title: Tissue-engineered small intestine improves recovery after massive small bowel resection.
abstract: OBJECTIVE
  Rescue with tissue-engineered small intestine (TESI) after massive small bowel resection (MSBR).
  
  
  BACKGROUND
  Short bowel syndrome is a morbid product of massive small bowel resection. We report the first replacement of a vital organ by tissue engineering with TESI after MSBR.
  
  
  METHODS
  Ten male Lewis rats underwent TESI implantation with green fluorescent protein (GFP)-marked cells (TESI+, n = 5) or sham laparotomy (TESI-, n = 5) followed by MSBR. Side-to-side anastomosis of TESI to proximal small intestine was performed or omitted. TESIO animals underwent implantation of engineered intestine with no further surgery. Weights were measured QOD until day 40. Transit times were measured. DNA assay was performed with computer morphometry. Northern blots of RNA were probed for intestinal alkaline phosphatase (IAP) and villin. Hematoxylin and eosin, S100, and smooth muscle actin immunohistochemistry were performed. Blood was collected at sacrifice.
  
  
  RESULTS
  All 10 rats initially lost then regained weight. The initial rate of weight loss was higher in TESI+ versus TESI-, but the nadir was reached a week earlier with more rapid weight gain subsequently to 98% preoperative weight on day 40 in animals with engineered intestine versus 76% (P < 0.03). Serum B12 was higher at 439 pg/mL versus 195.4 pg/mL. IAP mRNA appeared greater in TESI+ than TESIO, with constant villin levels. Histology revealed appropriate architecture including nerve. GFP labeling persisted.
  
  
  CONCLUSIONS
  Anastomosis of TESI significantly improved postoperative weight and B12 absorption after MSBR. IAP, a marker of differentiation in intestinal epithelium, is present in TESI, and GFP labeling was accomplished.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
authors.forename: Tracy C
authors.initials: TC
authors.lastname: Grikscheit
authors.forename: Aleem
authors.initials: A
authors.lastname: Siddique
authors.forename: Erin R
authors.initials: ER
authors.lastname: Ochoa
authors.forename: Ashok
authors.initials: A
authors.lastname: Srinivasan
authors.forename: Eben
authors.initials: E
authors.lastname: Alsberg
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hodin
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Vacanti
mesh_terms: D000199:Actins / Q000378:metabolism; D000469:Alkaline Phosphatase / Q000378:metabolism; D000818:Animals; D001835:Body Weight; D005755:Gastrins / Q000097:blood; D005772:Gastrointestinal Transit; D007150:Immunohistochemistry; D007421:Intestine, Small / Q000166:cytology / Q000378:metabolism / Q000601:surgery / Q000637:transplantation*; D008297:Male; D008840:Microfilament Proteins / Q000378:metabolism; D009940:Organoids / Q000637:transplantation; D012313:RNA / Q000378:metabolism; D051381:Rats; D011917:Rats, Inbred Lew; D009418:S100 Proteins / Q000378:metabolism; D023822:Tissue Engineering; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D000199:Actins; D005755:Gastrins; D008840:Microfilament Proteins; D009418:S100 Proteins; C026615:villin; D012313:RNA; D000469:Alkaline Phosphatase; D014805:Vitamin B 12