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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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Jeong HJ, Nam H, Jang J, Lee SJ. 3D Bioprinting Strategies for the Regeneration of Functional Tubular Tissues and Organs. Bioengineering (Basel) 2020; 7:E32. [PMID: 32244491 PMCID: PMC7357036 DOI: 10.3390/bioengineering7020032] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 01/01/2023] Open
Abstract
It is difficult to fabricate tubular-shaped tissues and organs (e.g., trachea, blood vessel, and esophagus tissue) with traditional biofabrication techniques (e.g., electrospinning, cell-sheet engineering, and mold-casting) because these have complicated multiple processes. In addition, the tubular-shaped tissues and organs have their own design with target-specific mechanical and biological properties. Therefore, the customized geometrical and physiological environment is required as one of the most critical factors for functional tissue regeneration. 3D bioprinting technology has been receiving attention for the fabrication of patient-tailored and complex-shaped free-form architecture with high reproducibility and versatility. Printable biocomposite inks that can facilitate to build tissue constructs with polymeric frameworks and biochemical microenvironmental cues are also being actively developed for the reconstruction of functional tissue. In this review, we delineated the state-of-the-art of 3D bioprinting techniques specifically for tubular tissue and organ regeneration. In addition, this review described biocomposite inks, such as natural and synthetic polymers. Several described engineering approaches using 3D bioprinting techniques and biocomposite inks may offer beneficial characteristics for the physiological mimicry of human tubular tissues and organs.
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Affiliation(s)
- Hun-Jin Jeong
- Department of Mechanical Engineering, Wonkwang University, 460, Iksan-daero, Iksan-si, Jeollabuk-do 54538, Korea;
| | - Hyoryung Nam
- Department of Creative IT Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-Gu, Pohang, Gyeongbuk 37673, Korea;
| | - Jinah Jang
- Department of Creative IT Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-Gu, Pohang, Gyeongbuk 37673, Korea;
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-Gu, Pohang, Gyeongbuk 37673, Korea
- Department of Mechanical Engineering, Pohang University of Science and Technology, 77 Cheongam-Ro, Nam-Gu, Pohang, Gyeongbuk 37673, Korea
- Institute of Convergence Science, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
| | - Seung-Jae Lee
- Department of Mechanical Engineering, Wonkwang University, 460, Iksan-daero, Iksan-si, Jeollabuk-do 54538, Korea;
- Department of Mechanical and Design Engineering, Wonkwang University, 460, Iksan-daero, Iksan-si, Jeollabuk-do 54538, Korea
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Liu Y, Wang Y, Chakroff J, Johnson J, Farrell A, Besner GE. Production of Tissue-Engineered Small Intestine in Rats with Different Ages of Cell Donors. Tissue Eng Part A 2018; 25:878-886. [PMID: 30284958 DOI: 10.1089/ten.tea.2018.0226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
IMPACT STATEMENT This study compared side-by-side the impact of donor age on the production of tissue-engineered small intestine (TESI). Each age represents a specific period of life: E18 for fetuses, 5-day-old pups for neonates, 21-day-old rats for weanlings, and 6-week-old rats for adults. The TESI produced was compared macroscopically and microscopically. The mechanism(s) contributing to the differences observed was explored by detecting proliferating cells in the TESI and by analyzing intestinal stem cell gene expression in donor cells. These data may provide valuable information for future application of TESI clinically.
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Affiliation(s)
- Yanchun Liu
- 1 The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Yijie Wang
- 1 The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | | | | | - Aidan Farrell
- 1 The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Gail E Besner
- 1 The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.,3 Department of Pediatric Surgery at Nationwide Children's Hospital, Columbus, Ohio
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Composite Scaffolds Based on Intestinal Extracellular Matrices and Oxidized Polyvinyl Alcohol: A Preliminary Study for a New Regenerative Approach in Short Bowel Syndrome. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7824757. [PMID: 29992163 PMCID: PMC5994320 DOI: 10.1155/2018/7824757] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 04/17/2018] [Indexed: 12/11/2022]
Abstract
Pediatric Short Bowel Syndrome is a rare malabsorption disease occurring because of massive surgical resections of the small intestine. To date, the issues related to current strategies including intestinal transplantation prompted the attention towards tissue engineering (TE). This work aimed to develop and compare two composite scaffolds for intestinal TE consisting of a novel hydrogel, that is, oxidized polyvinyl alcohol (OxPVA), cross-linked with decellularized intestinal wall as a whole (wW/OxPVA) or homogenized (hW/OxPVA). A characterization of the supports was performed by histology and Scanning Electron Microscopy and their interaction with adipose mesenchymal stem cells occurred by MTT assay. Finally, the scaffolds were implanted in the omentum of Sprague Dawley rats for 4 weeks prior to being processed by histology and immunohistochemistry (CD3; F4/80; Ki-67; desmin; α-SMA; MNF116). In vitro studies proved the effectiveness of the decellularization, highlighting the features of the matrices; moreover, both supports promoted cell adhesion/proliferation even if the wW/OxPVA ones were more effective (p < 0.01). Analysis of explants showed a continuous and relatively organized tissue wall around the supports with a connective appearance, such as myofibroblastic features, smooth muscle, and epithelial cells. Both scaffolds, albeit with some difference, were promising; nevertheless, further analysis will be necessary.
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Cromeens BP, Wang Y, Liu Y, Johnson J, Besner GE. Critical intestinal cells originate from the host in enteroid-derived tissue-engineered intestine. J Surg Res 2018; 223:155-164. [PMID: 29433868 DOI: 10.1016/j.jss.2017.11.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 09/25/2017] [Accepted: 11/03/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Enteroid-derived tissue-engineered intestine (TEI) contains intestinal subepithelial myofibroblasts (ISEMFs) and smooth muscle cells (SMCs). However, these cell types are not present in the donor enteroids. We sought to determine the origin of these cell types and to quantify their importance in TEI development. MATERIALS AND METHODS Crypts from pan-EGFP or LGR5-EGFP mice were used for enteroid culture and subsequent implantation for the production of TEI. TEI from pan-EGFP enteroids was labeled for smooth muscle alpha actin (SMA) to identify ISEMFs and SMCs and green fluorescent protein (GFP) to identify cells from pan-EGFP enteroids. Fluorescence in situ hybridization (FISH) for the Y chromosome was applied to TEI from male LGR5-EGFP enteroids implanted into female nonobese diabetic/severe combined immunodeficiency mice. To identify chemotactic effects of intestinal epithelium on ISEMFs, a Boyden chamber assay was performed. RESULTS Immunofluorescence of TEI from pan-EGFP enteroids revealed GFP-positive epithelium with surrounding SMA positivity and no colocalization of the two. FISH of TEI from male LGR5-EGFP enteroids implanted into female nonobese diabetic/severe combined immunodeficiency mice revealed that only the epithelium was Y chromosome positive. Chemotactic assays demonstrated increased ISEMF migration in the presence of enteroids (983 ± 133) compared to that in the presence of either Matrigel alone (357 ± 36) or media alone (339 ± 24; P ≤ 0.05). CONCLUSIONS Lack of GFP/SMA colocalization suggests that ISEMFs and SMCs are derived from host animals. This was confirmed by FISH which identified only epithelial cells as being male. All other cell types originated from host animals. The mechanism by which these cells are recruited is unknown; however, Boyden chamber assays indicate a direct chemotactic effect of intestinal epithelium on ISEMFs.
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Affiliation(s)
- Barrett P Cromeens
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | - Yijie Wang
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | - Yanchun Liu
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | | | - Gail E Besner
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio.
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Buscemi S, Palumbo V, Maffongelli A, Fazzotta S, Palumbo F, Licciardi M, Fiorica C, Puleio R, Cassata G, Fiorello L, Buscemi G, lo Monte A. Electrospun PHEA-PLA/PCL Scaffold for Vascular Regeneration: A Preliminary in Vivo Evaluation. Transplant Proc 2017; 49:716-721. [DOI: 10.1016/j.transproceed.2017.02.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Abstract
The demands for repair and renewal of worn out or injured human tissue grow year on year<Eth> it is a demand that cannot be met from live human donors. A partial solution may be found from cadaveric or trans-species transplantation of tissue, but these approaches are steeped in the problems of disease transfer and ethical dilemma. Tissue engineering is a new technology that seeks to meet these increasing demands by utilizing novel cell culture methods in vitro to provide tissue replacements in vivo. This article reviews the current state of tissue engineering and its potential for use in the realms of trauma surgery.
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Affiliation(s)
- JP Garner
- Biomedical Sciences, Dstl Porton Down, Salisbury, Wiltshire, UK
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Gupta A, Seifalian AM, Ahmad Z, Edirisinghe MJ, Winslet MC. Novel Electrohydrodynamic Printing of Nanocomposite Biopolymer Scaffolds. J BIOACT COMPAT POL 2016. [DOI: 10.1177/0883911507078268] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this paper, we uncover a new method for the preparation of biopolymer scaffolds and demonstrate its potential for the development of organs with the aid of tissue engineering. Two novel nanocomposite polymers, a nonbiodegradable polyhedral oligomeric silsesquioxane-poly (carbonate-urea)urethane and a biodegradable polyhedral oligomeric silsesquioxane-polycaprolactone-poly(carbonate-urea)urethane, have been subjected to flow in an electric field. Electrically forced microthreading of the polymers occurs and a three-dimensional print-patterning device was used to deposit fine (<50 µm) threads of polymer according to a predesigned architecture to prepare scaffolds. The technique can offer tremendous potential in the development of organs.
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Affiliation(s)
- Ashish Gupta
- Biomaterials and Tissue Engineering Centre, Academic Division of Surgery and Interventional Sciences, University College London, Hampstead Campus, London NW3 2PF, UK
| | - Alexander M. Seifalian
- Biomaterials and Tissue Engineering Centre, Academic Division of Surgery and Interventional Sciences, University College London, Hampstead Campus, London NW3 2PF, UK
| | - Zeeshan Ahmad
- Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK
| | - Mohan J. Edirisinghe
- Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK,
| | - Marc C. Winslet
- Royal Free Hampstead NHS Trust Hospital, Pond Street, London NW3 2QG, UK
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Cromeens BP, Liu Y, Stathopoulos J, Wang Y, Johnson J, Besner GE. Production of tissue-engineered intestine from expanded enteroids. J Surg Res 2016; 204:164-75. [PMID: 27451883 DOI: 10.1016/j.jss.2016.02.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 02/08/2016] [Accepted: 02/24/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Short bowel syndrome is a life-threatening condition with few solutions. Tissue-engineered intestine (TEI) is a potential treatment, but donor intestine is a limiting factor. Expanded epithelial surrogates termed enteroids may serve as a potential donor source. MATERIALS AND METHODS To produce TEI from enteroids, crypts were harvested from mice and enteroid cultures established. Enteroids were seeded onto polymer scaffolds using Matrigel or culture medium and implanted in immunosuppressed mice for 4 wk. Histology was analyzed using Periodic acid-Schiff staining and immunofluorescence. Neomucosa was quantified using ImageJ software. To determine whether TEI could be produced from enteroids established from small intestinal biopsies, 2 × 2-mm pieces of jejunum were processed for enteroid culture, enteroids were expanded and seeded onto scaffolds, and scaffolds implanted for 4 wk. RESULTS Enteroids in Matrigel produced TEI in 15 of 15 scaffolds, whereas enteroids in medium produced TEI in 9 of 15 scaffolds. Use of Matrigel led to more neomucosal surface area compared to media (10,520 ± 2905 μm versus 450 ± 127 μm, P < 0.05). Histologic examination confirmed the presence of crypts and blunted villi, normal intestinal epithelial lineages, intestinal subepithelial myofibroblasts, and smooth muscle cells. Crypts obtained from biopsies produced an average of 192 ± 71 enteroids. A single passage produced 685 ± 58 enteroids, which was adequate for scaffold seeding. TEI was produced in 8 of 9 scaffolds seeded with expanded enteroids. CONCLUSIONS Enteroids can be obtained from minimal starting material, expanded ex vivo, and implanted to produce TEI. This method shows promise as a solution to the limited donor intestine available for TEI production in patients with short bowel syndrome.
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Affiliation(s)
- Barrett P Cromeens
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | - Yanchun Liu
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | | | - Yijie Wang
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio
| | | | - Gail E Besner
- Department of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio.
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10
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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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Abstract
Tissue engineering is an emerging discipline that combines engineering principles and the biological sciences toward the development of functional replacement tissue. Virtually every tissue in the body has been investigated and tremendous advances have been made in many areas. This article focuses on the gastrointestinal tract and reviews the current status of bioengineering gastrointestinal tissues, including the esophagus, stomach, small intestine and colon. Although progress has been achieved, there continues to be significant challenges that need to be addressed.
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Affiliation(s)
- Rebecca A Penkala
- University of Washington, Department of Bioengineering, Seattle, WA, USA.
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Pérez Alonso AJ, del Olmo Rivas C, Machado Romero I, Pérez Cabrera B, Cañizares Garcia FJ, Torne Poyatos P. Reconstrucción del conducto biliar mediante tubos tridimensionales de colágeno. Cir Esp 2013; 91:590-4. [DOI: 10.1016/j.ciresp.2012.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Revised: 09/05/2012] [Accepted: 10/01/2012] [Indexed: 11/26/2022]
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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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Knight T, Basu J, Rivera EA, Spencer T, Jain D, Payne R. Fabrication of a multi-layer three-dimensional scaffold with controlled porous micro-architecture for application in small intestine tissue engineering. Cell Adh Migr 2013; 7:267-74. [PMID: 23563499 DOI: 10.4161/cam.24351] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Various methods can be employed to fabricate scaffolds with characteristics that promote cell-to-material interaction. This report examines the use of a novel technique combining compression molding with particulate leaching to create a unique multi-layered scaffold with differential porosities and pore sizes that provides a high level of control to influence cell behavior. These cell behavioral responses were primarily characterized by bridging and penetration of two cell types (epithelial and smooth muscle cells) on the scaffold in vitro. Larger pore sizes corresponded to an increase in pore penetration, and a decrease in pore bridging. In addition, smaller cells (epithelial) penetrated further into the scaffold than larger cells (smooth muscle cells). In vivo evaluation of a multi-layered scaffold was well tolerated for 75 d in a rodent model. This data shows the ability of the components of multi-layered scaffolds to influence cell behavior, and demonstrates the potential for these scaffolds to promote desired tissue outcomes in vivo.
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Howell JC, Wells JM. Generating intestinal tissue from stem cells: potential for research and therapy. Regen Med 2012; 6:743-55. [PMID: 22050526 DOI: 10.2217/rme.11.90] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Intestinal resection and malformations in adult and pediatric patients result in devastating consequences. Unfortunately, allogeneic transplantation of intestinal tissue into patients has not been met with the same measure of success as the transplantation of other organs. Attempts to engineer intestinal tissue in vitro include disaggregation of adult rat intestine into subunits called organoids, harvesting native adult stem cells from mouse intestine and spontaneous generation of intestinal tissue from embryoid bodies. Recently, by utilizing principles gained from the study of developmental biology, human pluripotent stem cells have been demonstrated to be capable of directed differentiation into intestinal tissue in vitro. Pluripotent stem cells offer a unique and promising means to generate intestinal tissue for the purposes of modeling intestinal disease, understanding embryonic development and providing a source of material for therapeutic transplantation.
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Affiliation(s)
- Jonathan C Howell
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA
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16
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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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17
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Yoshida A, Noda T, Tani M, Oyama T, Watanabe Y, Kiyomoto H, Nishiyama A. The role of basic fibroblast growth factor to enhance fetal intestinal mucosal cell regeneration in vivo. Pediatr Surg Int 2009; 25:691-5. [PMID: 19547988 DOI: 10.1007/s00383-009-2405-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND/PURPOSE The limited application of small bowel transplantation for short bowel syndrome, mainly on the account of the morbidity and long-term implications of the procedure, has led to a search for alternative therapies. The purpose of this study was to evaluate whether basic fibroblast growth factor (bFGF) could facilitate regeneration of fetal small intestinal mucosa in vivo. METHODS Intestinal epithelial organoid units harvested from fetal Lewis rats were injected into adult male Lewis rats whose colon was denuded of mucosa, as syngeneic recipients. One experimental group transplanted with the addition of 50 ng/ml bFGF, was compared with a control group that were transplanted without bFGF. The grafts were harvested and analyzed using histology and immunohistochemistry 3 weeks after operation. RESULTS There were 4 anesthetic deaths, two in each group, and 11 deaths due to adhesive ileus. In no rat did neomucosa fully cover the denuded colonic muscle throughout the whole length of lumen. Histologically, the structure of the neomucosa, when present, was normal small intestinal mucosa. The small intestinal mucosa was partially restored in 100% (6 of 6) of bFGF, and in 28.6% (2 of 7) of those not given bFGF (P = 0.0021). CONCLUSIONS These data demonstrate that bFGF can facilitate the restoration of intestinal epithelial cells, at least to some degree. Potentially, refinements of this technique could be used to facilitate the physiologic tissue engineering of small intestine in a way that allows it to move peristaltically, and have an application in the management of patients with short bowel syndrome.
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Affiliation(s)
- Atsushi Yoshida
- Department of Pediatric Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kida-gun, Kagawa, 761-0793, Japan.
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Gupta A, Dixit A, Sales KM, Winslet MC, Seifalian AM. Tissue engineering of small intestine--current status. Biomacromolecules 2007; 7:2701-9. [PMID: 17025341 DOI: 10.1021/bm060383e] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Short bowel syndrome (SBS) has always posed a great threat to patients and has been one of the biggest challenges for doctors due to its high morbidity and mortality. So far, parenteral nutrition (PN) and small bowel transplantation remain the only viable therapeutic options. However, sepsis and liver failure associated with PN and limited availability of the donor organs and high graft rejection rates associated with transplantation have limited their use to a nonpermanent solution. Clearly, there is a need for an alternative therapy whereby increasing the absorptive surface area would help neonates and adults suffering from permanent intestinal failure. Techniques such as sequential intestinal lengthening are being explored in animal models with little success. Attempts to engineer small intestine since the late 1980s have achieved varying degrees of success in animal models with evolving refinements in biotechnology. The most encouraging results so far have been the generation of intestinal neomucosa in the form of cysts when intestinal epithelial organoid units isolated from neonatal rats were seeded onto biodegradable polymers before implantation in syngeneic adult rats' omentum. Although still experimental, continued attempts worldwide using cultured stem cells and improved polymer technology offer promise to provide an off-the-shelf artificial intestine as a novel therapy for patients with SBS. This article reviews the current status of progress in the field of small intestinal tissue engineering and addresses various types of cell sources and scaffold material having potential to be used in this field.
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Affiliation(s)
- Ashish Gupta
- Biomaterials and Tissue Engineering Centre, Academic Division of Surgery and Interventional Sciences, University College London, London NW3 2PF, United Kingdom
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19
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Abstract
Short bowel syndrome is a chronic malabsorptive state usually resulting from extensive small bowel resections. A combination of diarrhea, nutrient malabsorption, dysmotility, and bowel dilatation may constitute the clinical symptomatology of this syndrome. The remaining bowel undergoes a process called adaptation, which may replace lost intestinal function. Chronic complications include nutrient, electrolyte, and vitamin deficiencies. Therapy depends largely on the administration of various factors stimulating intestinal adaptation of the remaining bowel. If the patient despite medical therapy fails to return to oral diet alone, then long-term parenteral nutrition is required. However, long-term parenteral nutrition may gradually induce cholestatic liver disease. Surgical methods may be required for treatment including intestinal transplantation, as a last resort for the treatment of end-stage intestinal failure. The goal of this review is to analyze the clinical spectrum and pathophysiologic aspects of the syndrome, the process of intestinal adaptation, and to outline the medical and surgical methods currently used to treat this complicated group of patients.
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Affiliation(s)
- Evangelos P Misiakos
- 3rd Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Athens, Greece.
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20
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Abstract
Advances in tissue engineering and materials science have led to significant progress in hard and soft tissue repair and regeneration. Studies demonstrate the successful application of tissue engineering for bioengineering dental tissues. The ability to apply tissue engineering to repair or regenerate dental tissues and even whole teeth is becoming a reality. Current efforts focus on directing the formation of bioengineered dental tissues and whole teeth of predetermined size and shape. Advances in dental progenitor cell characterizations, combined with improved methods of fabricating biodegradable scaffold materials, bring closer the goal of making tooth tissue engineering a clinically relevant practice.
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Affiliation(s)
- Pamela C Yelick
- Department of Cytokine Biology, The Forsyth Institute, Boston, MA 02115, USA.
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21
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Dekaney CM, Rodriguez JM, Graul MC, Henning SJ. Isolation and characterization of a putative intestinal stem cell fraction from mouse jejunum. Gastroenterology 2005; 129:1567-80. [PMID: 16285956 DOI: 10.1053/j.gastro.2005.08.011] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2005] [Accepted: 07/25/2005] [Indexed: 01/01/2023]
Abstract
BACKGROUND & AIMS Although there have been many recent advances regarding the biology of intestinal stem cells, the field has been hampered significantly by the lack of a method to isolate these cells. Therefore, the aim of this study was to explore the hypothesis that viable intestinal stem cells can be isolated as a side population (SP) by fluorescence-activated cell sorting after staining with the DNA-binding dye Hoechst 33342. METHODS Preparations of individual cells from either whole mucosa or epithelium of mouse jejunum were stained with Hoechst 33342 and propidium iodide and then sorted using fluorescence-activated cell sorting. Cells were characterized using fluorochrome-labeled antibodies to surface markers, intracellular markers, and annexin V to detect early apoptosis. Total RNA was isolated from sorted fractions and used for quantitative real-time reverse-transcription polymerase chain reaction to evaluate the expression of cell lineage markers and the intestinal stem-cell marker, Musashi-1. RESULTS Adult and neonatal jejunum contain a viable population of cells that shows the SP phenotype and is sensitive to verapamil. This population of cells (from both mucosal and epithelial preparations) includes a CD45-negative fraction corresponding to nonhematopoietic cells, which shows minimal expression of surface markers typically found on stem cells from other tissues and of intracellular markers found in mesenchymal cells. Additionally, these cells were enriched for Musashi-1 and beta1-integrin, were cytokeratin positive, and survived in culture for up to 14 days. CONCLUSIONS The CD45-negative SP fraction, although not pure, represents the successful isolation of a viable population significantly enriched in small intestinal epithelial stem cells.
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Miyazawa M, Torii T, Toshimitsu Y, Okada K, Koyama I, Ikada Y. A tissue-engineered artificial bile duct grown to resemble the native bile duct. Am J Transplant 2005; 5:1541-7. [PMID: 15888066 DOI: 10.1111/j.1600-6143.2005.00845.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The aim of this study was to fabricate an artificial bile duct for the development of a new treatment for biliary diseases. Eighteen hybrid pigs were implanted with a bile duct organoid unit (BDOU) made of a bioabsorbable polymer. Twelve of the transplanted BDOUs had been seeded with autologous bone marrow cells (BMCs) in advance. Six animals, the controls, were grafted with the scaffold alone with no BMCs seeded. The common bile duct was cut, the hepatic cut end of the native common bile duct was anastomosed to the BDOU and the other end was anastomosed to the duodenum. The controls underwent a similar operation. The neo-bile duct was removed at pre-determined time points and investigated histologically. All 18 recipient pigs survived until their sacrifice at 6 weeks, 10 weeks or 6 months. Histological examination revealed incomplete epithelialization of the neo-bile duct at 6 weeks and 10 weeks after transplantation. At 6 months, the organoid exhibited a morphology almost identical to that of the native common bile duct. No differences were found between the controls and BMC-seeded pigs. These results show that the artificial bile duct thus fabricated can serve as a substitute for the native bile duct.
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Maemura T, Ogawa K, Shin M, Mochizuki H, Vacanti JP. Assessment of tissue-engineered stomach derived from isolated epithelium organoid units. Transplant Proc 2005; 36:1595-9. [PMID: 15251392 DOI: 10.1016/j.transproceed.2004.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Isolated stomach epithelial organoid units developed on biodegradable polymers were transplanted to assess the feasibility of a tissue-engineered stomach. BACKGROUND Despite recent advances in reconstruction techniques, total gastrectomy is still accompanied by various complications. An alternative treatment would be a tissue-engineered stomach, which replaces the mechanical and metabolic functions of a normal stomach. METHODS Stomach epithelial organoid units isolated from neonatal rats were seeded onto biodegradable polymers. The constructs implanted into the omenta of adult rats were harvested for examination at designated times. Nine rats underwent a second operation for anastomosis. RESULTS The constructs resulted in cyst-like formations showing vascularized tissue with neomucosa lining the lumen. The surface morphology as assessed using scanning electron microscopy was similar to that of a native stomach. Immunohistochemical staining for alpha-actin smooth muscle and gastric mucin indicated the presence of a smooth muscle layer and a well-developed gastric epithelium, respectively. The luminal surface of the anastomosed tissue-engineered stomach was well-covered with epithelium. CONCLUSIONS Epithelium-derived stomach organoid units seeded on biodegradable polymers and transplanted into donor rats were shown to vascularize, survive, and regenerate into complex tissue resembling native stomach. Anastomosis between the units and native small intestine may have the potential to stimulate epithelial growth. This research may provide insight into new approaches to alleviate complications following total gastrectomy.
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Affiliation(s)
- T Maemura
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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Gardner-Thorpe J, Grikscheit TC, Ito H, Perez A, Ashley SW, Vacanti JP, Whang EE. Angiogenesis in tissue-engineered small intestine. ACTA ACUST UNITED AC 2004; 9:1255-61. [PMID: 14670113 DOI: 10.1089/10763270360728161] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Tissue-engineered intestine offers promise as a potential novel therapy for short bowel syndrome. In this study we characterized the microvasculature and angiogenic growth factor profile of the engineered intestine. Twenty-three tissue-engineered small intestinal grafts were harvested from Lewis rat recipients 1 to 8 weeks after implantation. Architectural similarity to native bowel obtained from juvenile rats was assessed with hematoxylin and eosin-stained sections. Capillary density, measured after immunohistochemical staining for CD34, was expressed as number of capillaries per 1000 nuclei. Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) tissue levels were measured by ELISA and normalized to total protein. Over the 8-week period cysts increased in volume (0.5 cm(3) at week 1 versus 12.6 cm(3) at week 8) and mass (1.30 +/- 0.29 versus 9.74 +/- 0.3 g; mean +/- SEM). Muscular and mucosal layers increased in thickness, but capillary density remained constant (82.95 +/- 4.81 capillaries per 1000 nuclei). The VEGF level was significantly higher in juvenile rat bowel than in engineered cyst (147.6 +/- 23.9 versus 42.3 +/- 3.4 pg/mg; p < 0.001). Tissue bFGF levels were also higher (315 +/- 65.48 versus 162.3 +/- 15.09 pg/mg; p < 0.05). The mechanism driving angiogenesis differs in engineered intestine and in normal bowel. VEGF and bFGF delivery may prove useful for bioengineering of intestine.
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Affiliation(s)
- James Gardner-Thorpe
- Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA
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De Ugarte DA, Choi E, Weitzbuch H, Wulur I, Caulkins C, Wu B, Fonkalsrud EW, Atkinson JB, Dunn JC. Mucosal Regeneration of a Duodenal Defect Using Small Intestine Submucosa. Am Surg 2004. [DOI: 10.1177/000313480407000111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Intestinal tissue engineering has the potential of developing new treatment strategies for patients with a deficit in intestinal surface area. The purpose of this study was to investigate the capacity of small intestine submucosa (SIS) to regenerate intestinal epithelia in a rodent model for a duodenal defect. A duodenotomy was created in 20 Sprague-Dawley rats and was repaired with a circular patch of SIS. The repaired sites were retrieved 1, 2, 4, and 12 weeks after implantation. The size of the residual mucosal defect was measured. The retrieved tissues were fixed in formalin and processed by standard histologic techniques. The animals tolerated the procedure well. The mean size of the mucosal defects significantly decreased with time. Complete epithelializa-tion of the defects was noted within 4 weeks in three of five samples. Histologically, the defects were lined with crypts and villi, but the muscularis layer did not regenerate. In the rodent model, SIS can be used as a patch to repair a duodenotomy. Mucosal regeneration was observed in the area of the defect. Further studies will determine whether SIS may be used to preserve or increase mucosal surface area in patients whose bowel length is compromised.
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Affiliation(s)
| | - Edmund Choi
- UCLA Department of Surgery, Division of Pediatric Surgery and the
| | - Hal Weitzbuch
- UCLA Department of Surgery, Division of Pediatric Surgery and the
| | - Isabella Wulur
- UCLA Department of Bioengineering, Los Angeles, California
| | | | - Ben Wu
- UCLA Department of Bioengineering, Los Angeles, California
| | | | | | - James C.Y. Dunn
- UCLA Department of Surgery, Division of Pediatric Surgery and the
- UCLA Department of Bioengineering, Los Angeles, California
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Abstract
Organ shortage and suboptimal prosthetic or biological materials for repair or replacement of diseased or destroyed human organs and tissues are the main motivation for increasing research in the emerging field of tissue engineering. No organ or tissue is excluded from this multidisciplinary research field, which aims to provide vital tissues with the abilities to function, grow, repair, and remodel. There are several approaches to tissue engineering, including the use of cells, scaffolds, and the combination of the two. The most common approach is biodegradable or resorbable scaffolds configured to the shape of the new tissue (e.g. a heart valve). This scaffold is seeded with cells, potentially derived from either biopsies or stem cells. The seeded cells proliferate, organize, and produce cellular and extracellular matrix. During this matrix formation, the starter matrix is degraded, resorbed, or metabolized. First clinical trials using skin or cartilage substitutes are currently under way. Both the current state of the field and future prospects are discussed.
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Affiliation(s)
- U A Stock
- Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Center for Innovative Minimally Invasive Therapy, 55 Fruit Street, Boston, Massachusetts 02114, USA.
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Kaihara S, Kim SS, Kim BS, Mooney D, Tanaka K, Vacanti JP. Long-term follow-up of tissue-engineered intestine after anastomosis to native small bowel. Transplantation 2000; 69:1927-32. [PMID: 10830233 DOI: 10.1097/00007890-200005150-00031] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Our laboratory has investigated the fabrication of a tissue-engineered intestine using biodegradable polymer scaffolds. Previously we reported that isolated intestinal epithelial organoid units on biodegradable polymer scaffolds formed cysts and the neointestine was successfully anastomosed to the native small bowel. The purpose of this study was to observe the development of tissue-engineered intestine after anastomosis and to demonstrate the effect of the anastomosis over a 9-month period. METHODS Microporous biodegradable polymer tubes were created from polyglycolic acid. Intestinal epithelial organoid units were harvested from neonatal Lewis rats and seeded onto the polymers, which were implanted into the abdominal cavity of adult male Lewis rats followed by 75% small bowel resection (n=24). Three weeks after implantation, the unit/polymer constructs were anastomosed to the native jejunum in a side-to-side fashion. The anastomosed tissue-engineered intestine was measured by laparotomy 10, 24, and 36 weeks after the implantation (n= 14). During the laparotomy, all rats with an obstruction in their anastomosis were killed and excluded from the statistical analysis. Another five rats were also killed at 10 and 36 weeks for histological and morphometric studies. RESULTS All analyzed rats survived this study and significantly increased their body weight by 36 weeks. Obstruction of the anastomosis was observed in one rat at 24 weeks and in two rats at 36 weeks; however, the anastomosis was patent in the other 11 rats by 36 weeks. The tissue-engineered intestine of these 11 rats increased in length and diameter at 10, 24, and 36 weeks after anastomosis; there were statistically significant differences between each time point except between the length of 10 and 24 weeks (P<0.016 by Wilcoxon signed rank test). Histologically the inner surface of the tissue-engineered intestine was lined with well-developed neomucosa at 10 and 36 weeks; however, there were small bare areas lacking neomucosa in the tissue-engineered intestine at 36 weeks. Morphometric analysis demonstrated no significant differences in villus number, villus height, and surface length of the neomucosa at 10 and 36 weeks. CONCLUSIONS Anastomosis between tissue-engineered intestine and native small bowel resulted in no complications after operation and maintained a high patency rate for up to 36 weeks. The tissue-engineered intestine increased in size and was lined with well-developed neomucosa for the duration of the study.
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Affiliation(s)
- S Kaihara
- Department of Surgery, Massachusetts General Hospital & Harvard Medical School, Boston 02114, USA
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