal tubular tissues.
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Affiliation(s)
- Suk-Hee Park
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Ansan-si, Gyeonggi-do 426-910, Korea
| | | | - Ji Eun Lee
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Ansan-si, Gyeonggi-do 426-910, Korea
| | - Seung Woo Chun
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Ansan-si, Gyeonggi-do 426-910, Korea
| | | | | | | | | | | | - Nak Kyu Lee
- Micro/Nano Scale Manufacturing R&D Group, Korea Institute of Industrial Technology , Ansan-si, Gyeonggi-do 426-910, Korea
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Cheng Y, Xiong XZ, Zhou RX, Deng YL, Jin YW, Lu J, Li FY, Cheng NS. Repair of a common bile duct defect with a decellularized ureteral graft. World J Gastroenterol 2016; 22:10575-10583. [PMID: 28082809 PMCID: PMC5192268 DOI: 10.3748/wjg.v22.i48.10575] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/04/2016] [Accepted: 11/13/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the feasibility of repairing a common bile duct defect with a decellularized ureteral graft in a porcine model.
METHODS Eighteen pigs were randomly divided into three groups. An approximately 1 cm segment of the common bile duct was excised from all the pigs. The defect was repaired using a 2 cm long decellularized ureteral graft over a T-tube (T-tube group, n = 6) or a silicone stent (stent group, n = 6). Six pigs underwent bile duct reconstruction with a graft alone (stentless group). The surviving animals were euthanized at 3 mo. Specimens of the common bile ducts were obtained for histological analysis.
RESULTS The animals in the T-tube and stent groups survived until sacrifice. The blood test results were normal in both groups. The histology results showed a biliary epithelial layer covering the neo-bile duct. In contrast, all the animals in the stentless group died due to biliary peritonitis and cholangitis within two months post-surgery. Neither biliary epithelial cells nor accessory glands were observed at the graft sites in the stentless group.
CONCLUSION Repair of a common bile duct defect with a decellularized ureteral graft appears to be feasible. A T-tube or intraluminal stent was necessary to reduce postoperative complications.
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Tanimoto Y, Tashiro H, Mikuriya Y, Kuroda S, Hashimoto M, Kobayashi T, Taniura T, Ohdan H. Radiopaque biodegradable stent for duct-to-duct biliary reconstruction in pigs. Langenbecks Arch Surg 2016; 401:513-7. [DOI: 10.1007/s00423-016-1442-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/26/2016] [Indexed: 01/15/2023]
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Lewis PL, Shah RN. 3D Printing for Liver Tissue Engineering: Current Approaches and Future Challenges. CURRENT TRANSPLANTATION REPORTS 2016. [DOI: 10.1007/s40472-016-0084-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Struecker B, Hillebrandt KH, Raschzok N, Jöhrens K, Butter A, Tang P, Andreou A, Napierala H, Reutzel-Selke A, Denecke T, Pratschke J, Sauer IM. Implantation of a Tissue-Engineered Neo-Bile Duct in Domestic Pigs. Eur Surg Res 2015; 56:61-75. [PMID: 26684913 DOI: 10.1159/000441720] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/14/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Extrahepatic bile duct injuries remain severe complications during cholecystectomies and often require reconstruction by bilioenteric anastomosis (i.e., hepaticojejunostomy), which comes with further long-term complications (e.g., recurring ascending cholangitis, secondary biliary cirrhosis). In the case of inherent extrahepatic biliary atresia or during liver transplant, artificial or engineered bile ducts could allow novel surgical strategies without the need for hepaticojejunostomy. METHODS We present data on the implantation of in vitro-generated neo-bile ducts in 5 domestic pigs. The neo-bile ducts were engineered through decellularization of allogeneic blood vessels and recellularization with autologous cholangiocytes. On postoperative days 0, 1, 7, and 14, blood samples were taken and analyzed (aspartate aminotransferase, alanine aminotransferase, bilirubin, alkaline phosphatase, creatinine, and leukocytes). Magnetic resonance cholangiopancreatography was performed on postoperative day 14 on 1 pig. Fourteen days after implantation, the pigs were sacrificed and the bile ducts were explanted. RESULTS All pigs survived the complete study period without severe complications. None of the pigs showed signs of biliary leakage or peritonitis. The neo-bile ducts were infiltrated by neutrophils, and neoangiogenesis was observed around and into the implanted tissue. CONCLUSION We present a novel strategy for extrahepatic bile duct replacement by implantation of an autologous neo-bile duct generated ex vivo. Whether the presented technique allows the long-term replacement of native bile ducts must be further evaluated.
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Affiliation(s)
- Benjamin Struecker
- Department of General, Visceral, and Transplantation Surgery, Charitx00E9; - Universitx00E4;tsmedizin Berlin, Berlin, Germany
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An Artificial Bile Duct Made of Bioabsorbable Polymer: A Viable Substitute for Narrowed Portion of the Extrahepatic Bile Duct. Int Surg 2015. [DOI: 10.9738/intsurg-d-15-00037.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The aim of this study was to investigate whether an artificial bile duct made of bioabsorbable polymer could serve as a substitute for narrowed portions of the bile duct. The experiments were performed using hybrid pigs (n = 11). After laparotomy under general anesthesia, the extrahepatic bile duct was identified and ligated around the confluence with the cystic duct. A week later, repeat laparotomy was performed on the animals, and the bile duct on the hepatic side of the ligature was resected. The cut end was connected to the duodenum using a bioabsorbable artificial bile duct fabricated from a copolymer of polycaprolactone and polylactic acid fibers. The grafts were recovered for gross, histologic, and blood chemical studies at 4 months after the surgery. All recipient pigs survived until they were humanely killed for collection of the implants. A week of ligation of the extrahepatic bile duct dilated the duct to approximately 1 cm in diameter and increased total bilirubin. Total bilirubin had returned to the pre-implantation level in all animals at 4 months post implantation. Examinations of the grafts revealed complete freedom of stricture and the regeneration of a neo-bile duct of approximately 1 cm in diameter from the graft site in 10 of 11 animals. Gross observation of the graft from the 1 remaining animal revealed stricture at the anastomosis site and poor bile duct epithelization. We have concluded that this bioabsorbable polymer bile duct can serve as a replacement for narrowed portions of the bile duct.
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Miyazawa M, Aikawa M, Watanabe Y, Takase KI, Okamoto K, Shrestha S, Okada K, Koyama I, Ikada Y. Extensive regeneration of the stomach using bioabsorbable polymer sheets. Surgery 2015; 158:1283-90. [PMID: 25964027 DOI: 10.1016/j.surg.2015.04.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 03/28/2015] [Accepted: 04/05/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND The growing prevalence of endoscopic surgery in recent years has led to the minimization of postoperative scarring. However, this procedure does not allow for the regeneration of the resected digestive tract, which compromises the postoperative maintenance of digestive function. In this preliminary study, we developed an artificial gastric wall (AGW) using bioabsorbable polymer (BAP), and evaluated the ability of this BAP patch to repair and regenerate a widely defective gastric wall in an animal model. METHODS Pigs were laparotomized under general anesthesia. An 8 × 8-cm, round portion of the anterior gastric wall was excised and replaced by an AGW. The AGW was composed of a copolymer comprising 50% lactic acid and 50% caprolactone. The animals were relaparotomized 4, 8, or 12 weeks after implantation, after which they underwent resection of the entire stomach for gross and histologic evaluation of the graft sites. RESULTS All recipient pigs survived until killing. By 4-8 weeks, the graft site revealed progressively fewer mucosal defect after each day. Moreover, the grafted area was indistinguishable from the native stomach 12 weeks after AGW implantation. The structures of the regenerated mucous membrane and muscle layers were identical to those of the native stomach. Furthermore, proton pumps were found in the regenerated tissue. CONCLUSION The BAP sheets helped to restore extensive gastric defects without causing any deformation. The use of BAP sheets may become a new therapeutic method that prevents alterations of gastric volume after extensive gastrectomy for stomach cancer and other diseases.
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Affiliation(s)
- Mitsuo Miyazawa
- Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan.
| | - Masayasu Aikawa
- Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yukihiro Watanabe
- Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Ken-ichiro Takase
- Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Kojun Okamoto
- Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Santosh Shrestha
- Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Katsuya Okada
- Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Isamu Koyama
- Department of Surgery, Gastrointestinal Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yoshito Ikada
- Division of Life Science, Nara Medical University, Nara, Japan
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Zong C, Wang M, Yang F, Chen G, Chen J, Tang Z, Liu Q, Gao C, Ma L, Wang J. A novel therapy strategy for bile duct repair using tissue engineering technique: PCL/PLGA bilayered scaffold with hMSCs. J Tissue Eng Regen Med 2015; 11:966-976. [DOI: 10.1002/term.1996] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 07/22/2014] [Accepted: 12/09/2014] [Indexed: 12/30/2022]
Affiliation(s)
- Chen Zong
- Laboratory of Stem Cells, Institute of Cell Biology, College of Life Sciences; Zhejiang University; Hangzhou Zhejiang China
- Tumor Immunology and Gene Therapy Centre, Eastern Hepatobiliary Surgery Hospital; The Second Military Medical University; Shanghai China
| | - Meicong Wang
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering; Zhejiang University; Hangzhou China
| | - Fuchun Yang
- Hepatic Biliary Pancreatic Surgery, The First Affiliated Hospital; Zhejiang University; Hangzhou Zhejiang China
| | - Guojun Chen
- Division of Paediatrics; Zhejiang General Hospital of Armed Police Forces; Jiaxing City Zhejiang China
| | - Jiarong Chen
- Laboratory of Stem Cells, Institute of Cell Biology, College of Life Sciences; Zhejiang University; Hangzhou Zhejiang China
| | - Zihua Tang
- Laboratory of Stem Cells, Institute of Cell Biology, College of Life Sciences; Zhejiang University; Hangzhou Zhejiang China
| | - Quanwen Liu
- Laboratory of Stem Cells, Institute of Cell Biology, College of Life Sciences; Zhejiang University; Hangzhou Zhejiang China
| | - Changyou Gao
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering; Zhejiang University; Hangzhou China
| | - Lie Ma
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering; Zhejiang University; Hangzhou China
| | - Jinfu Wang
- Laboratory of Stem Cells, Institute of Cell Biology, College of Life Sciences; Zhejiang University; Hangzhou Zhejiang China
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A newly designed anal fistula plug: clinicopathological study in an experimental iatrogenic fistula model. Int Surg 2014; 98:122-8. [PMID: 23701146 DOI: 10.9738/cc180] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We report on a clinicopathologic study in an animal model of treatment with a new bioabsorbable polymer plug (BAPP). Over a 2-week period, 6 porcine models, which each had 4 anal fistulae, were created using Blake drains. The pigs were divided into 2 groups: the BAPP-treatment group (n = 12 fistulae) and the control group (n = 12 fistulae). Two weeks later, the pigs were humanely killed, and the perianal sites were excised and examined with gross and pathologic studies. Each fistula in the BAPP group was completely cured. In the pathologic study, the treatment sites had little disarray, few defects in the muscular layer, and small numbers of inflammatory cells. The control group had a significantly greater number of inflammatory cells and microabscesses than the BAPP group. The newly developed BAPP reduced the infection and induced good healing in anal fistulae. The BAPP may be a useful new device for the clinical treatment of anal fistulae.
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Abstract
Despite the tremendous hurdles presented by the complexity of the liver's structure and function, advances in liver physiology, stem cell biology and reprogramming, and the engineering of tissues and devices are accelerating the development of cell-based therapies for treating liver disease and liver failure. This State of the Art Review discusses both the near- and long-term prospects for such cell-based therapies and the unique challenges for clinical translation.
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Affiliation(s)
- Sangeeta N Bhatia
- Institute for Medical Engineering & Science at MIT, Department of Electrical Engineering and Computer Science, David H. Koch Institute at MIT, and the Howard Hughes Medical Institute, Cambridge, MA 02139, USA. Division of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Gregory H Underhill
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Kenneth S Zaret
- Institute for Regenerative Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ira J Fox
- Department of Surgery, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, and McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15224, USA
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Del Gaudio C, Baiguera S, Ajalloueian F, Bianco A, Macchiarini P. Are synthetic scaffolds suitable for the development of clinical tissue-engineered tubular organs? J Biomed Mater Res A 2013; 102:2427-47. [PMID: 23894109 DOI: 10.1002/jbm.a.34883] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 07/11/2013] [Accepted: 07/17/2013] [Indexed: 02/06/2023]
Abstract
Transplantation of tissues and organs is currently the only available treatment for patients with end-stage diseases. However, its feasibility is limited by the chronic shortage of suitable donors, the need for life-long immunosuppression, and by socioeconomical and religious concerns. Recently, tissue engineering has garnered interest as a means to generate cell-seeded three-dimensional scaffolds that could replace diseased organs without requiring immunosuppression. Using a regenerative approach, scaffolds made by synthetic, nonimmunogenic, and biocompatible materials have been developed and successfully clinically implanted. This strategy, based on a viable and ready-to-use bioengineered scaffold, able to promote novel tissue formation, favoring cell adhesion and proliferation, could become a reliable alternative to allotransplatation in the next future. In this article, tissue-engineered synthetic substitutes for tubular organs (such as trachea, esophagus, bile ducts, and bowel) are reviewed, including a discussion on their morphological and functional properties.
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Affiliation(s)
- Costantino Del Gaudio
- University of Rome "Tor Vergata", Department of Industrial Engineering, Intrauniversitary Consortium for Material Science and Technology (INSTM), Research Unit Tor Vergata, Rome, Italy
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Aikawa M, Miyazawa M, Okamoto K, Okada K, Akimoto N, Yamaguchi S, Koyama I, Taguchi T, Ikada Y. Novel pancreatoenteric reconstruction using a bioabsorbable polymer sheet and biocompatible bond. J Surg Res 2013; 183:1-7. [DOI: 10.1016/j.jss.2012.11.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/23/2012] [Accepted: 11/28/2012] [Indexed: 10/27/2022]
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Siqueira OHK, Herani Filho B, Paula RED, Ascoli FO, Nóbrega ACLD, Carvalho ACG, Pires ARC, Gaglionone NC, Cunha KSG, Granjeiro JM. Tamoxifen decreases the myofibroblast count in the healing bile duct tissue of pigs. Clinics (Sao Paulo) 2013; 68:101-6. [PMID: 23420165 PMCID: PMC3552444 DOI: 10.6061/clinics/2013(01)oa16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 09/21/2012] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of oral tamoxifen treatment on the number of myofibroblasts present during the healing process after experimental bile duct injury. METHODS The sample consisted of 16 pigs that were divided into two groups (the control and study groups). Incisions and suturing of the bile ducts were performed in the two groups. Tamoxifen (20 mg/day) was administered only to the study group. The animals were sacrificed after 30 days. Quantification of myofibroblasts in the biliary ducts was made through immunohistochemistry analysis using anti-alpha smooth muscle actin of the smooth muscle antibody. Immunohistochemical quantification was performed using a digital image system. RESULTS In the animals treated with tamoxifen (20 mg/day), there was a significant reduction in immunostaining for alpha smooth muscle actin compared with the control group (0.1155 vs. 0.2021, p = 0.046). CONCLUSION Tamoxifen reduced the expression of alpha smooth muscle actin in the healing tissue after bile duct injury, suggesting a decrease in myofibroblasts in the scarred area of the pig biliary tract. These data suggest that tamoxifen could be used in the prevention of biliary tract stenosis after bile duct surgeries.
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Liang YL, Yu YC, Liu K, Wang WJ, Ying JB, Wang YF, Cai XJ. Repair of bile duct defect with degradable stent and autologous tissue in a porcine model. World J Gastroenterol 2012; 18:5205-10. [PMID: 23066314 PMCID: PMC3468852 DOI: 10.3748/wjg.v18.i37.5205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 07/04/2012] [Accepted: 07/18/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To introduce and evaluate a new method to repair bile duct defect with a degradable stent and autologous tissues.
METHODS: Eight Ba-Ma mini-pigs were used in this study. Experimental models with common bile duct (CBD) defect (0.5-1.0 cm segment of CBD resected) were established and then CBD was reconstructed by duct to duct anastomosis with a novel degradable stent made of poly [sebacic acid-co-(1,3-propanediol)-co-(1,2-propanediol)]. In addition, a vascularized greater omentum was placed around the stent and both ends of CBD. Cholangiography via gall bladder was performed for each pig at postoperative months 1 and 3 to rule out stent translocation and bile duct stricture. Complete blood count was examined pre- and post-operatively to estimate the inflammatory reaction. Liver enzymes and serum bilirubin were examined pre- and post-operatively to evaluate the liver function. Five pigs were sacrificed at month 3 to evaluate the healing of anastomosis. The other three pigs were raised for one year for long-term observation.
RESULTS: All the animals underwent surgery successfully. There was no intraoperative mortality and no bile leakage during the observation period. The white blood cell counts were only slightly increased on day 14 and month 3 postoperatively compared with that before operation, the difference was not statistically significant (P = 0.652). The plasma level of alanine aminotransferase on day 14 and month 3 postoperatively was also not significantly elevated compared with that before operation (P = 0.810). Nevertheless, the plasma level of γ-glutamyl transferase was increased after operation in both groups (P = 0.004), especially 2 wk after operation. The level of serum total bilirubin after operation was not significantly elevated compared with that before operation (P = 0.227), so did the serum direct bilirubin (P = 0.759). By cholangiography via gall bladder, we found that the stent maintained its integrity of shape and was still in situ at month 1, and it disappeared completely at month 3. No severe CBD dilation and stricture were observed at both months 1 and 3. No pig died during the 3-mo postoperative observation period. No sign of necrosis, bile duct stricture, bile leakage or abdominal abscess was found at reoperation at month 3 postoperatively. Pigs had neither fragments of stent nor stones formed in the CBD. Collagen deposit was observed in the anastomosis by hematoxylin and eosin (HE) and Masson’s trichrome stains. No severe cholestasis was observed in liver parenchyma by HE staining. Intestinal obstruction was found in a pig 4 mo after operation, and no bile leakage, bile duct stricture or biliary obstruction were observed in laparotomy. No sign of bile duct stricture or bile leakage was observed in the other two pigs.
CONCLUSION: The novel method for repairing bile duct defect yielded a good short-term effect without postoperative bile duct stricture. However, the long-term effect should be further studied.
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Li Q, Tao L, Chen B, Ren H, Hou X, Zhou S, Zhou J, Sun X, Dai J, Ding Y. Extrahepatic bile duct regeneration in pigs using collagen scaffolds loaded with human collagen-binding bFGF. Biomaterials 2012; 33:4298-308. [PMID: 22429981 DOI: 10.1016/j.biomaterials.2012.03.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 03/03/2012] [Indexed: 12/21/2022]
Abstract
Extrahepatic bile duct defects and their complications are benign lesions but with malignant outcomes. Extrahepatic bile duct regeneration at the injury site could be important for the repair. In our previous work, a human basic fibroblast growth factor (bFGF) fused with a collagen-binding domain (CBD) was produced to activate the collagen membrane to obtain targeted tissue regeneration. This collagen/growth factor functional biomaterial could promote the regeneration of skin, bladder and full-thickness abdominal wall by accelerating vascularization and cellularization of autologous tissues. We speculate that the functional biomaterial could also provide the repairing effect on extrahepatic bile duct injuries. Using a pig extrahepatic bile duct injury model, we found that the collagen/CBD-bFGF composite biomaterial could significantly promote the extrahepatic bile duct regeneration at the injury site without causing structure deformation or hepatic dysfunction during both short- and long-time observations.
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Affiliation(s)
- Qiang Li
- Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
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An extrahepatic bile duct grafting using a bioabsorbable polymer tube. J Gastrointest Surg 2012; 16:529-34. [PMID: 22223111 DOI: 10.1007/s11605-011-1801-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 12/14/2011] [Indexed: 01/31/2023]
Abstract
BACKGROUND Thus far, no ideal substitutions have been developed for completely replacing the extrahepatic bile duct (EHBD). METHODS We used a bioabsorbable polymer tube (BAPT) for the complete reconstruction of an EHBD in pigs. A 2-cm-long EHBD was resected from the duodenal side, and a 4-cm-long BAPT graft was implanted at that site. The animals were re-laparotomized at 1 or 4 months after the grafting; subsequently, gross, histological, and blood chemical studies were performed. RESULTS At 1 month after grafting, tubular structure was observed in all resected specimens, and the lumen of the graft site had remnants of degraded BAPT. Gross examination at 4 months after grafting revealed that the BAPT had been completely absorbed, and the graft site was indistinguishable from the native extrahepatic bile duct. The lengths of the graft region at 4 months were 70% of the replaced BAPT. Simultaneously performed histological examination revealed the growth of a neo-bile duct at the graft site, with an epithelium identical to that of the native bile duct. CONCLUSION The BAPT graft implanted in this study completely replaced the EHBD defect. Hence, BAPT has the potential for application as a novel treatment modality for hepatobiliary diseases.
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Cheng Y, Lin Y, Xiong X, Wu S, Lu J, Cheng N. The human umbilical cord: A novel substitute for reconstruction of the extrahepatic bile duct. JOURNAL OF MEDICAL HYPOTHESES AND IDEAS 2012. [DOI: 10.1016/j.jmhi.2012.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Nau P, Liu J, Ellison EC, Hazey JW, Henn M, Muscarella P, Narula VK, Melvin WS. Novel reconstruction of the extrahepatic biliary tree with a biosynthetic absorbable graft. HPB (Oxford) 2011; 13:573-8. [PMID: 21762301 PMCID: PMC3163280 DOI: 10.1111/j.1477-2574.2011.00337.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The reference standard technique for the reconstruction of the extrahepatic biliary tree is Roux-en-Y hepaticojejunostomy. This procedure is not without complications and may not be feasible in some patients. This project sought to evaluate a novel approach for repairing common bile duct injuries with a biosynthetic graft. This allows for the reconstruction of the anatomy without necessitating an intestinal bypass. METHODS Study subjects were 11 mongrel hounds. Utilizing an open approach, the common bile duct was transected in each animal. A 1-cm graft of a synthetic bioabsorbable prosthesis was interposed over a 5-Fr pancreatic stent and sewn in place as an interposition tube graft with absorbable sutures. Intraoperative cholangiograms and monthly liver function tests were completed. Animals were killed at 6, 7, 8, 10 and 12 months. RESULTS The first five animals were killed early in the process of protocol development. One animal developed obstructive symptoms and was killed on postoperative day 14. The next five animals were longterm survivors without evidence of clinically significant graft stenosis. Mean alkaline phosphatase and total bilirubin were normal, at 140 U/l and 0.2 mg/dl, respectively. Histology showed the complete replacement of the graft with native tissue at 6 months. CONCLUSIONS Biliary reconstruction using a synthetic bioabsorbable prosthetic as an interposition tube graft is feasible based on initial results.
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Affiliation(s)
- Peter Nau
- Department of Surgery, Ohio State University School of Medicine and Public HealthColumbus, OH, USA
| | - James Liu
- Department of Pathology, Ohio State University School of Medicine and Public HealthColumbus, OH, USA
| | - E Christopher Ellison
- Department of Surgery, Ohio State University School of Medicine and Public HealthColumbus, OH, USA
| | - Jeffrey W Hazey
- Department of Surgery, Ohio State University School of Medicine and Public HealthColumbus, OH, USA
| | - Matthew Henn
- Department of Surgery, Ohio State University School of Medicine and Public HealthColumbus, OH, USA
| | - Peter Muscarella
- Department of Surgery, Ohio State University School of Medicine and Public HealthColumbus, OH, USA
| | - Vimal K Narula
- Department of Surgery, Ohio State University School of Medicine and Public HealthColumbus, OH, USA
| | - W Scott Melvin
- Department of Surgery, Ohio State University School of Medicine and Public HealthColumbus, OH, USA
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Miyazawa M, Aikawa M, Okada K, Toshimitsu Y, Okamoto K, Koyama I, Ikada Y. Regeneration of extrahepatic bile ducts by tissue engineering with a bioabsorbable polymer. J Artif Organs 2011; 15:26-31. [DOI: 10.1007/s10047-011-0590-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 07/04/2011] [Indexed: 12/29/2022]
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Wang X, Yan Y, Zhang R. Recent trends and challenges in complex organ manufacturing. TISSUE ENGINEERING PART B-REVIEWS 2010; 16:189-97. [PMID: 19824803 DOI: 10.1089/ten.teb.2009.0576] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Presently, there is a recognized and imperative need for bioartificial organs. The technological advances in transgenosis, tissue engineering, and rapid prototyping have led to the development of spatially complex tissues. An ideal artificial organ should provide nutrient transport system, mechanical stable architecture, and synergetic multicellular organization in one construct. The multinozzle rapid prototyping technique simultaneously assembles vascular systems including hierarchical multicellular structures in an automated and reproducible manner and offers an effective way for treating organ failures. In this article, a brief overview of the recent trends and outstanding challenges in organ manufacturing is provided. From the viewpoint of disciplinary crossing, integration, and development, future directions in the coming years were pointed out.
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Affiliation(s)
- Xiaohong Wang
- Center of Organ Manufacturing & Key Laboratory for Advanced Materials Processing Technology, Ministry of Education, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, P.R. China
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A novel treatment for bile duct injury with a tissue-engineered bioabsorbable polymer patch. Surgery 2010; 147:575-80. [DOI: 10.1016/j.surg.2009.10.049] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2008] [Accepted: 10/12/2009] [Indexed: 01/24/2023]
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Palmes D, Wolters H, Spiegel HU, M Ller E, Minin E, Heistermann HP. Morphological changes during creation of a neo-bile duct using a vein and a biodegradable endoluminal stent. J INVEST SURG 2010; 22:435-44. [PMID: 20001814 DOI: 10.3109/08941930903410791] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Major bile duct lesions are usually treated by a hepaticojejunostomy which is often complicated by cholangitis and liver fibrosis. The aim of this study was to investigate the morphologic features of a neo-bile duct created from a vein and a biodegradable endoluminal stent. The neo-bile duct was created using a segment of the external jugular vein which was endoluminally stented by a biodegradable poly-lactate-acid stent. In 18 pigs, the common bile duct was resected and replaced by the vein with (n = 12) or without endoluminal stent (n = 6). Six animals served as controls. Survival, liver function and morphological changes of the neo-bile duct and the liver were observed for six months. After six months, the neo-bile duct morphologically resembled the native bile duct showing Ck7-positive columnar epithelium and newly formed capillaries in the bile duct wall. The biodegradable stent disappeared after four months. All animals survived and showed normal liver function and no cholestasis. In contrast, after sole vein reconstruction of the bile duct, four animals died due to biliary peritonitis and cholangitis. Creation of a neo-bile duct which morphologically resembles the native bile duct is feasible by using a body's own vein and a biodegradable endoluminal stent.
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Affiliation(s)
- Daniel Palmes
- Surgical Research, Department of General and Visceral Surgery, Muenster University Hospital, Muenster, Germany
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Aikawa M, Miyazawa M, Okada K, Toshimitsu Y, Okamoto K, Akimoto N, Koyama I, Ikada Y. Development of a novel reflux-free bilioenteric anastomosis procedure by using a bioabsorbable polymer tube. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2009; 17:284-90. [DOI: 10.1007/s00534-009-0178-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 08/25/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Masayasu Aikawa
- Gastrointestinal Center; Saitama Medical University International Medical Center; 1397-1 Yamane, Hidaka Saitama 350-1298 Japan
| | - Mitsuo Miyazawa
- Gastrointestinal Center; Saitama Medical University International Medical Center; 1397-1 Yamane, Hidaka Saitama 350-1298 Japan
| | - Katsuya Okada
- Gastrointestinal Center; Saitama Medical University International Medical Center; 1397-1 Yamane, Hidaka Saitama 350-1298 Japan
| | - Yasuko Toshimitsu
- Gastrointestinal Center; Saitama Medical University International Medical Center; 1397-1 Yamane, Hidaka Saitama 350-1298 Japan
| | - Kojun Okamoto
- Gastrointestinal Center; Saitama Medical University International Medical Center; 1397-1 Yamane, Hidaka Saitama 350-1298 Japan
| | - Naoe Akimoto
- Gastrointestinal Center; Saitama Medical University International Medical Center; 1397-1 Yamane, Hidaka Saitama 350-1298 Japan
| | - Isamu Koyama
- Gastrointestinal Center; Saitama Medical University International Medical Center; 1397-1 Yamane, Hidaka Saitama 350-1298 Japan
| | - Yoshito Ikada
- Gastrointestinal Center; Saitama Medical University International Medical Center; 1397-1 Yamane, Hidaka Saitama 350-1298 Japan
- Division of Life Science; Nara Medical University; Nara Japan
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Kanatani I, Kanematsu A, Inatsugu Y, Imamura M, Negoro H, Ito N, Yamamoto S, Tabata Y, Ikada Y, Ogawa O. Fabrication of an Optimal Urethral Graft Using Collagen-Sponge Tubes Reinforced with Copoly(L-Lactide/ε-Caprolactone) Fabric. ACTA ACUST UNITED AC 2007; 13:2933-40. [DOI: 10.1089/ten.2007.0052] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Isao Kanatani
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Akihiro Kanematsu
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Masaaki Imamura
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Hiromitsu Negoro
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Noriyuki Ito
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shingo Yamamoto
- Department of Urology, Hyogo Medical College, Nishinomiya, Hyogo, Japan
| | - Yasuhiko Tabata
- Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
| | - Yoshito Ikada
- Department of Bioenvironmental Medicine, Nara Medical University, Nara, Japan
| | - Osamu Ogawa
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Miyazawa M, Aikawa M, Torii T, Okada K, Otani Y, Koyama I, Ikada Y. evelopment of a Bioabsorbable Stent to Treat Benign Bile Duct Stenosis. ACTA ACUST UNITED AC 2007. [DOI: 10.5833/jjgs.40.1548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - Isamu Koyama
- Department of Surgery, Saitama Medical University
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