Tissue-engineered colon exhibits function in vivo.
BACKGROUND
Postcolectomy morbidities include important changes in enterohepatic circulation, stool microbiology, and absorption. The surgical substitution of an ileal pouch for the absent colon also has a number of serious complications. We report in vivo colon replacement by tissue-engineered colon (TEC) in lieu of an ileal pouch.


METHODS
End-ileostomies were created in 22 male Lewis rats. In 11 animals, side-to-side ileum-TEC anastomosis was performed 1 cm from the stoma. This group was compared with end-ileostomy alone. Serial weights were measured, and animals were harvested sequentially for assessment of histologic signs of pouchitis. Transit times, stool dry and wet weights, and serum and stool colon function markers were collected.


RESULTS
Animals survived 41 days. Weight loss was more than 1.5 times greater in the end-ileostomy alone group compared with the ileum-TEC group. Transit times were significantly longer in the ileum-TEC group than the end-ileostomy alone group, with lower stool moisture content and higher total serum bile acids. Animals without TEC had statistically significant hyponatremia, elevated serum urea nitrogen, and lower stool short chain fatty acids (13.5 micromol/kg vs 84.2) with an abnormal distribution.


CONCLUSIONS
TEC successfully recapitulates some major physiologic functions of native large intestine in vivo.
Grikscheit
Tracy C
TC
Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Center for the Integration of Medicine and Innovation in Technology, Boston 02114, USA.
Ogilvie
Jennifer B
JB
Ochoa
Erin R
ER
Alsberg
Eben
E
Mooney
David
D
Vacanti
Joseph P
JP
D000714:Anastomosis, Surgical; D000818:Animals; D001647:Bile Acids and Salts / Q000097:blood; D001806:Blood Urea Nitrogen; D003082:Colectomy; D003106:Colon / Q000502:physiology*; D005232:Fatty Acids, Volatile / Q000097:blood; D005243:Feces / Q000382:microbiology; D007081:Ileostomy / Q000379:methods*; D007410:Intestinal Diseases / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D019449:Pouchitis / Q000401:mortality / Q000517:prevention & control; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D051381:Rats; D011917:Rats, Inbred Lew; D023822:Tissue Engineering / Q000379:methods*
D001647:Bile Acids and Salts; D005232:Fatty Acids, Volatile