Artificial Organs Progress- Tissue engineered, scaffolding based insertions

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Degradation of scaffold and infiltration of ne...
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Dr. Anthony Atala is the Medical Director of the Wake Forest Institute for Regenerative Medicine, where he has been leading his research group to develop various autologous (from their own cells) tissue-engineered components for human use.  This group includes Dr. Shay Soker, who has been perfecting his scaffolding technique, necessary for tissue engineered organs.  (We first reported on Dr. Shay’s successes here.  We also reported on scaffolding results there from Spain, and then Rice University.)

Dr. Atala’s group first reported success was published five years ago in the Lancet.  In that publication, his group described their efforts to insert artificial bladders into young children (age 4 to 19).  These children had myelomeningocele (end stage bladder disease); normal therapy would involve inserting gastrointestinal segments to replace the bladder.   Instead, urothelial and muscle cells were taken from the patients which were seeded into a collagen scaffolding.  These cells then grew over the next 7 weeks or so, covering the matrix; the autologous bladders were covered by omentum (peritoneum portion that provides immunity, affords fat deposition, and wound and infection isolation for the stomach and intestines) and inserted into the patients.  Follow-up over the next 2 to five years demonstrated the viability of the process.

Recently, Dr. Atala’s group reported (again, the Lancet)  on the inserted of autologous urethras into five patients.  All the patients had undergone trauma that damaged their urethras.  The normal treatment process involves graft insertion (with a 50% success rate) or life rife with infection and/or incontinence. The patient’s muscle and epithelial cells (from their urethras) were seeded into polyglocolic acid scaffolding.   Once the cells had grown, the scaffolding-cell structure was employed to reconstruct their urethras.   Follow-up studies through 6 years after surgery on the patients (who were 10 to 14 at the time of surgery) demonstrated that they were performing without any strictures; the urethra architecture had returned to normal by three months post insertion and remained so.  While this was a small study (five subjects), the high success ratio imports well for the continued development of these techniques.

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