Augmentation cystoplasty using decellularized vermiform appendix in rabbit model

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Urology

Background:

• The vermiform appendix (sacculus rotundus) possesses unique mechanical properties and abundant collagen, making it a potential candidate for tissue engineering.
• Current bladder augmentation methods face challenges, necessitating innovative biomaterials.

Purpose of the Study:

• To decellularize the rabbit vermiform appendix (sacculus rotundus) and assess its suitability for bladder augmentation and appendicovesicostomy.
• To evaluate the feasibility of using this acellular matrix as a scaffold for bladder reconstruction.

Main Methods:

• The acellular matrix of the rabbit vermiform appendix was prepared and characterized.
• Rabbits underwent bladder augmentation cystoplasty (Group I), scaffold implantation without urothelial connection (Group II), or appendicovesicostomy simulation (Group III).
• Histological and immunohistochemical analyses were performed on post-operative biopsies at 3, 12, and 36 months.

Main Results:

• Pre-transplantation analysis confirmed a decellularized structure with intact extracellular matrix, suitable for cell seeding.
• Post-transplantation, Groups I and III demonstrated successful cell seeding with urothelial lining.
• Group II showed no urothelial lining in the inner lumen, indicating the importance of direct connection for recellularization.

Conclusions:

• Decellularized rabbit appendix matrix is a viable option for bladder augmentation and appendicovesicostomy.
• The bladder acts as a natural bioreactor, promoting autologous recellularization of the acellular matrix.
• This approach may offer a safer alternative to existing augmentation cystoplasty techniques, paving the way for clinical applications.