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Functional integration of an autologous engineered esophagus in a large-animal model - PubMed

5 hours ago
  • #large-animal model
  • #tissue engineering
  • #esophageal regeneration
  • Tissue engineering of the esophagus has been limited by stent dependence and poor muscle regeneration.
  • An integrated strategy was developed to engineer a 2.5-cm esophageal segment using autologous pericyte-like myogenic precursors and fibroblasts in a decellularized porcine scaffold.
  • The engineered esophagus was tested in 10-kg minipigs (n = 8) to model pediatric use.
  • Bioreactor maturation induced a proangiogenic phenotype, supported by biodegradable intraluminal stents and a vascularizing pleural wrap in vivo.
  • The approach yielded safe and effective esophageal conduits; oral feeding supported normal growth, and morbidity resembled clinical esophageal replacement.
  • 63% (5/8) of the minipigs survived to the 6-month endpoint.
  • Multimodal analyses showed progressive recapitulation of native architecture, with increasing neuromuscular regeneration and vascularization.
  • Functional recovery included absence of symptomatic stricture and presence of secondary peristalsis by 6 months.
  • The combination of regenerative, conditioning, and surgical strategies enabled a functionally integrated, contractile esophageal graft without immunosuppression.