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- W2189371055 abstract "1report the fi rst human clinical trial with engineered bladders. Seven patients with myelomeningocele and resultant dysfunctional bladders underwent bladder augmentations with autologous, smooth muscle, and urothelial cell-seeded scaff olds. The engineered tissue improved overall bladder function in all patients, with mean follow-up of almost 4 years. For almost a century, genitourinary science has been pursuing an ideal bladder substitute. Is it possible that we are no longer confi ned to the bowel for bladder replacement? Bladder substitution has traditionally been done with intestinal segments. Not only does this involve an organ system that is not diseased, but complications can arise from adhesion formation, intestinal mucous secretion, or metabolic changes. Urologists agree that a need exists for a new replacement method. In Atala and colleagues’ report, all three patients who had composite scaff olds and omental wrap had better outcomes than earlier decellularised bladder submucosa scaff old cystoplasties, both with and without omental blood supply. All patients with composite scaff olds had CT scans to aid in sizing the bladder constructs, whereas it seems the fi rst four patients did not. Is the improvement more associated with better bladder-volume sizing or the use of an appropriate scaff old and the presence of blood supply? The volume of the fi rst four bladder constructs had been calculated by estimating the average expected bladder size according to the patient’s age. Thus sizing, although not as accurate, is probably not the key element in the success of the tissue-engineered bladders. Atala and colleagues report optimum bladder function with a biodegradable collagen and polyglycolic acid com posite scaff old. Most scaff olds that are bio degradable and resorbable create a microenvironment conducive to proper cellular function and provide a framework that allows cells to populate and mature in the appropriate spatial dimension are appropriate. Such scaff olds may include porcine small-intestinal sub mucosa, 2" @default.
- W2189371055 created "2016-06-24" @default.
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- W2189371055 date "2006-01-01" @default.
- W2189371055 modified "2023-09-24" @default.
- W2189371055 title "Bladder tissue-engineering: a new practical solution?" @default.
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