Tissue-engineered autologous bladders for patients needing cystoplasty

Anthony Atala, Stuart B. Bauer, Shay Soker, James J. Yoo, Alan B. Retik

Research output: Contribution to journalArticle

1291 Citations (Scopus)

Abstract

Background: Patients with end-stage bladder disease can be treated with cystoplasty using gastrointestinal segments. The presence of such segments in the urinary tract has been associated with many complications. We explored an alternative approach using autologous engineered bladder tissues for reconstruction. Methods: Seven patients with myelomeningocele, aged 4-19 years, with high-pressure or poorly compliant bladders, were identified as candidates for cystoplasty. A bladder biopsy was obtained from each patient. Urothelial and muscle cells were grown in culture, and seeded on a biodegradable bladder-shaped scaffold made of collagen, or a composite of collagen and polyglycolic acid. About 7 weeks after the biopsy, the autologous engineered bladder constructs were used for reconstruction and implanted either with or without an omental wrap. Serial urodynamics, cystograms, ultrasounds, bladder biopsies, and serum analyses were done. Results: Follow-up range was 22-61 months (mean 46 months). Post-operatively, the mean bladder leak point pressure decrease at capacity, and the volume and compliance increase was greatest in the composite engineered bladders with an omental wrap (56%, 1·58-fold, and 2·79-fold, respectively). Bowel function returned promptly after surgery. No metabolic consequences were noted, urinary calculi did not form, mucus production was normal, and renal function was preserved. The engineered bladder biopsies showed an adequate structural architecture and phenotype. Conclusions: Engineered bladder tissues, created with autologous cells seeded on collagen-polyglycolic acid scaffolds, and wrapped in omentum after implantation, can be used in patients who need cystoplasty.

Original languageEnglish
Pages (from-to)1241-1246
Number of pages6
JournalLancet
Volume367
Issue number9518
DOIs
StatePublished - Apr 15 2006
Externally publishedYes

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Urinary Bladder
Polyglycolic Acid
Biopsy
Collagen
Urinary Bladder Diseases
Pressure
Meningomyelocele
Urinary Calculi
Omentum
Urodynamics
Mucus
Urinary Tract
Muscle Cells
Compliance
Phenotype
Kidney
Serum

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Atala, A., Bauer, S. B., Soker, S., Yoo, J. J., & Retik, A. B. (2006). Tissue-engineered autologous bladders for patients needing cystoplasty. Lancet, 367(9518), 1241-1246. https://doi.org/10.1016/S0140-6736(06)68438-9

Tissue-engineered autologous bladders for patients needing cystoplasty. / Atala, Anthony; Bauer, Stuart B.; Soker, Shay; Yoo, James J.; Retik, Alan B.

In: Lancet, Vol. 367, No. 9518, 15.04.2006, p. 1241-1246.

Research output: Contribution to journalArticle

Atala, A, Bauer, SB, Soker, S, Yoo, JJ & Retik, AB 2006, 'Tissue-engineered autologous bladders for patients needing cystoplasty', Lancet, vol. 367, no. 9518, pp. 1241-1246. https://doi.org/10.1016/S0140-6736(06)68438-9
Atala A, Bauer SB, Soker S, Yoo JJ, Retik AB. Tissue-engineered autologous bladders for patients needing cystoplasty. Lancet. 2006 Apr 15;367(9518):1241-1246. https://doi.org/10.1016/S0140-6736(06)68438-9
Atala, Anthony ; Bauer, Stuart B. ; Soker, Shay ; Yoo, James J. ; Retik, Alan B. / Tissue-engineered autologous bladders for patients needing cystoplasty. In: Lancet. 2006 ; Vol. 367, No. 9518. pp. 1241-1246.
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