title: Implantation of a Tissue-Engineered Neo-Bile Duct in Domestic Pigs.
abstract: BACKGROUND
  Extrahepatic bile duct injuries remain severe complications during cholecystectomies and often require reconstruction by bilioenteric anastomosis (i.e., hepaticojejunostomy), which comes with further long-term complications (e.g., recurring ascending cholangitis, secondary biliary cirrhosis). In the case of inherent extrahepatic biliary atresia or during liver transplant, artificial or engineered bile ducts could allow novel surgical strategies without the need for hepaticojejunostomy.
  
  
  METHODS
  We present data on the implantation of in vitro-generated neo-bile ducts in 5 domestic pigs. The neo-bile ducts were engineered through decellularization of allogeneic blood vessels and recellularization with autologous cholangiocytes. On postoperative days 0, 1, 7, and 14, blood samples were taken and analyzed (aspartate aminotransferase, alanine aminotransferase, bilirubin, alkaline phosphatase, creatinine, and leukocytes). Magnetic resonance cholangiopancreatography was performed on postoperative day 14 on 1 pig. Fourteen days after implantation, the pigs were sacrificed and the bile ducts were explanted.
  
  
  RESULTS
  All pigs survived the complete study period without severe complications. None of the pigs showed signs of biliary leakage or peritonitis. The neo-bile ducts were infiltrated by neutrophils, and neoangiogenesis was observed around and into the implanted tissue.
  
  
  CONCLUSIONS
  We present a novel strategy for extrahepatic bile duct replacement by implantation of an autologous neo-bile duct generated ex vivo. Whether the presented technique allows the long-term replacement of native bile ducts must be further evaluated.
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Charitx00E9; - Universitx00E4;tsmedizin Berlin, Berlin, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Struecker
authors.forename: Karl-Herbert
authors.initials: KH
authors.lastname: Hillebrandt
authors.forename: Nathanael
authors.initials: N
authors.lastname: Raschzok
authors.forename: Korinna
authors.initials: K
authors.lastname: Jöhrens
authors.forename: Antje
authors.initials: A
authors.lastname: Butter
authors.forename: Peter
authors.initials: P
authors.lastname: Tang
authors.forename: Andreas
authors.initials: A
authors.lastname: Andreou
authors.forename: Hendrik
authors.initials: H
authors.lastname: Napierala
authors.forename: Anja
authors.initials: A
authors.lastname: Reutzel-Selke
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.forename: Igor Maximilian
authors.initials: IM
authors.lastname: Sauer
mesh_terms: D000818:Animals; D001652:Bile Ducts / Q000166:cytology* / Q000601:surgery*; D049448:Cholangiopancreatography, Magnetic Resonance; D002763:Cholecystectomy; D004247:DNA / Q000032:analysis; D064347:Microscopy, Electrochemical, Scanning; D013552:Swine; D023822:Tissue Engineering
chemical_list: D004247:DNA