Scientists rebuild bladders in lab
and World Science staff
In what scientists are describing as the first complex organ to be rebuilt from living, laboratory-cultivated tissue, new bladders have been engineered and implanted into seven patients with bladder disease.
The development is reported in a paper published online April 4 in the medical journal The Lancet.
Patients with bladder disease can have problems with high pressures in their bladders that may lead to kidney damage.
One treatment is surgical reconstruction of the bladder, which usually involves tissue grafts from a section of the small intestine or stomach. This can protect kidney function and improve incontinence in patients, researchers say. But the use of such tissue segments is also associated with many complications.
Anthony Atala of Wake Forest University Medical School in Winston-Salem, N.C. and colleagues investigated an approach using engineered bladders grown from patients’ own cells.
They identified seven patients, between the ages of 4 and 19, who had poor bladder function due to a congenital abnormality called a myelomeningocele. The team obtained a bladder biopsy from each patient, from which they grew muscle cells and bladder cells called urothelial cells in the lab.
The cells were then placed onto a specially designed bladder-shaped scaffold and left to grow for between seven and eight weeks. Surgeons then attached the engineered bladders to the patients’ own bladders and followed progress for between two and five years. They reported that bladder function improved without any of the ill effects associated with the technique using bowel tissue.
“The implanted composite engineered bladders showed improved functional parameters that were durable over a period of years. Although follow-up longer than five years is reported, additional studies will be needed before this procedure can be used widely,” Atala said.
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