In-Vivo Regeneration of Bladder Muscular Wall With Whole Decellularized Bladder Matrix: A Novel Hourglass Technique for Duplication of Bladder Volume in Rabbit Model Publisher Pubmed



Sabetkish S¹ ; Sabetkish N¹ ; Kajbafzadeh AM¹ Show Affiliations
Source: Journal of Pediatric Surgery Published:2020

Abstract

Objective: To determine histological aspects of decellularized bladder graft to achieve a double-sized bladder by novel hourglass technique; using rabbit models. Methods: Sixteen rabbit bladders were decellularized and underwent laboratory investigations. After making a laparotomy incision and exposure of bladders in another 16 rabbits (partial detrusor myomectomy), they were separated into two groups. The fundus of the decellularized scaffold was anastomosed to the fundus of the native bladder via the serosal layer, and the omentum and a double-J stent were placed in the decellularized bladder by no direct contact with the urine (Group A, n = 8). In group B (n = 8), the bladder was augmented applying the decellularized bladder that was in contact with the urine. After 6 months, the omentum was brought out of the neck of the engineered bladder and the anastomosis was opened. Biopsies were taken at 1, 3, and 9 months postoperatively. Results: Cell removal with preservation of extracellular matrix structure was confirmed in decellularized bladders. Histological examination after 1 month demonstrated few cells at the border of the grafts. After 3 months, the region of the graft was indistinguishable from the natural bladder with continuity of transitional epithelium of natural bladder on the decellularized grafted scaffolds. The organization of muscle layers was similar to native bladder muscle layers after 9 months. IHC staining markers were highly expressed after 9 months. Interestingly, bladders had a high fibrosis grade in group B compared with hourglass technique. Conclusion: We confirmed that decellularized bladder may be a reliable scaffold and viable material for bladder augmentation. © 2019 Elsevier Inc.