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Regenerative Medicine Some success stories!
(Part-III)
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1. Applying Regenerative Medicine to Bladder
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Applying Regenerative Medicine to Bladder

• Neurogenic bladder disorder, for example.
• Cystoplasty a surgical treatment.
• What we did???
• Human bladder was engineered!

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How???

• Perform bladder biopsy for urothelial and muscle
  cells.
• In vitro culturing and expansion of cells.
• Seeding of cells on a biodegradable
  bladder-shaped scaffold.
• New organ was ready after 8 weeks.

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Regenerated bladder
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Contd

• 5. Anastomosis
• 6. Apply fibrin glue.
• 7. Omental wrapping.

Anastomosis
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Omentum layer
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Omental wrapping
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Results

• After 46 months
• Improved function capacity of ureter.
• Renal function was normal through out the follow
  up.
• No metabolic complication occured.

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• Positives
• No immuno-suppression required!
• Negatives
• No immediate Reconstruction of Vascular supply.
• Instant Oxygen and nutrients supply is by
  diffusion.
• Inflammation before re-angiogenesis.

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2. Applying Regenerative Medicine to Upper
Airways
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2. Applying Regenerative Medicine to Upper
Airways

• End stage bronchio-malacia in a 30 year old
  woman, for example.
• What we did???
• Ex- vivo bioengineering of trachea.

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How???

• Retrieving of deceased donor trachea.
• Decellularization.
• Obtaining epithelial cells from bronchial mucosa.
• Isolation of stem cells from patients bone
  marrow.
• Differentiation of SCs into chondrocytes.
• 4 days maturation.
• Human trachea was used as natural scaffold.
• Seeding with autologous epithelial cells and
  chondrocytes.
• Implantation of construct to replace the diseased
  one.

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Trachea scaffold
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Culturing the trachea
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Results

• After 18 months
• Imaging showed normal architecture.
• Patient was doing well.
• Advantage!
• Use of natural/ human scaffold.

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But Behave!!
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Not all offices have science fellows.
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Ethical issues

• About
• Moral status of the embryo for ESCs.
• Completely Informed consent of patient required.
• Enrollment of subjects for clinical trials.
• Protecting the rights and welfare of human
  subjects.
• Resource allocation cost.
• Intellectual property considerations.

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Thanks! ?