Collagen I:III ratio in canine heterologous bladder acellular matrix grafts

The objective of this study was to investigate the limitations of a heterologous bladder acellular matrix graft (BAMG) and the influence of the collagen ratio on functional regeneration in a large animal model. Ten female dogs underwent partial cystectomy; eight received BAMG (two homologous; six heterologous) and two partial cystectomy only. A cystometry was performed prior to surgery and 7 months postoperatively when all animals underwent sacral root stimulation. Tissue specimens were studied by histologic and immunohistochemical techniques and for collagen types. At month 7, all animals survived and bladder capacity in the grafted animals was increased. All grafts demonstrated all components of a normal bladder wall. Nerves were seen with the density decreasing with distance from the anastomosis. The BAMG processing and follow-up demonstrated no changes in the homologous tissue, whereas in the heterologous tissue, the amount of collagen changed with the processing during implantation. None of these heterologous specimens demonstrated a similar collagen ratio to the hosts'. The homologous BAMG undergoes more complete regeneration. In the heterologous BAMG, collagen seems not to be replaced. The amounts and ratio of collagen types I and III seem to influence smooth muscle regeneration.