Tracheal transplantation: is there lumen at the end of the tunnel?

Pêgo-Fernandes, Paulo Manuel; Azevedo-Pereira, Artur Eugênio de

doi:10.1590/s1516-31802009000500001

Cited by 4 publications

(8 citation statements)

References 5 publications

(3 reference statements)

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“…Conversely, the tracheal arterial supply has a segmental pattern, without a major tracheal artery or vein. In the clinical environment, this anatomical arrangement makes the intravascular administration of preservation solutions into the trachea exceedingly difficult (2,7). …”

Section: Discussionmentioning

confidence: 99%

“…A large number of surgical techniques and implantable devices have been tested, with disappointing results (1,2). In spite of that, some recent findings on tracheal revascularization and graft reepithelialization have renewed interest in tracheal transplantation (2–5). However, for tracheal transplantation to succeed, the effects of ischemic injury secondary to harvesting and storage on tracheal tissues need to be better understood.…”

Section: Introductionmentioning

confidence: 99%

“…Because of the particular segmental pattern of tracheal vascularization, with no major tracheal vessels, the intravascular administration of preservation solutions into tracheal grafts is far from useful in a clinical scenario (2,6,7). Therefore, we previously investigated whether preservation solutions were effective when applied topically.…”

Section: Introductionmentioning

confidence: 99%

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The impact of topically applied preservation solutions on the respiratory epithelium of tracheal grafts submitted to cold ischemia: functional and morphological analysis

Azevedo-Pereira¹,

Saka²,

Oliveira-Braga³

et al. 2013

Clinics

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OBJECTIVE:Advances in graft reepithelialization and revascularization have renewed interest in airway transplantation. This study aims to determine whether topically applied preservation solutions can ameliorate ischemic injury to tracheal grafts. We analyzed 1) the effects of cold ischemia on the mucociliary clearance of tracheal grafts and 2) the impact of topically applied preservation solutions on the effects of cold ischemia on mucociliary clearance.METHOD:Tracheal segments (n = 217) from 109 male Wistar rats were harvested, submerged in low-potassium-dextran-glucose, histidine-tryptophan-ketoglutarate, or saline solution (saline group), and stored at 4°C for 6, 10, 16, or 24 hours. A control group (not submerged) was analyzed immediately after harvesting. In situ mucociliary transport and ciliary beating frequency were measured using a stroboscope. Epithelial integrity, cellular infiltration, and mucus storage were quantified by light microscopy and image analysis software, along with transmission electron microscopy.RESULTS:1) The effects of cold ischemia: in situ mucociliary transport and ciliary beating frequency were greater in the control group than after cold ischemia. Microscopic analysis results were similar between groups. 2) The effects of preservation solutions: there was no difference between the low-potassium-dextran-glucose, histidine-tryptophan-ketoglutarate, and saline groups in functional or light microscopy analysis. The saline group presented stronger signs of ischemic injury with transmission electron microscopy.CONCLUSIONS:Cold ischemia diminished the mucociliary clearance of the tracheal respiratory epithelium. Topically applied preservation solutions did not ameliorate the injury caused by cold ischemia to the tracheal respiratory epithelium.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of topically applied preservation solutions on the respiratory epithelium of tracheal grafts submitted to cold ischemia: functional and morphological analysis

Azevedo-Pereira¹,

Saka²,

Oliveira-Braga³

et al. 2013

Clinics

View full text Add to dashboard Cite

show abstract

“…A large number of surgical techniques and implantable devices has been tested with poor results 1,2. In spite of that, some recent findings on tracheal revascularization and graft epithelial replacement have renewed the interest on tracheal transplantation, with special attention to graft bioengineering 2-5. However, in order to succeed in tracheal transplantation, the effects of tracheal ischemic injury secondary to harvesting need to be better understood.…”

Section: Introductionmentioning

confidence: 99%

Impact of topically-applied lpd-glucose on tracheal mucociliary clearance after warm and cold ischemia: short communication

Azevedo-Pereira

Saka

Oliveira

et al. 2011

Clinics

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“…of the patients. 13,14 Moreover, stenting represents only a palliative option for patients with malignant tracheal tumors. Over the years, researchers faced the challenge of airway replacement by proposing very different solutions: these include (1) synthetic bio-prostheses, (2) tracheal or aortic allografts, (3) autologous tissue composites, (4) tracheal transplantation, and (5) bio-engineered scaffolds, each of them presenting advantages and limitations.…”

mentioning

confidence: 99%

Human tracheal transplantation: A systematic review of case reports

Verzeletti,

Mammana,

Zambello

et al. 2024

Clinical Transplantation

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BackgroundPatients with long‐segment airway stenosis not amenable to conventional surgery may benefit from tracheal transplantation. However, this procedure has been only anecdotally reported, and its indications, techniques, and outcomes have not been extensively reviewed.MethodsWe conducted a systematic Literature search to identify all original articles reporting attempts at tracheal transplantation in humans.ResultsOf 699 articles found by the initial search, 11 were included in the systematic review, describing 14 cases of tracheal transplantation. Patients underwent transplantation for benign stenosis in nine cases, and for malignancies in five cases. In 12 cases blood supply to the trachea was provided by wrapping the graft in a vascularized recipient's tissue, while in 2 cases the trachea was directly transplanted as a vascularized composite allograft. The transplantation procedure was aborted before orthotopic transplantation in two patients. Among the remaining 12 patients, there was 1 operative mortality, while 4 patients experienced complications. Immunosuppressants drugs were administered to the majority of patients postoperatively, and only one group of authors attempted their withdrawal, in five patients. At the end of follow‐up, all 11 patients surviving the operation were alive, but 2 had a recurrent tracheal stenosis requiring an airway appliance for breathing.ConclusionHuman tracheal transplantation is still at an embryonic phase. Studies available in the Literature report different surgical techniques, and information on long‐term outcomes is still limited. Future research is needed in order to understand the clinical value of this procedure.

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Tracheal transplantation: is there lumen at the end of the tunnel?

Cited by 4 publications

References 5 publications

The impact of topically applied preservation solutions on the respiratory epithelium of tracheal grafts submitted to cold ischemia: functional and morphological analysis

The impact of topically applied preservation solutions on the respiratory epithelium of tracheal grafts submitted to cold ischemia: functional and morphological analysis

Impact of topically-applied lpd-glucose on tracheal mucociliary clearance after warm and cold ischemia: short communication

Human tracheal transplantation: A systematic review of case reports

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