AI Article Synopsis

  • Resection and reconstruction of the esophagus can be risky for patients, but recent studies using a porcine model showed promise with a cell-seeded polyurethane graft, known as the Cellspan esophageal implant (CEI), to encourage esophageal regeneration.
  • A patient undergoing a complex tumor surgery received an investigational treatment involving the creation of an engineered esophageal graft using autologous adipose-derived mesenchymal stromal cells (Ad-MSCs) cultured before the surgery.
  • Post-surgery results indicated successful segmental reconstruction of the esophagus, showing complete epithelialization and partial tissue regeneration after 7.5 months, highlighting the graft's potential for recovery.

Article Abstract

Introduction: Resection and reconstruction of the esophagus remains fraught with morbidity and mortality. Recently, data from a porcine reconstruction model revealed that segmental esophageal reconstruction using an autologous mesenchymal stromal cell-seeded polyurethane graft (Cellspan esophageal implant [CEI]) can facilitate esophageal regrowth and regeneration. To this end, a patient requiring a full circumferential esophageal segmental reconstruction after a complex multiorgan tumor resection was approved for an investigational treatment under the Food and Drug Administration Expanded Access Use (Investigational New Drug 17402).

Methods: Autologous adipose-derived mesenchymal stromal cells (Ad-MSCs) were isolated from the Emergency Investigational New Drug patient approximately 4 weeks before surgery from an adipose tissue biopsy specimen. The Ad-MSCs were grown and expanded under current Good Manufacturing Practice manufacturing conditions. The cells were then seeded onto a polyurethane fiber mesh scaffold (Cellspan scaffold) and cultured in a custom bioreactor to manufacture the final CEI graft. The cell-seeded scaffold was then shipped to the surgical site for surgical implantation. After removal of a tumor mass and a full circumferential 4 cm segment of the esophagus that was invaded by the tumor, the CEI was implanted by suturing the tubular CEI graft to both ends of the remaining native esophagus using end-to-end anastomosis.

Results: In this case report, we found that a clinical-grade, tissue-engineered esophageal graft can be used for segmental esophageal reconstruction in a human patient. This report reveals that the graft supports regeneration of the esophageal conduit. Histologic analysis of the tissue postmortem, 7.5 months after the implantation procedure, revealed complete luminal epithelialization and partial esophageal tissue regeneration.

Conclusions: Autologous Ad-MSC seeded onto a tubular CEI tissue-engineered graft stimulates tissue regeneration following implantation after a full circumferential esophageal resection.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8474397PMC
http://dx.doi.org/10.1016/j.jtocrr.2021.100216DOI Listing

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