Tissue-engineered esophagus: experimental substitution by onlay patch or interposition.
OBJECTIVE
We proposed to fabricate a tissue-engineered esophagus and to use it for replacement of the abdominal esophagus.


METHODS
Esophagus organoid units, mesenchymal cores surrounded by epithelial cells, were isolated from neonatal or adult rats and paratopically transplanted on biodegradable polymer tubes, which were implanted in syngeneic hosts. Four weeks later, the tissue-engineered esophagus was either harvested or anastomosed as an onlay patch or total interposition graft. Green Fluorescent Protein labeling by means of viral infection of the organoid units was performed before implantation. Histology and immunohistochemical detection of the antigen alpha-actin smooth muscle were performed.


RESULTS
Tissue-engineered esophagus grows in sufficient quantity for interposition grafting. Histology reveals a complete esophageal wall, including mucosa, submucosa, and muscularis propria, which was confirmed by means of immunohistochemical staining for alpha-actin smooth muscle. Tissue-engineered esophagus architecture was maintained after interposition or use as a patch, and animals gained weight on a normal diet. Green Fluorescent Protein-labeled tissue-engineered esophagus preserved its fluorescent label, proving the donor origin of the tissue-engineered esophagus.


CONCLUSIONS
Tissue-engineered esophagus resembles the native esophagus and maintains normal histology in anastomosis, with implications for therapy of long-segment esophageal tissue loss caused by congenital absence, surgical excision, or trauma.
Grikscheit
Tracy
T
Department of Surgery, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Ochoa
Erin R
ER
Srinivasan
Ashok
A
Gaissert
Henning
H
Vacanti
Joseph P
JP
D000199:Actins / Q000378:metabolism; D000714:Anastomosis, Surgical; D000818:Animals; D001344:Autopsy; D004195:Disease Models, Animal; D004947:Esophagus / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005471:Fluoroscopy; D005753:Gastric Mucosa / Q000378:metabolism; D007150:Immunohistochemistry; D008297:Male; D008955:Models, Cardiovascular; D009131:Muscle, Smooth, Vascular / Q000378:metabolism / Q000601:surgery; D051381:Rats; D011917:Rats, Inbred Lew; D013270:Stomach / Q000473:pathology / Q000601:surgery; D023822:Tissue Engineering / Q000379:methods*
D000199:Actins