Tissue engineering – Magdalena Fossum

Pediatric Surgery deals with the surgical treatment of a variety of malformations in different organs. In Pediatric Urology, some patients are treated with reconstructions because of small, incompliant bladders and other patients need urethral reconstructions because of hypospadias.

The surgical treatment can sometimes be challenged due to lack of tissue. In these cases, either tissue from nearby structures, or free grafts from distant tissues can be incorporated for the repair. Different techniques are however associated with different types of complications.

Within the field of Tissue Engineering, autologous cells can be cultured and expanded outside the body for later transplantation. The cells can be combined with different carrier materials that stimulate tissue regeneration inside the body or the body itself can be used as a bioreactor for tissue expansion without needing in vitro cell culturing. Some important features with the techniques includes that cells can be expanded almost infinitely and that the tissues, being autologous, are not rejected. Three-dimensional transplants can also be customized according to the needs of the patient.

We have developed methods for application of Tissue Engineering in Urological Reconstructive Surgery. For easier harvesting of urothelial cells, we now isolate and culture the cells from the bladder mucosa after bladder washings with saline. The method is non-invasive and does not require general anesthesia. We have also developed analyses for reassurance of safety and good quality of cells to be transplanted back to the patient. Tissue Engineering can now be used clinically for urethral reconstructions in patients with severe hypospadias.

In our research studies we are now aiming to further develop Tissue Engineering for urological reconstructions mainly for augmentation of the urinary bladder but also for easier catheterizations of the bladder by creating tissue tubes. We believe that Tissue Engineering is going to be helpful also for treating malformations in other organs and for reconstructive surgery after cancer therapy or traumatic injury in adults.