Reconstruction of the trachea and carina: Surgical reconstruction, autologous tissue transplantation, allograft transplantation, and bioengineering

Ren, Jianghao; Xu, Yuanyuan; Z, Guo; Ren, Jiangbin; Wang, Kan; Luo, Yiqing; Zhu, Mingyang; Tan, Qiang

doi:10.1111/1759-7714.14315

Cited by 12 publications

(8 citation statements)

References 71 publications

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“…Therefore, it will be necessary to keep the differences in mind during tracheoplasty and transplantation. Especially in autologous transplantation, it should be taken into account since a part of the trachea is transplanted to another part [24]. In xenografts, the transplantation of the same part may improve engraftment and stenosis rates.…”

Section: Safshekan Et Al (mentioning

confidence: 99%

Regional variations and sex-related differences in human tracheal ligaments

Fukushige

Okubo

Shan

et al. 2022

Preprint

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This study aimed to investigate the characteristics of the ligaments present between the thyroid, cricoid, and tracheal cartilages on living human bodies and cadavers using a digital palpation device. The mean dynamic stiffness values of the cricothyroid ligaments were 622.0 ± 88.2 N/m (mean ± SD) for humans, 956.1 ± 75.0 N/m when measured directly in the cadavers, and 826.5 ± 105.7 N/m when removed from the cadavers. There was no significant difference in dynamic stiffness between the cricothyroid and the first annular ligaments. The dynamic stiffness of annular ligaments measured in the superior trachea of human subjects and cadavers decreased gradually toward the distal trachea, whereas the mechanical stress relaxation time increased distally. There was no difference in dynamic stiffness between males and females in the upper part of the trachea; however, the dynamic stiffness of the middle and inferior parts was significantly higher in females than in males. Furthermore, males, but not females, showed significant differences in dynamic stiffness between the superior and middle parts. These results reveal that there are regional and sex-related differences in tracheal ligaments. This information might prove useful for surgical airway management and so on.

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Section: Safshekan Et Al (mentioning

confidence: 99%

Regional variations and sex-related differences in human tracheal ligaments

Fukushige

Okubo

Shan

et al. 2022

Preprint

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“…Several pathologic conditions, including tracheal stenosis, malacia, or primary tracheal neoplasms, may require resection of a tracheal segment, and subsequent airway reconstruction 1–4 . However, when the airway tract to be resected is longer than 5–6 cm, standard surgical techniques for reconstruction (i.e., tracheal resection and end‐to‐end anastomosis) are not feasible, 3,5–12 and currently, there are no other well‐established reconstructive procedures.…”

Section: Introductionmentioning

confidence: 99%

“…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. [1][2][3][4] Compared to other techniques, tracheal transplantation is particularly appealing, since it is the only one capable of restoring a fully functional airway, with native mechanical properties and a ciliated respiratory epithelium; moreover, it has the benefit of being based on a principle already well established for other solid organs.…”

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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“…Therefore, external treatment is required in the latter case including autografts and allografts [ 6 , 7 , 8 ]. Although allograft is a main practice for repairing damaged bone tissues, a shortage of donors has still remained [ 9 , 10 , 11 ]. According to Health Resources & Services Administration (HRSA) data, over one hundred thousand people are on the national transplant waiting list, but only 40,000 transplants were performed in 2021 [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

PCL and DMSO2 Composites for Bio-Scaffold Materials

et al. 2023

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Polycaprolactone (PCL) has been one of the most popular biomaterials in tissue engineering due to its relatively low melting temperature, excellent thermal stability, and cost-effectiveness. However, its low cell attraction, low elastic modulus, and long-term degradation time have limited its application in a wide range of scaffold studies. Dimethyl sulfone (DMSO2) is a stable and non-hazardous organosulfur compound with low viscosity and high surface tension. PCL and DMSO2 composites may overcome the limitations of PCL as a biomaterial and tailor the properties of biocomposites. In this study, PCL and DMSO2 composites were investigated as a new bio-scaffold material to increase hydrophilicity and mechanical properties and tailor degradation properties in vitro. PCL and DMSO2 were physically mixed with 10, 20, and 30 wt% of DMSO2 to evaluate thermal, hydrophilicity, mechanical, and degradation properties of the composites. The water contact angle of the composites for hydrophilicity decreased by 15.5% compared to pure PCL. The experimental results showed that the mechanical and degradation properties of PCL and DMSO2 were better than those of pure PCL, and the properties can be tuned by regulating DMSO2 concentration in the PCL matrix. The elastic modulus of the composite with 30 wt% of DMSO2 showed 532 MPa, and its degradation time was 18 times faster than that of PCL.

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Reconstruction of the trachea and carina: Surgical reconstruction, autologous tissue transplantation, allograft transplantation, and bioengineering

Cited by 12 publications

References 71 publications

Regional variations and sex-related differences in human tracheal ligaments

Regional variations and sex-related differences in human tracheal ligaments

Human tracheal transplantation: A systematic review of case reports

PCL and DMSO2 Composites for Bio-Scaffold Materials

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