Tissue engineered buccal mucosa for urethroplasty: Progress and future directions

• Published in: Advanced drug delivery reviews 2015-03, Vol.82-83, p.69-76
• Main Authors: Osman, N.I., Hillary, C., Bullock, A.J., MacNeil, S., Chapple, C.R.
• Format: Article
• Language: English
• Subjects: Animals; Autografts - transplantation; Biocompatible Materials - therapeutic use; Buccal mucosa; Humans; Mouth Mucosa - transplantation; Oral mucosa; Reconstruction; Reconstructive Surgical Procedures - methods; Stricture; Tissue engineering; Tissue Engineering - methods; Tissue Scaffolds; urethra; Urethral Stricture - surgery
• ISSN: 0169-409X; 1872-8294
• DOI: 10.1016/j.addr.2014.10.006

Autologous buccal mucosa is commonly utilized in the surgical treatment of urethral strictures. Extensive strictures require a larger quantity of tissue, which may lead to donor site morbidity. This review assesses progress in producing tissue engineered buccal mucosa as an alternative graft material. Few clinical studies have introduced cells onto biological or synthetic scaffolds and implanted resulting constructs in patients. The available studies show that buccal mucosa cells on acellular human dermis or on collagen matrix lead to good acute stage tissue integration. Urothelial cells on a synthetic substrate also perform well. However while some patients do well many years post-grafting, others develop stricture recurrence. Acellular biomaterials used to treat long urethral defects in animals commonly lead to fibrosis. Tissue engineered buccal mucosa shows promise as a substitute for native tissue. The fibrosis which occurs months post-implantation may reflect the underlying disease process recurring in these patients. [Display omitted]