BACKGROUND: Postcolectomy morbidities include important changes in enterohepatic circulation, stool microbiology, and absorption. The surgical substitution of an ileal pouch for the absent colon also has a number of serious complications. We report in vivo colon replacement by tissue-engineered colon (TEC) in lieu of an ileal pouch. METHODS: End-ileostomies were created in 22 male Lewis rats. In 11 animals, side-to-side ileum-TEC anastomosis was performed 1 cm from the stoma. This group was compared with end-ileostomy alone. Serial weights were measured, and animals were harvested sequentially for assessment of histologic signs of pouchitis. Transit times, stool dry and wet weights, and serum and stool colon function markers were collected. RESULTS: Animals survived 41 days. Weight loss was more than 1.5 times greater in the end-ileostomy alone group compared with the ileum-TEC group. Transit times were significantly longer in the ileum-TEC group than the end-ileostomy alone group, with lower stool moisture content and higher total serum bile acids. Animals without TEC had statistically significant hyponatremia, elevated serum urea nitrogen, and lower stool short chain fatty acids (13.5 micromol/kg vs 84.2) with an abnormal distribution. CONCLUSIONS: TEC successfully recapitulates some major physiologic functions of native large intestine in vivo.
BACKGROUND: Postcolectomy morbidities include important changes in enterohepatic circulation, stool microbiology, and absorption. The surgical substitution of an ileal pouch for the absent colon also has a number of serious complications. We report in vivo colon replacement by tissue-engineered colon (TEC) in lieu of an ileal pouch. METHODS: End-ileostomies were created in 22 male Lewis rats. In 11 animals, side-to-side ileum-TEC anastomosis was performed 1 cm from the stoma. This group was compared with end-ileostomy alone. Serial weights were measured, and animals were harvested sequentially for assessment of histologic signs of pouchitis. Transit times, stool dry and wet weights, and serum and stool colon function markers were collected. RESULTS: Animals survived 41 days. Weight loss was more than 1.5 times greater in the end-ileostomy alone group compared with the ileum-TEC group. Transit times were significantly longer in the ileum-TEC group than the end-ileostomy alone group, with lower stool moisture content and higher total serum bile acids. Animals without TEC had statistically significant hyponatremia, elevated serum ureanitrogen, and lower stool short chain fatty acids (13.5 micromol/kg vs 84.2) with an abnormal distribution. CONCLUSIONS: TEC successfully recapitulates some major physiologic functions of native large intestine in vivo.
Authors: Ryan Gregory Spurrier; Allison L Speer; Xiaogang Hou; Wael N El-Nachef; Tracy C Grikscheit Journal: Tissue Eng Part A Date: 2014-11-20 Impact factor: 3.845
Authors: Tracy C Grikscheit; Aleem Siddique; Erin R Ochoa; Ashok Srinivasan; Eben Alsberg; Richard A Hodin; Joseph P Vacanti Journal: Ann Surg Date: 2004-11 Impact factor: 12.969
Authors: Christa N Grant; Salvador Garcia Mojica; Frederic G Sala; J Ryan Hill; Daniel E Levin; Allison L Speer; Erik R Barthel; Hiroyuki Shimada; Nicholas C Zachos; Tracy C Grikscheit Journal: Am J Physiol Gastrointest Liver Physiol Date: 2015-01-08 Impact factor: 4.052
Authors: Frédéric G Sala; Jamil A Matthews; Allison L Speer; Yasuhiro Torashima; Erik R Barthel; Tracy C Grikscheit Journal: Tissue Eng Part A Date: 2011-05-04 Impact factor: 3.845