Circumferential esophageal replacement by a decellularized esophageal matrix in a porcine model.

Animals Esophagus / anatomy & histology Feasibility Studies Female Mesenchymal Stem Cell Transplantation Models, Animal Omentum / cytology Stents Swine Tissue Engineering / methods Tissue Scaffolds Transplantation, Autologous

Journal

Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347

Informations de publication

Date de publication:
02 2022
Historique:
received: 19 12 2020
revised: 03 06 2021
accepted: 12 07 2021
pubmed: 17 8 2021
medline: 17 2 2022
entrez: 16 8 2021
Statut: ppublish

Résumé

Tissue engineering is an attractive alternative to conventional esophageal replacement techniques using intra-abdominal organs which are associated with a substantial morbidity. The objective was to evaluate the feasibility of esophageal replacement by an allogenic decellularized esophagus in a porcine model. Secondary objectives were to evaluate the benefit of decellularized esophagus recellularization with autologous bone marrow mesenchymal stromal cells and omental maturation of the decellularized esophagus. Eighteen pigs divided into 4 experimental groups according to mesenchymal stromal cells recellularization and omental maturation underwent a 5-cm long circumferential replacement of the thoracic esophagus. Turbo green florescent protein labelling was used for in vivo mesenchymal stromal cells tracking. The graft area was covered by a stent for 3 months. Clinical and histologic outcomes were analyzed over a 6-month period. The median follow-up was 112 days [5; 205]. Two animals died during the first postoperative month, 2 experienced an anastomotic leakage, 13 experienced a graft area stenosis following stent migration of which 3 were sacrificed as initially planned after successful endoscopic treatment. The stent could be removed in 2 animals: the graft area showed a continuous mucosa without stenosis. After 3 months, the graft area showed a tissue specific regeneration with a mature epithelium and muscular cells. Clinical and histologic results were similar across experimental groups. Circumferential esophageal replacement by a decellularized esophagus was feasible and allowed tissue remodeling toward an esophageal phenotype. We could not demonstrate any benefit provided by the omental maturation of the decellularized esophagus nor its recellularization with mesenchymal stromal cells.

Sections du résumé

BACKGROUND
Tissue engineering is an attractive alternative to conventional esophageal replacement techniques using intra-abdominal organs which are associated with a substantial morbidity. The objective was to evaluate the feasibility of esophageal replacement by an allogenic decellularized esophagus in a porcine model. Secondary objectives were to evaluate the benefit of decellularized esophagus recellularization with autologous bone marrow mesenchymal stromal cells and omental maturation of the decellularized esophagus.
METHODS
Eighteen pigs divided into 4 experimental groups according to mesenchymal stromal cells recellularization and omental maturation underwent a 5-cm long circumferential replacement of the thoracic esophagus. Turbo green florescent protein labelling was used for in vivo mesenchymal stromal cells tracking. The graft area was covered by a stent for 3 months. Clinical and histologic outcomes were analyzed over a 6-month period.
RESULTS
The median follow-up was 112 days [5; 205]. Two animals died during the first postoperative month, 2 experienced an anastomotic leakage, 13 experienced a graft area stenosis following stent migration of which 3 were sacrificed as initially planned after successful endoscopic treatment. The stent could be removed in 2 animals: the graft area showed a continuous mucosa without stenosis. After 3 months, the graft area showed a tissue specific regeneration with a mature epithelium and muscular cells. Clinical and histologic results were similar across experimental groups.
CONCLUSION
Circumferential esophageal replacement by a decellularized esophagus was feasible and allowed tissue remodeling toward an esophageal phenotype. We could not demonstrate any benefit provided by the omental maturation of the decellularized esophagus nor its recellularization with mesenchymal stromal cells.

Identifiants

DOI: 10.1016/j.surg.2021.07.009 PMID: 34392978
pubmed: 34392978
pii: S0039-6060(21)00692-9
doi: 10.1016/j.surg.2021.07.009
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

384-392

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Guillaume Levenson (G)

Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Department de Chirurgie Viscérale, Oncologique, et Endocrinienne, Paris, France; INSERM U976 et CIC-BT501, Université de Paris, Hôpital Saint-Louis, Paris, France. Electronic address: https://twitter.com/Levenson_G.

Arthur Berger (A)

Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Service de Gastroentérologie, Paris, France. Electronic address: https://twitter.com/bergerarthur7.

Jonathan Demma (J)

Hadassah Medical Center, Service de Chirurgie Générale, Université Hébraïque de Jerusalem, Jerusalem, Israel.

Guillaume Perrod (G)

Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Service de Gastroentérologie, Paris, France.

Thomas Domet (T)

INSERM U976 et CIC-BT501, Université de Paris, Hôpital Saint-Louis, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, Paris, France.

Lousineh Arakelian (L)

INSERM U976 et CIC-BT501, Université de Paris, Hôpital Saint-Louis, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, Paris, France.

Patrick Bruneval (P)

Department of Pathology, Georges-Pompidou European hospital, AP-HP and Université de Paris, Paris, France.

Chloe Broudin (C)

Department of Pathology, Georges-Pompidou European hospital, AP-HP and Université de Paris, Paris, France.

Mohamed Jarraya (M)

Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Banque de Tissus Humains, Paris, France.

Niclas Setterblad (N)

Plateforme technologique de l'IRSL/ Technological Core Facility, Saint-Louis Research Institute, Saint-louis Hospital, Université de Paris.

Gabriel Rahmi (G)

Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Service de Gastroentérologie, Paris, France.

Jerome Larghero (J)

INSERM U976 et CIC-BT501, Université de Paris, Hôpital Saint-Louis, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, Paris, France.

Pierre Cattan (P)

Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Department de Chirurgie Viscérale, Oncologique, et Endocrinienne, Paris, France; INSERM U976 et CIC-BT501, Université de Paris, Hôpital Saint-Louis, Paris, France. Electronic address: pierre.cattan@aphp.fr.

Lionel Faivre (L)

INSERM U976 et CIC-BT501, Université de Paris, Hôpital Saint-Louis, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis, Unité de Thérapie Cellulaire, Paris, France. Electronic address: https://twitter.com/FaivreLionel1.

Tigran Poghosyan (T)

INSERM U976 et CIC-BT501, Université de Paris, Hôpital Saint-Louis, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Service de Chirugie Viscérale et Oncologique, Paris, France. Electronic address: https://twitter.com/PoghosyanTigra1.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Circumferential esophageal replacement by a...
questionsmedicales.fr › Système digestif › Tube digestif › Tube digestif supérieur › Oesophage › Circumferential esophageal replacement by a...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études de faisabilité › Circumferential esophageal replacement by a...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation cellulaire › Transplantation de cellules souches › Transplantation de cellules souches mésenchymateuses › Circumferential esophageal replacement by a...
questionsmedicales.fr › Techniques d'investigation › Modèles animaux › Circumferential esophageal replacement by a...
questionsmedicales.fr › Régions du corps › Tronc › Abdomen › Cavité abdominale › Omentum › Circumferential esophageal replacement by a...
questionsmedicales.fr › Équipement et fournitures › Prothèses et implants › Endoprothèses › Circumferential esophageal replacement by a...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Artiodactyla › Suidae › Circumferential esophageal replacement by a...
questionsmedicales.fr › Technologie, industrie et agriculture › Ingénierie › Bioingénierie › Ingénierie cellulaire › Ingénierie tissulaire › Circumferential esophageal replacement by a...
questionsmedicales.fr › Équipement et fournitures › Prothèses et implants › Structures d'échafaudage tissulaires › Circumferential esophageal replacement by a...
questionsmedicales.fr › Procédures de chirurgie opératoire › Transplantation › Transplantation autologue › Circumferential esophageal replacement by a...