April 11, 2014
Doctors Implant Lab-Grown Vaginas Into Women With Rare Disease
[ Watch the Video: Behind The Research To Engineer Human Vaginal Organs ]
Brett Smith for redOrbit.com - Your Universe OnlineMayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare genetic disorder in which a female’s vagina and uterus are underdeveloped or missing. A new technique has now allowed doctors to implant laboratory-grown vaginas into teenage girls, bringing some sense of normalcy into their lives, according to a new report in The Lancet journal.
The laboratory-grown organs were generated using the patients’ own cells – eliminating the complications associated with organ transplants. The team that conducted the procedure said their method could also be used to treat patients with vaginal cancer or injuries.
"This pilot study is the first to demonstrate that vaginal organs can be constructed in the lab and used successfully in humans," said Dr. Anthony Atala, director of Wake Forest Baptist Medical Center's Institute for Regenerative Medicine. "This may represent a new option for patients who require vaginal reconstructive surgeries. In addition, this study is one more example of how regenerative medicine strategies can be applied to a variety of tissues and organs."
Operations described in the study were performed between June 2005 and October 2008 on girls who were between 13 and 18 years old at the time. Follow-up analyses revealed that the organs were functioning normally up to eight years after the surgeries.
"Tissue biopsies, MRI scans and internal exams using magnification all showed that the engineered vaginas were similar in makeup and function to native tissue,” said study author Atlantida-Raya Rivera, director of the HIMFG Tissue Engineering Laboratory at the Metropolitan Autonomous University in Mexico City.
The artificial organs were made by using muscle and epithelial tissue derived from a small biopsy of each patient's external genital area. Cells were then taken from the tissues, expanded and then put on a biomaterial that was formed into a vagina-like design. The scaffolds were customized to fit each patient individually.
Next, the specialists developed a space in the patient's pelvis and attached the scaffold to internal structures. Once implanted in the body, cell-seeded scaffolds develop surrounding nerves and blood vessels while the cells increase in size and form tissue. Concurrently, the scaffolding material is absorbed by the body as the cells set down materials to form a lasting replacement structure.
A follow-up analysis revealed the border between native tissue and the engineered segments was impossible to differentiate and the scaffold had developed into tri-layer vaginal tissue, the researchers said.
Conventional treatments for MRKH include dilation of pre-existing tissue or reconstructive surgical treatment to produce new vaginal cells. However, these replacements often don't have a normal muscle layer, leading to the narrowing or contracting of the vagina. The scientists claimed that with these treatments the complication rate can be as much as 75 percent in pediatric patients, with the requirement of vaginal dilation due to narrowing being the most standard issue.
The newly-described work is based on previous research by the same team surrounding lab-generated vaginas in mice and rabbits. In these studies, researchers found the significance of using cells on the scaffolds. The team used a comparable procedure for replacement bladders that were implanted in nine children starting in 1998.
The researchers said they plan to determine the overall effectiveness of their newly-developed procedure.