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Bladder wall replacement by tissue engineering and autologous keratinocytes in minipigs
Author(s) -
BREHMER BERNHARD,
ROHRMANN DOROTHEA,
RAU GÜNTER,
JAKSE GERHARD
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06005.x
Subject(s) - bladder augmentation , cystography , tissue engineering , urinary bladder , epithelium , medicine , ileum , urology , scaffold , keratinocyte , surgery , anatomy , pathology , urinary system , cell culture , biomedical engineering , biology , genetics
OBJECTIVE To develop a tissue‐engineered bladder wall replacement with autologous cells and a biodegradable scaffold, as whenever there is a lack of native urological tissue the bladder is reconstructed with different bowel segments, which has inevitable complications. MATERIAL AND METHODS Skin biopsies were taken from six minipigs, and primary fibroblast and keratinocyte cell cultures established. A partial resection of the urinary bladder was reconstructed by a cell‐seeded scaffold covered with completely differentiated epithelium and supported by a mucosa‐free pedicled ileum graft. Each pig was assessed urodynamically and by cystography before operation and every month until explantation; the pigs were killed at 1, 2 and 3 months after augmentation. Control groups (of six pigs each) with bladder augmentation with complete or denuded ileum were used. The bladders were assessed histologically and by distensibility measurements RESULTS The differentiated keratinocyte epithelium was still present on the reconstructed bladder wall after 3 months. The overall shrinkage rate was 6.5%. The engineered bladder wall had lower distensibility than the native one. The inflammatory reaction present initially had disappeared after 3 months. CONCLUSIONS The implanted, tissue‐engineered substitution of the bladder wall is not only a bridging graft, but also a complete reconstruction. With this model, extended bladder wall substitution seems feasible and should be investigated in further studies.