Repair of a common bile duct defect with a decellularized ureteral graft

Cheng, Yao; Xiong, Xian‐Ze; Zhou, Rongxing; Deng, Yong; Jin, Yu; Lu, Jiong; Li, Fuyu; Cheng, Nan-Sheng

doi:10.3748/wjg.v22.i48.10575

Cited by 12 publications

(28 citation statements)

References 29 publications

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“…The use of decellularization strategies for ductal tissue engineering purposes has previously shown successful in animal models. Cheng et al (2016) successfully transplanted a decellularized ureter, splinted by a silicone stent or a T‐tube, in guinea pigs. In parallel, Struecker et al (2016) transplanted porcine abdominal aorta, which was recellularized with autologous cholangiocytes, in a porcine model.…”

Section: Discussionmentioning

confidence: 99%

Scaffolds obtained from decellularized human extrahepatic bile ducts support organoids to establish functional biliary tissue in a dish

Willemse

Roos

Voogt

et al. 2020

Biotech & Bioengineering

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Biliary disorders can lead to life‐threatening disease and are also a challenging complication of liver transplantation. As there are limited treatment options, tissue engineered bile ducts could be employed to replace or repair damaged bile ducts. We explored how these constructs can be created by seeding hepatobiliary LGR5+ organoids onto tissue‐specific scaffold. For this, we decellularized discarded human extrahepatic bile ducts (EBD) that we recellularized with organoids of different origin, that is, liver biopsies, extrahepatic bile duct biopsies, and bile samples. Here, we demonstrate efficient decellularization of EBD tissue. Recellularization of the EBD extracellular matrix (ECM) with the organoids of extrahepatic origin (EBD tissue and bile derived organoids) showed more profound repopulation of the ductal ECM when compared with liver tissue (intrahepatic bile duct) derived organoids. The bile duct constructs that were repopulated with extrahepatic organoids expressed mature cholangiocyte‐markers and had increased electrical resistance, indicating restoration of the barrier function. Therefore, the organoids of extrahepatic sources are identified to be the optimal candidate for the development of personalized tissue engineered EBD constructs.

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Section: Discussionmentioning

confidence: 99%

Scaffolds obtained from decellularized human extrahepatic bile ducts support organoids to establish functional biliary tissue in a dish

Willemse

Roos

Voogt

et al. 2020

Biotech & Bioengineering

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“…The similarity in diameter, thickness, flexibility and strength leads to advantages in the ease of anastomosis and the matching of different tissues as well as in the preservation of the Oddis sphincter function in preventing reflux cholangitis. A homologous animal-derived decellularized ureteral graft was explored in a BD defect porcine model[ 12 ]. However, only 3 mo of observation was carried out accompanied by unsatisfying results of the patency of the graft without T-tube or a silicone stent inserted.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, the duration of the operation and the BD anastomosis were basically the same as in human surgery. Cheng et al [ 12 ] established an animal BD damage and repair model by resecting a 1 cm long CBD followed by bridging the defect using a 2 cm long decellularized ureteral graft without tension. However, this animal experiment only considered the tension of anastomosis without considering the increased risk of biliary stricture caused by the fold of the redundant BD after the operation.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, due to limitations by the immunocompatibility and difficulties in matching the tube diameter, studies of industrial and synthetic artificial BDs are still in the stage of animal experiments. In 2016, Cheng et al [ 12 ] reported the application of decellularized ureteral grafts in BD defect repair in a homologous porcine model. However, this research was limited to 3 mo of observation and showed that a T-tube or a silicone stent was needed to maintain the patency of the graft.…”

Section: Introductionmentioning

confidence: 99%

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Extrahepatic bile duct reconstruction in pigs with heterogenous animal-derived artificial bile ducts: A preliminary experience

Shang¹,

Zeng²,

Wang³

et al. 2020

WJG

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BACKGROUND Extrahepatic biliary duct injury (BDI) remains a complicated issue for surgeons. Although several approaches have been explored to address this problem, the high incidence of complications affects postoperative recovery. As a nonimmunogenic scaffold, an animal-derived artificial bile duct (ada-BD) could replace the defect, providing good physiological conditions for the regeneration of autologous bile duct structures without changing the original anatomical and physiologic conditions. AIM To evaluate the long-term feasibility of a novel heterogenous ada-BD for treating extrahepatic BDI in pigs. METHODS Eight pigs were randomly divided into two groups in the study. The animal injury model was developed with an approximately 2 cm segmental defect of various parts of the common bile duct (CBD) for all pigs. A 2 cm long novel heterogenous animal-derived bile duct was used to repair this segmental defect (group A, ada-BD-to-duodenum anastomosis to repair the distal CBD defect; group B, ada-BD-to-CBD anastomosis to repair the intermedial CBD defect). The endpoint for observation was 6 mo (group A) and 12 mo (group B) after the operation. Liver function was regularly tested. Animals were euthanized at the above endpoints. Histological analysis was carried out to assess the efficacy of the repair. RESULTS The median operative time was 2.45 h (2-3 h), with a median anastomosis time of 60.5 min (55-73 min). All experimental animals survived until the endpoints for observation. The liver function was almost regular. Histologic analysis indicated a marked biliary epithelial layer covering the neo-bile duct and regeneration of the submucosal connective tissue and smooth muscle without significant signs of immune rejection. In comparison, the submucosal connective tissue was more regular and thicker in group B than in group A, and there was superior integrity of the regeneration of the biliary epithelial layer. Despite the advantages of the regeneration of the bile duct smooth muscle observed in group A, the effect on the patency of the ada-BD grafts in group B was not confirmed by macroscopic assessment and cholangiography. CONCLUSION This approach appears to be feasible for repairing a CBD defect with an ada-BD. A large sample study is needed to confirm the durability and safety of these preliminary results.

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“…The morphological state of the bile ducts remains one of the most pressing problems of modern medical science [5,6,13,17]. Damage to the bile ducts often poses a serious threat to the patient's life [4,24,26].…”

Section: Introductionmentioning

confidence: 99%

Morphological features of the wall of common bile duct under the conditions of experimental opioid exposure

2020

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The morphological condition of the bile ducts remains one of the most important problems of modern medical science. In order to obtain an analgesic effect in patients with acute cholangitis, opioids are often used. However, information on the effectiveness of opioids in the treatment of pathological conditions of the bile ducts is contradictory. The rapidly progressive destruction of the intrahepatic bile ducts associated with the use of narcotic agents has been described. Further study of the effect of opioids on the structural organization of the common bile duct is relevant. In order to establish the morphological state of the common bile duct under conditions of long-term opioid exposure, a study was performed on 24 sexually mature white male rats, aged 3.5-5.0 months and weighing 180-200 g, which were injected intramuscularly with Nalbuphine for 6 weeks. The study material is represented by histological specimens of the common bile duct of white rats. The “Aver Media” computer system was used to photograph microspecimens. The “ImageJ” computer program was used to measure the diameter of the lumen and the wall thickness of the common bile duct. After 2 weeks of Nalbuphine administration to white rats, plethora of wall microvessels and a significant increase in the longitudinal diameter of the lumen of the common bile duct were observed. After 4 weeks of the experiment, the common bile duct was dilated, the transverse and longitudinal diameters of its lumen almost doubled, pathological changes in its wall had all the signs of inflammation. In the later stages of the experiment (introduction of Nalbuphine for 6 weeks), the pathological changes increased and manifested by destructuring the wall of the common bile duct, disorganization of cholangiocytes, thinning of the cell layer due to detachment of cholangiocytes, polymorphism of their nuclei, destruction of intercellular junctions, stratification of its own plate, vacuolar dystrophy of the muscular membrane “varicose” expansion of venules, significant smooth muscle hyperplasia of arterioles, the presence of perivascular lymphocytic infiltrates in the duct wall.

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Repair of a common bile duct defect with a decellularized ureteral graft

Cited by 12 publications

References 29 publications

Scaffolds obtained from decellularized human extrahepatic bile ducts support organoids to establish functional biliary tissue in a dish

Scaffolds obtained from decellularized human extrahepatic bile ducts support organoids to establish functional biliary tissue in a dish

Extrahepatic bile duct reconstruction in pigs with heterogenous animal-derived artificial bile ducts: A preliminary experience

Morphological features of the wall of common bile duct under the conditions of experimental opioid exposure

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