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Xenogenic Extracellular Matrices as Potential Biomaterials for Interposition Grafting in Urological Surgery

期刊

JOURNAL OF UROLOGY
卷 184, 期 6, 页码 2246-2253

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.juro.2010.07.038

关键词

tissue engineering; extracellular matrix; reconstructive surgical procedures; intestine; small; urinary bladder

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Purpose: The field of tissue engineering focuses on developing strategies for reconstructing injured, diseased, and congenitally absent tissues and organs. During the last decade urologists have benefited from remodeling and regenerative properties of bioscaffolds derived from xenogenic extracellular matrices. We comprehensively reviewed the current literature on structural and functional characteristics of xenogenic extracellular matrix grafting since it was first described in urological surgery. We also reviewed the clinical limitations, and assessed the potential for safe and effective urological application of extracellular matrix grafting in place of autogenous tissue. Materials and Methods: We performed literature searches for English language publications using the PubMed (R) and MEDLINE (R) databases. Keywords included xenogenic, extracellular matrix and genitourinary tract applications. A total of 112 articles were scrutinized, of which 50 were suitable for review based on clinical relevance and importance of content. Results: Since the mid 1990s xenogenic extracellular matrices have been used to successfully treat a number of pathological conditions that affect the upper and lower genitourinary tract. They are typically prepared from porcine organs such as small intestine and bladder. These organs are harvested and subjected to decellularization and sterilization techniques before surgical implantation. Bioinductive growth factors that are retained during the preparation process induce constructive tissue remodeling as the extracellular matrix is simultaneously degraded and excreted. However, recent documented concerns over durability, decreased mechanical strength and residual porcine DNA after preparation techniques have temporarily hampered the potential of extracellular matrices as a reliable replacement for genitourinary tract structures. Conclusions: Extracellular matrices are a useful alternative for successfully treating a number of urological conditions that affect the genitourinary tract. However, clinical concerns regarding mechanical limitations and biosafety need to be addressed before their long-term role in reconstructive urological surgery can be clearly established.

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