REGENERATION OF FUNCTIONAL BLADDER SUBSTITUTES USING LARGE SEGMENT ACELLULAR MATRIX ALLOGRAFTS IN A PORCINE MODEL

Abstract

No AccessJournal of UrologyReconstruction1 Sep 2000REGENERATION OF FUNCTIONAL BLADDER SUBSTITUTES USING LARGE SEGMENT ACELLULAR MATRIX ALLOGRAFTS IN A PORCINE MODEL PRAMOD P. REDDY, DIEGO J. BARRIERAS, GREGORY WILSON, DARIUS J. BÄGLI, GORDON A. McLORIE, ANTOINE E. KHOURY, and PAUL A. MERGUERIAN PRAMOD P. REDDYPRAMOD P. REDDY More articles by this author , DIEGO J. BARRIERASDIEGO J. BARRIERAS More articles by this author , GREGORY WILSONGREGORY WILSON More articles by this author , DARIUS J. BÄGLIDARIUS J. BÄGLI More articles by this author , GORDON A. McLORIEGORDON A. McLORIE More articles by this author , ANTOINE E. KHOURYANTOINE E. KHOURY More articles by this author , and PAUL A. MERGUERIANPAUL A. MERGUERIAN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67221-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We previously reported on the short-term (4 weeks) morphometric analysis of a large bladder acellular matrix allograft used as a bladder bioprosthesis (average size 24 cm.2). We demonstrated cellular repopulation through the entire thickness of the graft. We now present the long-term (12 weeks) morphometric results of graft regenerated porcine bladders using segments measuring an average of 40 cm.2. Materials and Methods: Bladders harvested from pigs were subjected to detergent and enzymatic extractions to render them acellular. Partial cystectomy was performed in 21 pigs and the defect was repaired with a bladder acellular matrix allograft (average size 40.52 cm.2). Of the animals 8 were sacrificed at 1, 2 and 4 weeks and 13 were sacrificed at 8 and 12 weeks. To evaluate cellular repopulation and matrix reorganization the native bladder and graft were analyzed using standard histological and immunofluorescent techniques. To evaluate for calcium deposits in the grafts a radiological evaluation of the graft was performed after explantation. Results: All animals survived the surgical procedure and there were no significant urinary leaks. No stones were noted in any of the bladders. At 1 week there was a diffuse infiltration with acute inflammatory cells. At 2 weeks the luminal surface of the graft was lined with a single layer of urothelium, and there was stromal infiltration with unorganized smooth muscle cells and angiogenesis. At 4 weeks the urothelium was multilayered with organizing groups of smooth muscle cells and angiogenesis. At 8 and 12 weeks there was repopulation throughout the bladder acellular matrix allograft implant with all native cellular components participating. Conclusions: We present evidence that large patch bladder acellular matrix allograft implantation is technically feasible and may prove to be a viable surgical alternative to bladder augmentation with intestinal segments. Its advantages may include the potential for complete and functional regeneration of a bladder substitute. References 1 : Complications of bladder substitution and continent urinary diversion. Urology1989; 34: 329. Google Scholar 2 : Implantation in vivo and retrieval of artificial structures consisting of rabbit and human urothelium and human bladder muscle. J Urol, part 2.1993; 150: 608. Abstract, Google Scholar 3 : Functional rat bladder regeneration through xenotransplantation of the bladder acellular matrix graft. Br J Urol1998; 81: 548. Google Scholar 4 : In vitro functional properties of the rat bladder regenerated by the bladder acellular matrix graft. J Urol1998; 159: 1717. Link, Google Scholar 5 : Acellular matrix allograft small caliber vascular prosthesis. ASAIO Trans1990; 36: M340. Google Scholar 6 : Development of a pericardial acellular matrix biomaterial: biochemical and mechanical effects of cell extraction. J Biomed Mater Res1994; 28: 655. Google Scholar 7 : Acellular matrix: a biomaterials approach for coronary artery bypass and heart valve replacement. Ann Thorac Surg1995; 60: S353. Google Scholar 8 : Regeneration of bladder urothelium, smooth muscle, blood vessels and nerves into an acellular tissue matrix. J Urol, part 21996; 156: 571. Link, Google Scholar 9 : Sirius Red F3BA as a stain for connective tissues. Arch Path1964; 78: 69. Google Scholar 10 : Molecular analysis of collagens in bladder fibrosis. J Urol1998; 160: 1518. Link, Google Scholar 11 : The collagens and their urologic significance. Scand J Urol Nephrol1997; 184: 25. Google Scholar 12 : Methods for the isolation, culture and characterization of equine pulmonary artery endothelial cells. Res Vet Sci1997; 62: 147. Google Scholar 13 : Peripherin: a novel marker for the immunohistochemical study of malformations of the enteric nervous system. Pediatr Pathol Lab Med1996; 16: 51. Google Scholar 14 : The use of alloplastic biomaterials in bladder substitution. J Urol1992; 148: 1377. Link, Google Scholar 15 : Tissue engineering in urologic surgery. Urol Clin North Am1998; 25: 39. Google Scholar 16 : Autologous cell transplantation for urologic reconstruction. J Urol1998; 159: 2. Link, Google Scholar 17 : De novo reconstitution of a functional mammalian urinary bladder by tissue engineering. Nat Biotechnol1999; 17: 149. Google Scholar 18 : The ontogeny of canine small intestinal submucosa regenerated bladder. J Urol1997; 158: 1105. Link, Google Scholar 19 : Small intestinal submucosa as a large diameter vascular graft in the dog. J Surg Res1989; 47: 74. Google Scholar 20 : Detrusor regeneration in the rat using porcine intestinal submucosal grafts: functional innervation and receptor expression. J Urol1996; 155: 374. Link, Google Scholar 21 : Characterization of small intestinal submucosa regenerated canine detrusor: assessment of reinnervation, in vitro compliance and contractility. J Urol, part 21996; 156: 599. Link, Google Scholar 22 : A simple versatile nondisruptive method for the isolation of morphologically and chemically pure basement membranes from several tissues. Life Sci1975; 17: 1721. Google Scholar From the Division of Urology, Department of Surgery, and Department of Cellular and Molecular Pathology, The Hospital for Sick Children, University of Toronto, Ontario, Canada© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKwon T, Yoo J and Atala A (2008) Local and Systemic Effects of a Tissue Engineered Neobladder in a Canine Cystoplasty ModelJournal of Urology, VOL. 179, NO. 5, (2035-2041), Online publication date: 1-May-2008.HAFEZ A, AFSHAR K, BÄGLI D, BAHORIC A, AITKEN K, SMITH C and KHOURY A (2018) AEROSOL TRANSFER OF BLADDER UROTHELIAL AND SMOOTH MUSCLE CELLS ONTO DEMUCOSALIZED COLONIC SEGMENTS FOR PORCINE BLADDER AUGMENTATION IN VIVO: A 6-WEEK EXPERIMENTAL STUDYJournal of Urology, VOL. 174, NO. 4 Part 2, (1663-1668), Online publication date: 1-Oct-2005.MASTER V, WEI G, LIU W and BASKIN L (2018) Urothlelium Facilitates the Recruitment and Trans-Differentiation of Fibroblasts into Smooth Muscle in Acellular MatrixJournal of Urology, VOL. 170, NO. 4 Part 2, (1628-1632), Online publication date: 1-Oct-2003.HAFEZ A, BÄGLI D, BAHORIC A, AITKEN K, SMITH C, HERZ D and KHOURY A (2018) Aerosol Transfer of Bladder Urothelial and Smooth Muscle Cells Onto Demucosalized Colonic Segments: A Pilot StudyJournal of Urology, VOL. 169, NO. 6, (2316-2320), Online publication date: 1-Jun-2003.Walker B, Gardner M, Gatti J, Lowichik A, Snow B and Cartwright P (2018) Bladder Augmentation in Dogs Using the Tissue Capsule Formed Around a Perivesical Tissue ExpanderJournal of Urology, VOL. 168, NO. 4 Part 1, (1534-1536), Online publication date: 1-Oct-2002. Volume 164Issue 3 Part 2September 2000Page: 936-941 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordstransplantation, homologousregenerationbladderMetricsAuthor Information PRAMOD P. REDDY More articles by this author DIEGO J. BARRIERAS More articles by this author GREGORY WILSON More articles by this author DARIUS J. BÄGLI More articles by this author GORDON A. McLORIE More articles by this author ANTOINE E. KHOURY More articles by this author PAUL A. MERGUERIAN More articles by this author Expand All Advertisement PDF downloadLoading ...