Grafting of cultured uroepithelium and bladder mucosa into de-epithelialized segments of colon in rabbits.
Urinary tract reconstruction using bowel can result in acid-base and electrolyte abnormalities. We tested the feasibility of grafting bladder mucosa and urothelial cells grown on a biodegradable polyglactin 910 scaffold onto de-epithelialized segments of bowel in the rabbit. A segment of de-epithelialized colon was either grafted with cultured urothelium on a collagen mesh scaffold (12 rabbits) or with free bladder mucosa (11 rabbits). In 10 rabbits that served as a control group another segment of bowel was isolated and de-epithelialized. No urothelial or bowel epithelial growth was present 4 weeks later in 10 of the isolated de-epithelialized colonic segments grafted with the cultured urothelium. In 2 segments a minute focus of epithelium staining positively for anticytokeratin antibodies AE1 and AE3 was seen but this could not be histologically differentiated as either urothelium or native colonic epithelium. All 7 surviving animals that underwent a bladder mucosal graft had viable urothelium at sacrifice 30 days postoperatively. In 2 of the 7 rabbits microscopic nests of colonic epithelium were also found underneath the urothelial layer. Of the 7 internal controls 6 had no evidence of bowel epithelial regrowth 4 weeks after de-epithelialization. This study demonstrated that a confluent layer of urothelial cells could be grown in culture using a scaffold of biodegradable mesh and rat tail collagen. We also showed that bladder mucosal grafts can be grown on de-epithelialized bowel segments. We were unable to graft successfully cultured urothelial cells onto a de-epithelialized bowel segment. Further improvement in understanding the role of the submucosal matrix in cell growth may lead to future success in covering large segments of de-epithelialized bowel with autologous urothelium.
Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
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P
Merguerian
D R
DR
Chavez
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S
Hakim
D000818:Animals; D017690:Cell Transplantation; D002478:Cells, Cultured; D003094:Collagen; D003106:Colon / Q000166:cytology* / Q000601:surgery; D004847:Epithelial Cells; D004848:Epithelium / Q000601:surgery; D009092:Mucous Membrane / Q000166:cytology; D011098:Polyglactin 910; D011817:Rabbits; D001743:Urinary Bladder / Q000166:cytology*
D011098:Polyglactin 910; D003094:Collagen