Biomimetic in situ tracheal microvascularization for segmental tracheal reconstruction in one‐step

Abstract

Formation of functional and perfusable vascular network is critical to ensure the long-term survival and functionality of the engineered tissue tracheae after transplantation. However, the greatest challenge in tracheal-replacement therapy is the promotion of tissue regeneration by rapid graft vascularization. Traditional prevascularization methods for tracheal grafts typically utilize omentum or muscle flap wrapping, which requires a second operation; vascularized segment tracheal orthotopic transplantation in one step remains difficult. This study proposes a method to construct a tissue-engineered tracheal graft, which directly forms the microvascular network after orthotopic transplantation in vivo. The focus of this study was the preparation of a hybrid tracheal graft that is non-immunogenic, has good biomechanical properties, supports cell proliferation, and quickly vascularizes. The results showed that vacuum-assisted decellularized trachea-polycaprolactone hybrid scaffold could match most of the above requirements as closely as possible. Furthermore, endothelial progenitor cells (EPCs) were extracted and used as vascularized seed cells and seeded on the surfaces of hybrid grafts before and during the tracheal orthotopic transplantation. The results showed that the microvascularized tracheal grafts formed maintained the survival of the recipient, showing a satisfactory therapeutic outcome. This is the first study to utilize EPCs for microvascular construction of long-segment trachea in one-step; the approach represents a promising method for microvascular tracheal reconstruction.

Instant trachea reconstruction using 3D-bioprinted C-shape biomimetic trachea based on tissue-specific matrix hydrogels

“…The ultimate purpose of the current study was to achieve segmental trachea defect repair using 3D-bioprinted C -shape biomimetic CVFIT . Recently, some studies have proposed a direct trachea defect repair strategy with cellular or acellular tracheal constructs, which innovatively achieved direct one-step replacement using tissue-engineered trachea [ 20 , 47 ]. In contrast to the conventional two-step method by mean of intramuscular pre-implantation, the one-step surgical mode of direct end-to-end anastomosis has the unique advantages of instant repair and highly efficient tissue regeneration without long-time waiting.…”

Application of tissue engineering techniques in tracheal repair: a bibliometric study

“…The success of trachea transplantation must be based on the acquisition of suitable transplantation materials. Starting from constructing tracheal scaffolds with simple basic polycaprolactones [ 37 , 38 ], researchers have been trying to modify or prepare new composite materials to meet higher requirements for biocompatibility and mechanical properties [ 39 , 40 ]. Based on this factor, the rationality of the results is greatly improved, which of course is inseparable from the strict peer review system of the journal itself and the high requirements for research innovation and results [ 41 ].…”

Surgical Innovations in Tracheal Reconstruction: A Review on Synthetic Material Fabrication

“…When used in rabbits, none showed signs of respiratory distress and electron microscopy confirmed the regeneration of cilia with its beating frequency identical to natural tracheal cilia [16]. The challenge of vascularisation was approached with a PCL/vacuum-assisted decellularised trachea, which exhibited angiogenesis in vivo alongside low immunogenicity [17]. It has an ideal non-toxic degradation alongside low porosity, which stimulates chondrogenesis, thus strengthening the cartilage [18].…”

“…Due to the trachea being primarily sourced by the inferior thyroid artery and superior bronchial artery, there is a lack of arteriovenous vessels for anastomosis, which prevents the graft from utilising the tracheal blood supply. Without a supply of endothelial progenitor cells for neovascularization, graft necrosis from vascular ischemia and cell death will result [17]. Long-segment tracheal reconstruction faces the biggest challenge, with many animals dying from respiratory distress caused by airway stenosis [30].…”