Human fetal intestine was decellularized to create a natural scaffold for bladder augmentation. The decellularization protocol successfully removed cellular material while preserving the extracellular matrix. The scaffolds were implanted in rabbit bladders, where host bladder cells effectively repopulated the scaffolds over time. Six months later, the tissue architecture of the repopulated scaffolds resembled the native bladder, demonstrating the potential of this approach for bladder tissue engineering applications.

1. Decellularized human fetal intestine as a bioscaffold
for bladder augmentation in rabbit model
A M Kajbafzadeh, R Khorramirouz, Ahmad Masoumi, Sorena Keihani, Seyede Maryam
Kameli
Pediatric Urology Research Centre, Section of Tissue Engineering and Stem Cell Therapy,
Pediatric Center of Excellence, Tehran University of Medical Sciences (TUMS), Tehran,
Iran (IRI)
INTRODUCTION
Biological scaffolds produced from fetal tissues exhibit
advantageous properties for tissue engineering. The
extracellular matrix (ECM) in these scaffolds contains
proteins that influence cell attachment, gene expression and
cell differentiation and have a higher capability for tissue
regeneration compared to mature tissues. Currently,
gastrointestinal segments are often employed for bladder
augmentation, but complications like stone formation,
metabolic abnormalities and secondary malignancies
commonly complicate this procedure .In this study we report
a method to create a natural acellular matrix scaffold from
human fetal small intestine and grafting to the bladder
seromuscular layers as an experimental model of
augmentation cystoplasty.
RESULTS
In acellular matrices, no nuclear remnants were detected and
ECM architecture was also well preserved using this
decellularization protocol. Histological analysis of the excised
grafts revealed the formation of muscular layer and blood
vessels in the implanted scaffolds similar to normal bladder.
These findings demonstrate the effective seeding of this
unique scaffold by host bladder cells. The tissue architecture
of re-cellularized scaffold was very similar to the native
bladder.
METHODS
The ethical committee of TUMS approved this study.
Human fetal intestines were decellularized by immersion in
a hypotonic solution containing 0.5% (w/v) SDS. The
success of this protocol was evaluated by histological
analysis, scanning electron microscopy and measurement of
collagen content and sulfated glycosaminoglycan (sGAG) of
the acellular construct. Eight adult rabbits were selected and
underwent seromuscular dissection. The acellular scaffolds
were then implanted on the exposed urothelium.
Urodynamic studies and cystography were performed six
months after the surgery. At 14, 120 and 180 days animals
were sacrificed, the augmented bladders were resected and
paraffin-embedded. Immunohistochemistry was performed
to evaluate different types of cell seeding.
DISCUSSION & CONCLUSIONS
These findings demonstrate the effective seeding of this
unique biological scaffold produced from human foetal
intestinal tissue similar to the host bladder cells. The tissue
architecture of re-cellularized scaffold was very similar to the
native bladder. The foetal intestine acellular matrix could be
an exceptional tissue for bladder augmentation in future
experimental studies and may pave the road for clinical
application.
Fig. 1: fetal acellular intestine implantation
Fig.3: Picro-sirius red staining confirmed increased collagen
staining during the implantation.
Fig.2. Movat pentachrome staining of control and
acellular fetal intestine