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Researchers Overcome Major Hurdle to Engineering Intestines for Transplant



Stem cell seeding has been successful in building less complex organs. In fact, just last November the second person in the world (and the first U.S. patient) received a trachea built from nanofibers seeded with his own stem cells in a procedure performed by Dr. Paolo Macchiarini, director of the Advanced Center for Translational Regenerative Medicine at the Karolinska Institute in Stockholm. In 2008 Dr. Macchiarini had performed the first adult stem cell-grown trachea transplantation.

Three months after the most recent procedure the patient, a 30-year-old man who had been told that he had inoperable tracheal cancer, was able to eat and speak on his own.

But the intestine poses a unique challenge due to the need to replicate the complex structure of its villi, the tiny, finger-like projections that protrude from the epithelial lining of the intestinal wall. The team demonstrated a technique in a rat model that successfully retains the villi by removing the original cells through the vascular system. The researchers say the resulting scaffold should be suitable for stem cell use and subsequent transplantation.

Dr. Paolo de Coppi, a clinical senior lecturer and consultant at the UCL Institute, was a lead investigator in the study. "The option of an engineered intestine, made partly from the patient's own cells, would be an important clinical advance," he said. "This paper represents a step forward, and we hope to publish promising studies with human tissue in due course."

Dr. Anthony Atala, editor of STEM CELLS Translational Medicine and director of the Wake Forest Institute of Regenerative Medicine, led the team that created and transplanted into a human patient the world's first lab-grown organ — a bladder — in 1999. The long-term results were reported in 2006. He also was on the engineered intestine research team.

Commenting on the research, Dr. Atala said, "The team's success at maintaining the integrity of the donor tissue, including its structural and mechanical properties, suggests its potential as a platform for bioengineering small bowel. In addition, the short time required to process this natural scaffold could positively impact its clinical translation to patients with intestinal failure."

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UCL : University College London
New York Times
NPR : National Public Radio