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Abstract
There is a need for efficient and “off-the-shelf” grafts in urethral reconstructive surgery. Currently available surgical techniques require harvesting of grafts from autologous sites, with increased risk of surgical complications and added patient discomfort. Therefore, a cost-effective and cell-free graft with adequate regenerative potential has a great chance to be translated into clinical practice. Tubular cell-free collagen grafts were prepared by varying the collagen density and fiber distribution, thereby creating a polarized low fiber density collagen graft (LD-graft). A uniform, high fiber density collagen graft (HD-graft) was engineered as a control. These two grafts were implanted to bridge a 2 cm long iatrogenic urethral defect in a rabbit model. Histology revealed that rabbits implanted with the LD-graft had a better smooth muscle regeneration compared to the HD-graft. The overall functional outcome assessed by contrast voiding cystourethrography showed patency of the urethra in 90% for the LD-graft and in 66.6% for the HD-graft. Functional regeneration of the rabbit implanted with the LD-graft could further be demonstrated by successful mating, resulting in healthy offspring. In conclusion, cell-free low-density polarized collagen grafts show better urethral regeneration than high-density collagen grafts.
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Details
1 Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Department of Pediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
2 Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Department of Surgery, University Malaya, Kuala Lumpur, Malaysia
3 Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
4 Department of Surgery, University Malaya, Kuala Lumpur, Malaysia
5 Tissue Engineering Group, Department of Orthopaedic Surgery, (NOCERAL) University Malaya, Kuala Lumpur, Malaysia
6 Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Institute for Molecular Engineering, University of Chicago, Chicago, IL, USA