Application of Bladder Acellular Matrix in Urinary Bladder Regeneration: The State of the Art and Future Directions

Table 3

Stem cell types seeded on bladder acellular matrix and their effects on urinary bladder regeneration.

Author, year Reference no.	Cells type	Experimental model	Urinary bladder regeneration
			BAM seeded with cells	Unseeded BAM
Drewa et al. 2009; [26]	Hair follicle stem cells	Rat	(i) All animals survived the observation period,; (ii) stone disease in one animal (11%),; (iii) regular shape of reconstructed bladders confirmed by cystography,; (iv) smooth muscle regrowth similar to the normal pattern of detrusor muscle,; (v) a structure resembling a hair follicle in the bladder of one animal (11%)	(i) Unexpected deaths due to the leakage and pyuria in two animals (22%),; (ii) stone disease in six animals (67%),; (iii) irregular shape of reconstructed bladders confirmed by cystography,; (iv) extremely thin smooth muscle layer in the central parts of reconstructed area,; (v) a thin urothelial layer
Zhu et al. 2010; [27]	Adipose derived stem cells	Rabbit	(i) All animals survived the observation period,; (ii) lack of graft shrinkage,; (iii) 95% of the original bladder capacity at 24 weeks postoperatively,; (iv) multilayered urothelium at implanted site at 4 weeks postoperatively,; (v) appearance of native bladder wall at 24 weeks postoperatively,; (vi) organized smooth muscle tissue, neoangiogenesis, and proliferation of neural cells	(i) One animal (8%) died due to infection secondary to bladder leakage,; (ii) graft shrinkage,; (iii) 69% of the original bladder capacity at 24 weeks postoperatively,; (iv) multilayered urothelium at implanted site at 4 weeks postoperatively,; (v) the smooth muscle cells at the periphery of the graft organized but distinguishable from normal bladder tissue
Yuan et al. 2013; [28]	Human umbilical mesenchymal stem cells	Dog	(i) All animals survived the observation period,; (ii) grafts covered by soft, vascularised, connective tissue; (iii) no stones, tumours, diverticulum formations,; (iv) complete regenerated urothelium and well developed smooth muscles at 12 weeks postoperatively	(i) All animals survived the observation period,; (ii) grafts covered by soft, vascularised, connective tissue; (iii) no stones, tumours, diverticulum formations; (iv) multilayered urothelium and weekly developed smooth muscles at 12 weeks postoperatively
Pokrywczynska et al. 2013 [29]	Bone marrow mesenchymal stem cells	Rat	(i) All animals survived the observation period,; (ii) lack of graft shrinkage,; (iii) irregularly distributed smooth muscle fibres,; (iv) 61% of native smooth muscle content 12 weeks postoperatively,; (v) hyperplasic urothelium observed in three cases (60%),; (vi) increased capillary density,; (vii) presence of nerves in reconstructed area,; (viii) increased expression of anti-inflammatory cytokines in tissue engineered bladder wall	(i) All animals survived the observation period,; (ii) graft shrinkage,; (iii) extremely thin or complete absence of smooth muscle layer,; (iv) 25% of native smooth muscle content 12 weeks postoperatively,; (v) hyperplasic urothelium observed in all cases (100%),; (vi) lack of nerves in reconstructed area
Leite et al. 2014 [30]	Bone marrow mesenchymal stem cells	Rat	(i) No reduction of inflammation over time (7–28 days after bladder augmentation),; (ii) architecture of the muscular layer similar to native bladder at 28 days postoperatively,; (iii) absence of well formed neural network	(i) No reduction of inflammation over time (7–28 days after bladder augmentation),; (ii) disorganized architecture of the muscular layer, at 28 days postoperatively,; (iii) absence of well formed neural network

BAM: bladder acellular matrix.