A TISSUE-ENGINEERED STOMACH AS A REPLACEMENT OF THE NATIVE STOMACH

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Abstract
Background. Despite recent advances in reconstruction techniques, total gastrectomy is still accompanied by various complications. As an alternative treatment, we propose a tissue-engineered stomach that replaces the mechanical and metabolic functions of a normal stomach. The objective of this study was to demonstrate the function of a tissue-engineered stomach as a replacement of the native stomach. Methods. Tissue-engineered stomachs were formed in recipient rats from stomach epithelium organoid units isolated from neonatal donor rats. After 12 weeks, the animals underwent a second operation for replacement of the native stomachs. Results. Tissue-engineered stomachs were successfully used as a substitute of the native stomach in a rat model. An upper gastrointestinal tract study revealed no evidence of bowel stenosis or obstruction at both anastomosis sites. Histologically, the tissue-engineered stomachs had well-developed vascularized tissue with a neomucosa continuously lining the lumen and stratified smooth muscle layers. Immunohistochemical staining for α-actin smooth muscle showed that the smooth muscle layers were arranged in a regular fashion. Scanning electron microscopy showed that the surface topography of the tissue-engineered stomachs resembled that of native stomachs. Conclusions. It has been demonstrated that a tissueengineered stomach can replace a native stomach in a rat model. Replacement of the native stomach by a tissue-engineered stomach had beneficial effects on the formation of neomucosa and smooth muscle layers in the tissue-engineered stomach.

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