Tubular Constructs as Artificial Urinary Conduits

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• 作者：Marije Sloff ; ^{marije.sloff@radboudumc.nl" class="auth_mail" title="E-mail the corresponding author} ; Vasileios Simaioforidis ; Dorien M. Tiemessen ; Heinz P. Janke ; Barbara B.M. Kortmann ; Luc A.J. Roelofs ; Paul J. Geutjes ; Egbert Oosterwijk^&dagger ; ; Wout F.J. Feitz^&dagger ;
• 关键词：urinary diversion ; tissue engineering ; collagen type 1 ; polyglactin 910 ; regenerative medicine
• 刊名：The Journal of Urology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：196
• 期：4
• 页码：1279-1286
• 全文大小：3825 K

文摘

A readily available artificial urinary conduit might be substituted for autologous bowel in standard urinary diversions and minimize bowel associated complications. However, the use of large constructs remains challenging as host cellular ingrowth and/or vascularization is limited. We investigated large, reinforced, collagen based tubular constructs in a urinary diversion porcine model and compared subcutaneously pre-implanted constructs to cell seeded and basic constructs.

Materials and Methods

Reinforced tubular constructs were prepared from type I collagen and biodegradable Vicryl® meshes through standard freezing, lyophilization and cross-linking techniques. Artificial urinary conduits were created in 17 female Landrace pigs, including 7 with a basic untreated construct, 5 with a construct seeded with autologous urothelial and smooth muscle cells, and 5 with a free graft formed by subcutaneous pre-implantation of a basic construct. All pigs were evaluated after 1 month.

Results

The survival rate was 94%. At evaluation 1 basic and 1 cell seeded conduit were occluded. Urinary flow was maintained in all conduits created with pre-implanted constructs. Pre-implantation of the basic construct resulted in a vascularized tissue tube, which could be used as a free graft to create an artificial conduit. The outcome was favorable compared to that of the other conduits. Urinary drainage was better, hydroureteronephrosis was limited and tissue regeneration was improved.

Conclusions

Subcutaneous pre-implantation of a basic reinforced tubular construct resulted in a vascularized autologous tube, which may potentially replace bowel in standard urinary diversions. To our knowledge we introduce a straightforward 2-step procedure to create artificial urinary conduits in a large animal model.