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Bladder augmentation using an autologous neo-bladder construct
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http://www.kidney-international.org & 2009 International Society of Nephrology
Kidney International (2009) 76, 236; doi:10.1038/ki.2009.81
Bladder augmentation using an autologous neo-bladder construct Ashwin M. Raghavan1 and Patrick J. Shenot1 1
Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA Correspondence: Patrick J. Shenot, Department of Urology, Thomas Jefferson University, 1025 Walnut Street, Suite 1112, Philadelphia, Pennsylvania 19107, USA. E-mail: [email protected]
a
b
Figure 1 | Neurogenic bladder. (a) Preoperative cystogram. (b) Cystogram six months following bladder augmentation with the autologous neobladder construct. Arrows indicate the junction of the native bladder (below arrows) and regenerated bladder (above arrows).
A 17-year-old boy developed a small-capacity neurogenic bladder following excision of a conus medullaris dermoid cyst (Figure 1a). This resulted in elevated bladder storage pressures and the development of hydronephrosis that was refractory to medical therapy. Surgical bladder augmentation was recommended. The patient entered a clinical trial evaluating the feasibility of augmenting the bladder using tissue regenerated from autologous cells. A full thickness bladder biopsy was obtained and autologous urothelial and smooth muscle cells were isolated from it. The population of these cells was then expanded in vitro. Six weeks later, the
236
cultured cells were seeded onto a biodegradable scaffold to form the neobladder construct. The neobladder construct was surgically implanted onto his native bladder to augment bladder capacity and wrapped with omentum to provide neovascular support to the construct (Figure 1b). Regenerative medicine therapies such as this have the potential to create new, functional human tissues and organs using the patient’s autologous cells. ACKNOWLEDGMENTS
This study is supported by Tengion, East Norriton, Pennsylvania, USA.
Kidney International (2009) 76, 236
http://www.kidney-international.org & 2009 International Society of Nephrology
Kidney International (2009) 76, 236; doi:10.1038/ki.2009.81
Bladder augmentation using an autologous neo-bladder construct Ashwin M. Raghavan1 and Patrick J. Shenot1 1
Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA Correspondence: Patrick J. Shenot, Department of Urology, Thomas Jefferson University, 1025 Walnut Street, Suite 1112, Philadelphia, Pennsylvania 19107, USA. E-mail: [email protected]
a
b
Figure 1 | Neurogenic bladder. (a) Preoperative cystogram. (b) Cystogram six months following bladder augmentation with the autologous neobladder construct. Arrows indicate the junction of the native bladder (below arrows) and regenerated bladder (above arrows).
A 17-year-old boy developed a small-capacity neurogenic bladder following excision of a conus medullaris dermoid cyst (Figure 1a). This resulted in elevated bladder storage pressures and the development of hydronephrosis that was refractory to medical therapy. Surgical bladder augmentation was recommended. The patient entered a clinical trial evaluating the feasibility of augmenting the bladder using tissue regenerated from autologous cells. A full thickness bladder biopsy was obtained and autologous urothelial and smooth muscle cells were isolated from it. The population of these cells was then expanded in vitro. Six weeks later, the
236
cultured cells were seeded onto a biodegradable scaffold to form the neobladder construct. The neobladder construct was surgically implanted onto his native bladder to augment bladder capacity and wrapped with omentum to provide neovascular support to the construct (Figure 1b). Regenerative medicine therapies such as this have the potential to create new, functional human tissues and organs using the patient’s autologous cells. ACKNOWLEDGMENTS
This study is supported by Tengion, East Norriton, Pennsylvania, USA.
Kidney International (2009) 76, 236