Trinity J. Bivalacqua, MD, PhD, presented “The First Tissue Engineered Neo-Urinary Conduit (NUC) Clinical Trial for Complete Organ Replacement: Successes, Pitfalls, Challenges” during the 40th Annual Ralph E. Hopkins Urology Seminar on February 5th, 2020 in Jackson Hole, Wyoming.
How to cite: Bivalacqua, Trinity J. “The First Tissue Engineered Neo-Urinary Conduit (NUC) Clinical Trial for Complete Organ Replacement: Successes, Pitfalls, Challenges” February 5th, 2020. Accessed Dec 2024. https://grandroundsinurology.com/the-first-tissue-engineered-neo-urinary-conduit-nuc-clinical-trial-for-complete-organ-replacement-successes-pitfalls-challenges/
The First Tissue Engineered Neo-Urinary Conduit (NUC) Clinical Trial for Complete Organ Replacement: Successes, Pitfalls, Challenges – Summary:
Trinity J. Bivalacqua, MD, PhD, Director of Urologic Oncology at Johns Hopkins Medicine, discusses the first tissue-engineered neo-urinary conduit (NUC) clinical trial for complete organ replacement in patients with bladder cancer. He explains that the standard methods of using the genitourinary (GI) tract for cystectomy in patients with bladder cancer often cause sustained and significant complications associated with exposing the GI tissue to urine, and therefore the development of a urinary diversion using autologous cell sources for a tissue-engineered urinary conduit is warranted. Dr. Bivalacqua then details the process by which his team attempted to do this: isolating smooth muscle cells, seeding them on a biodegradable PLGA scaffold, and then implanting the construct after cystectomy, first in porcine subjects and then in human patients during the phase I trial. He notes that while all the NUCs had to be explanted due to stomal stenosis or NUC stricture, his team did successfully regenerate urinary tissue using smooth muscle cells, and he hopes researchers will progress toward the development of a clinically functional urinary conduit in an ongoing multicenter phase I/II trial.
About The 40th Annual Ralph E. Hopkins Urology Seminar:
The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, emerging surgical techniques, and general urology. Dr. Bivalacqua presented this lecture during the 40th iteration of the meeting on February 5th, 2020 in Jackson Hole, Wyoming.
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ABOUT THE AUTHOR
Trinity J. Bivalacqua, MD, PhD, is the Director of Urologic Oncology and the R. Christian B. Evensen Associate Professor of Urology and Oncology at the James Buchanan Brady Urological Institute of Johns Hopkins Medicine in Baltimore, Maryland. He also has an active clinical practice. Dr. Bivalacqua received his undergraduate, graduate, and medical degrees from Tulane University in New Orleans. He went on to complete general surgery and urology training at Johns Hopkins Hospital. He also completed an American Urological Association Foundation Post-Doctoral Fellowship.
Dr. Bivalacqua has a particular interest in prostate and bladder cancers, and focuses on organ-sparing therapies, minimally-invasive techniques, and orthotopic bladder substitution. He has received several research grants, including a Career Development Award from the National Institute of Health and an AUA “Rising Star” Award. At present, Dr. Bivalacqua’s research lab is largely focused on the development of preclinical models of urothelial carcinoma to test systemic and intravesical immunotherapies and nano-particular based chemotherapies. He is also interested in regenerative approaches to enhance autonomic nerve function and the development of engineered urinary tissue.