Edouard GIRARD PhD defense on 10/19/2018 - 2pm
PhD Defense of Édouard GIRARD from BioMMat team, on october the 19th, at 2pm :
« Development of a resorbable biliary prosthesis to secure the biliary anastomosis in liver transplantation. »
Place : Faculté de médecine, Amphi Boucherle, Domaine de la merci, 38700 La Tronche
Thesis supervisor:
- M. Grégory CHAGNON, Maître de conférences, Université Grenoble Alpes (Director)
- M. Benjamin NOTTELET, Professeur, Université de Montpellier (Codirector)
Jury :
- M. Jean-Robert DELPERO, Professeur, Université Aix-Marseille (President)
- M. Jean-Benoît LE CAM, Professeur, Université Rennes 1 (Reporter)
- M. Nicolas BLANCHEMAIN, Maître de conférences, Université Lille 2 (Reporter)
- M. Christian LETOUBLON, Professeur émérite, Université Grenoble Alpes (Member)
- M. Alexandre MOREAU-GAUDRY, Professeur, Université Grenoble Alpes (Member)
- Mme Emilie GREGOIRE, Maître de conférences, Université Aix-Marseille (Examiner)
liver transplantation, biliary anastomosis morbidity, resorbable internal biliary stent (RIBS), experimental characterization, biomechanical behavior, innovative implantable medical device
Abstract :
Benefit of implantation of an internal biliary stent (IBS) during liver transplantation to reduce biliary complications was recently demonstrated. Silicone IBS was used in practice, which require an endoscopic ablation procedure, a potentially morbid intervention for the patient. In order to avoid this, and to reduce biliary complications after liver transplantation we developed in this thesis a resorbable internal biliary stent (RIBS), made from a blend of degradable polymers visualizable by X-ray. We describe the development of this RIBS and make sure it complies with the drastic specifications to ensure it is usable and useful.
The first aim of the present work, was to synthetize a biomaterial based on a selected PLA50-PEG-PLA50 triblock copolymer with a triiodobenzoate-poly(e-caprolactone) radiopaque copolymer (PCL-TIB) as additive and design a RIBS. We evaluated its biocompatibility, validated that it could secure the biliary anastomosis and enable biliary regeneration, and confirmed that it meets the very strict objectives related to implementation and monitoring in liver transplantation. The second objective was to characterize the PCL-TIB/PLA50-PEG-PLA50 RIBS, by evaluating whether properties during in vitro and in vivo degradation comply with the specifications. An in vitro study in a simulated biliary environment and an in vivo rats implantation study was realized. We observed physico-chemical properties, radiological visualization, histology, and mechanical behavior during degradation. The last aim was to evaluate ex vivo implantability in human bile ducts, with the study of the bile duct mechanical behavior, and implantation tests on anatomic specimens.
In this thesis, radiological and mechanical behavior of novel radiopaque and resorbable IBS was successfully evaluated during in vitro and in vivo degradation with properties that meet requirements. A RIBS prototype device was successfully implanted in human anatomic specimen. The results obtained will allow the development of a novel class of trackable and degradable IBS to reduce biliary complications after liver transplantation.