Endoscopic treatment of reflux with autologous chondrocytes

Anthony Atala

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Injection of polytetrafluoroethylene (Teflon) or collagen has been used in the endoscopie treatment of vesicoureteral reflux. Although the principle of an endoscopic treatment is valid, there are concerns regarding the long-term safety and effectiveness of these substances. Toward this goal we had previously conducted long-term studies to determine the effect of i hondrocytes in vitro and in vivo. We have now adapted this system for the treatment of vesicoureteral reflux. Reflux was created in four Hanford mini-pigs by unroofing the ureters bilaterally with open surgery. Three months later the presence of bilateral reflux was confirmed with a cystogram. Elastic cartilage was obt lined from the auricular surface of each animal. Chondrocytes were har -ested and plated separately in vitro. After expansion, the cells were individually quantitated and concentrated to 25 million cells per cc. The cell suspensions were mixed with a sodium alginate and calcium sulfate solution. Using a 21 gauge needle through a cystoscope, each pig was injected unilaterally in the subureteral region with their autologous chondrocyte suspension. The opposite ureter served as an internal control in all animals. Cystograms showed resolution of reflux in the treated side and persistence of reflux in the opposite untreated side in each instance. Excretory urograms showed no evidence of obstruction. Histologic examination of the subureteral region showed the presence of cartilage. In conclusion, autologous chondrocytes can be readily harvested, expanded in vitro, and injected cystoscopically. The cells survive and form a cartilage nidus which is.non-antigenic. This system is able to correct reflux without any evidence of obstruction. Clinical trials are currently in progress using this new technology.

Original languageEnglish (US)
Number of pages1
JournalBritish Journal of Urology
Issue numberSUPPL. 2
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Urology


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