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Engineered Neo-Organs For Bladder Replacement

In this research, the investigators created a new form of bladder in vitro, outside the living organism in the lab, and implanted it in 6 beagle dogs. For this study, a total of 14 beagles had a cystectomy. Two dogs underwent closure without a reconstructive procedure. Six beagles had bladder reconstruction with a cell-free biodegradable polymer. The third group of six dogs received reconstruction using a bladder-shaped biodegradable polymer that delivered autologous cells from the bladder epithelium, plus smooth muscle cells. The cells had been expanded separately from a previously harvested autologous bladder biopsy. The researchers performed preoperative and postoperative urinary flow and X-ray studies. After their initial operation and recovery, the animals were sacrificed at 1,2,3,4,6 and 11 months. The investigators performed gross pathology, along with histological and other analyses. Their results showed that in the tissue engineered replacement bladders, the average bladder capacity was 95% of the original pre- cystectomy volume. The polymer-only grafts were 46% of preoperative values, and the cystectomy-only controls were at 22%. The compliance of the tissue-engineered bladders (the quality of yielding to fluid pressure) showed almost no difference from pre-operative values. In their analysis, the investigators found that the retrieved tissue engineered bladders had normal cellular organization, consisting of a tri-layer of normal bladder epithelium, submucosa, and muscle. The investigators believe that tissue engineering can create functionally and anatomically normal bladders. They assert that this technology in the future could improve or even supplant conventional methods of bladder replacement or augmentation.


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Contact: Bill Glitz
wglitz@aol.com
703-532-3797
American Urological Association
31-May-1998


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