OHKI Takeshi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Transplantation of tissue-engineered cell sheets for stricture prevention after endoscopic submucosal dissection of the oesophagus.
Journal Formal name:United European gastroenterology journal
Abbreviation:United European Gastroenterol J
ISSN code:20506406/20506406
Domestic / ForeginForegin
Volume, Issue, Page 4(6),pp.741-753
Author and coauthor Jonas Eduard, Sjöqvist Sebastian, Elbe Peter, Kanai Nobuo, Enger Jenny, Haas Stephan L, Mohkles-Barakat Ammar, Okano Teruo, Takagi Ryo, Ohki Takeshi, Yamamoto Masakazu, Kondo Makoto, Markland Katrin, Lim Mei Ling, Yamato Masayuki, Nilsson Magnus, Permert Johan, Blomberg Pontus, Löhr J-Matthias
Publication date 2016/12
Summary BACKGROUND AND OBJECTIVE:Endoscopic mucosal dissection (ESD) is a treatment option for oesophagus tumours localized to the mucosa enabling en bloc removal of large lesions. The resulting larger mucosal defects have resulted in an increase in the occurrence of post-treatment strictures. Transplantation of autologous cell sheets, cultured from oral mucosa, has been shown to prevent post-ESD strictures. The aim of the study was to assess the efficacy and safety of cell sheet transplantation after oesophageal ESD in a Western patient population where reflux-associated pre-malignant and malignant conditions predominate.METHODS:Patients with Barrett's oesophagus associated high-grade dysplasia or early adenocarcinoma where ESD entailed a resection >3 cm in length and ≥75% of the circumference were eligible for treatment under hospital exemption. Cell sheets were cultured from buccal mucosa according to Good Manufacturing Practice and were endoscopically applied to the post-ESD defect directly after resection. Patients were followed with weekly endoscopy examinations, including confocal laser microscopy, for a total of four weeks.RESULTS:Five patients were treated. ESD was extensive with resections being circumferential in three patients and 9-10 cm in length in two. The number of transplanted cell sheets ranged from two to six. Three patients developed strictures requiring two to five dilatation sessions.CONCLUSIONS:Cell sheet transplantation shows to be safe and feasible in a Western population. Results suggest that transplantation has a protective effect on the mucosal defect after ESD, decreasing both the risk for and extent of stricture formation.
DOI 10.1177/2050640616631205
PMID 28408991