AUA 2017: Regenerative Medicine: Where do we Stand?
This field started with “simpler” organs that are flat and easier to regenerate, i.e. skin, and then expanded to tubular structures such as vessels and bladders. They have successfully generated carotid vessels and have implanted them. With respect to genitourinary organs, they have reverse engineered a vagina, from a remnant vagina biopsy, and successfully implanted it into a patient with vaginal agenesis. In patients with contracted, noncompliant bladders (end stage bladders) they have implanted bladders that over time increased in compliance and capacity. This is proof of the recipient truly “accepting” these refurbished organs.
Following this, they moved on to the more complex solid organs. Their team has successfully regenerated a penile implant in a rodent model with the ability to sustain erection and ejaculate. Based on these studies, they are planning preliminary human studies.
Currently, they have regenerated livers and kidneys using a sophisticated scaffold of micro-channels that allows them to print the organ. Further, they can fit them exactly to the patient’s requirements using CT scans to guide the size of the required organ. Regenerated kidneys are now being investigated in clinical trials in end stage renal disease patients using primary renal cells with a collagen carrier. Their preclinical models (rodents) have successfully regenerated renal tissue and nephron units.
Dr. Atala did emphasize the importance of the rigorous work required to achieve this level of success. Over 450 faculty and over 30 years of work has taken their team to get this far. This amazing work is clearly a reflection of years of scientific rigor and imaginative work.
Presented by: Dr. Anthony Atala, Wake Forest
Written By: Kam Kaler, MD, FRCSC for UroToday.com
at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA