Artificial urinary bladder
The two main methods for replacing bladder function involve either redirecting urine flow or replacing the bladder in situ. Replacement can be done with an artificial urinary bladder, an artificial organ. The first ever laboratory-grown artificial organ to be transplanted into a human was an artificial bladder in the early 2000s in the United States.
On January 30, 1999, scientists announced that a lab-grown bladder had been successfully transplanted into dogs. These artificial bladders worked well for almost a year in the dogs. In 2000, a new procedure for creating artificial bladders for humans was developed. This procedure is called an orthotopic neobladder procedure. This procedure involves shaping a part (usually 35 to 40 inches) of a patient's small intestine to form a new bladder, however, as explained above, these bladders made of intestinal tissues produced unpleasant side-effects.
In 2006, the first publication of experimental transplantation of bioengineered bladders appeared in The Lancet. The trial involved seven people with spina bifida between the ages of four and nineteen who had been followed for up to five years after surgery to determine long term effects. The bladders were prepared and the trial run by a team of biologists at the Wake Forest University School of Medicine and Boston Children's Hospital led by Professor Anthony Atala.
First a CT scan of the patient is taken to determine the shape of the bladder that must be created. Next a tissue sample is taken from the patient's bladder. These cells (primarily urothelial and muscle cells) are grown over a period of 7 to 8 weeks then layered onto a biodegradable "scaffold" in the shape that the required bladder is to take. The entire bladder along with the biodegradable scaffold is then transplanted. Over time, the biodegradable scaffold will degrade within the patient's body.
The current standard for repairing a damaged urinary bladder involves partial or complete replacement using tissue from the small intestine. Patients with bladders made of intestinal tissues suffer unpleasant side-effects because intestinal tissues reabsorb chemicals that are meant to be eliminated through the urine.
A bladder fabricated from the patient's own cells, transplanted into the patient has been successful.
- "Treatments & Procedures", Urinary Reconstruction and Diversion, Cleveland Clinic, 2009, retrieved 2013-03-22
- Smith, Stephanie (2006), "Doctors grow organs from patients' own cells", CNN.com (CNN), retrieved 2013-03-22
- Atala, Anthony et al. (April 2006), "Tissue-engineered autologous bladders for patients needing cystoplasty", The Lancet (15) 367 (9518): 1241–1246, doi:10.1016/S0140-6736(06)68438-9, PMID 16631879, retrieved 2013-03-22, lay summary – The Lancet (2006-04-06) (subscription required)
- "Lab-grown bladders 'a milestone'", BBC.com (BBC), 2006-04-03, retrieved 2013-03-22
- Trivedi, Bijal (January 2007), Top 13 Medicine Stories of 2006, "2. Tissue Engineering Triumph: Lab-Grown Bladders", Discover, retrieved 2008-12-06
- Atala, Anthony (June 2012), Printing a human kidney (Video), BBC; TED
- Doctors Create Re-Engineered Bladders (Voice of America, 5 April 2006)[dead link]
- Artificial bladder being developed by James J. Yoo M.D., Ph.D.at the Department of Urology at Harvard Medical School. - non-biological artificial bladder.[dead link]