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Bio-engineered bladders successful in patients

00:01 04 April 2006

NewScientist.com news service

Roxanne Khamsi

 

Bladders engineered in the laboratory from patients' own cells and

then implanted into the body have succeeded in their first clinical

trial.

 

The feat was accomplished by Anthony Atala, at Wake Forest University

Medical School in Winston-Salem, North Carolina, and his colleagues.

He says that while scientists have had success with skin transplants

grown on scaffolds in the past, this is the first time they have

grown and transplanted a discrete, complex organ.

 

The success is the culmination of an idea that the team began

exploring 16 years ago. Atala adds that they are also working on

growing bio-engineered hearts and pancreases in the lab.

 

To create the new bladders, the researchers took a biopsy from

patients whose bladders functioned poorly due to an inherited nervous

system disorder. The team then placed muscle cells and cells from the

bladder lining on a biodegradable bladder-shaped scaffold and allowed

them to grow for about two months.

 

The scaffolds were made of the structural protein collagen, in some

cases adding polyglycolic acid, a polymer used in surgical sutures.

 

Major milestone

The team then transplanted these new bladders into their patients in

a delicate operation and monitored their recovery. Two of the

patients did not provide follow-up information. But Atala's group did

track the progress of seven patients, aged between 4 and 19 years,

for an average of nearly four years.

 

The patients with the bio-engineered bladders gained better urinary

control. The improvements were similar to those resulting from

standard surgery that relies on intestinal grafts to fix the bladder.

But the new technique does not require any damage to the intestine,

the researchers note.

 

" Atala and his colleagues should be praised for the milestone they

have reached, but further multi-institutional studies are needed with

longer follow-up, " writes Steve Chung, of the Advanced Urology

Institute of Illinois in Spring Valley, Illinois, in a commentary on

the study appearing in the Lancet. Until then, he adds, surgery using

intestinal tissue to repair the bladder " remains the gold standard " .

 

Bladder disease does not only cause urinary control problems but can

lead to kidney damage. At present, reconstructive surgery is often

performed to treat severe bladder problems.

 

This procedure involves grafting tissue from a section of the small

intestine or stomach. But medical experts say that many complications

can arise from this type of procedure.

 

Journal reference: Lancet (DOI: 10.1016/S0140-673(06)68438-9)