Tracheal Regeneration Following Tracheal Replacement With an Allogenic Aorta

Martinod, Emmanuel; Seguin, Agathe; Holder‐Espinasse, Muriel; Kambouchner, Marianne; Duterque-Coquillaud, Martine; Azorin, J.; Carpentier, Alain

doi:10.1016/j.athoracsur.2004.08.035

Cited by 97 publications

(74 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The absence of a safe and effective method of monitoring epithelial fate in vivo in humans prohibits observations of the fate of such epithelium. A number of preclinical studies have indicated re‐epithelialization occurs from migration of cells from the wound edge following tracheal transplantation 14, 15, tracheal replacement with aortic grafts 16, 17 or synthetic material 18. While this might question the need for re‐epithelizing grafts prior to transplantation, evidence exists supporting the role of epithelium in reducing postoperative stenosis and it is probable that transplanted epithelia act as a biological dressing as re‐epithelization occurs from the wound edge 19.…”

Section: Discussionmentioning

confidence: 99%

Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study

Hamilton

Kanani

Roebuck

et al. 2015

American Journal of Transplantation

160

145

View full text Add to dashboard Cite

In 2010, a tissue‐engineered trachea was transplanted into a 10‐year‐old child using a decellularized deceased donor trachea repopulated with the recipient's respiratory epithelium and mesenchymal stromal cells. We report the child's clinical progress, tracheal epithelialization and costs over the 4 years. A chronology of events was derived from clinical notes and costs determined using reference costs per procedure. Serial tracheoscopy images, lung function tests and anti‐HLA blood samples were compared. Epithelial morphology and T cell, Ki67 and cleaved caspase 3 activity were examined. Computational fluid dynamic simulations determined flow, velocity and airway pressure drops. After the first year following transplantation, the number of interventions fell and the child is currently clinically well and continues in education. Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity. Computational fluid dynamic analysis demonstrated increased velocity and pressure drops around a distal tracheal narrowing. Cross‐sectional area analysis showed restriction of growth within an area of in‐stent stenosis. This report demonstrates the long‐term viability of a decellularized tissue‐engineered trachea within a child. Further research is needed to develop bioengineered pediatric tracheal replacements with lower morbidity, better biomechanics and lower costs.

show abstract

Section: Discussionmentioning

confidence: 99%

Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study

Hamilton

Kanani

Roebuck

et al. 2015

American Journal of Transplantation

160

145

View full text Add to dashboard Cite

show abstract

“…For laryngeal function to be recreated, the trachea must first be lengthened with a hollow, integrated structure that is vascularized by the surrounding tissues. Numerous authors have considered the use of synthetic prostheses to replace a tracheal segment an inevitable failure, given the lack of graft epithelialization and/or the presence of tracheal obstruction or prosthetic migration [18,22].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous replacement materials have been tested [8][9][10] on animal models, including synthetic prostheses [3][4]11], tracheal homo-and allografts [12][13], tissue autoand allotransplantations [14][15][16][17][18][19][20][21][22][23], and cultured cell seeded implants [24][25]. Martinod et al used an aortic allograft linked to a silicone prosthesis as a tracheal substitute [14][15][16][17][18][19]. The initial results, obtained in sheep, were spectacular: the silicone tube was removed after 6 months, and the aortic tissue was transformed into a real trachea composed of cartilage organized in rings and covered with a mucociliary epithelium.…”

Section: Discussionmentioning

confidence: 99%

Development of surgical protocol for implantation of tracheal prostheses in sheep

Dupret‐Bories

Schultz²,

Vrana³

et al. 2011

JRRD

View full text Add to dashboard Cite

Abstract-This article documents experiments performed in ewes to design an artificial larynx. The artificial larynx is composed of a hollow, porous tube that elongates the trachea and is capped with a valve that acts as a laryngeal sphincter. Through an industrial collaboration, our team developed a porous biomaterial that can be colonized by cervical tissues. This biomaterial has been used in animals to replace part of the trachea, but it is meant to eventually substitute for laryngeal cartilage. The tracheal prosthesis is a hollow cylindrical tube composed of titanium microbeads. We performed a study in large animals to establish an optimal surgical protocol for tracheal replacement in humans. The study included 11 sheep (n = 11) and compared 5 methods of implantation. We successfully established an optimal three-step surgical protocol to make the porous-titanium tracheal prosthesis functional: (1) large lumen endoprosthetics, (2) colonization by the peripheral tissues, and (3) endoprosthetic epithelialization. This study is the first step in developing an artificial larynx because it successfully identifies a biomaterial capable of extending the trachea to allow it to open at the junction of the upper aerodigestive tracts.

show abstract

“…Each protocol was performed for 8h and 24h to analyze the influence of decellularization time. Light gray boxes refer to control of reactions (1,2,7,8); dark gray boxes refer to the employed protocols (3 to 6 and 9 to 12). Painted boxes represent methods that were employed during these protocols.…”

Section: Second Set Of Decellularization Protocols (Led Based Methods)mentioning

confidence: 99%

“…Tracheal lesions whose length is more than 50% (around 6 cm) in adults and a third of the trachea in small children require curative treatment [1][2][3][4][5][6][7][8] . In many cases, endoluminal therapies followed by surgical procedures are required, resulting in high costs to healthcare systems 4,9 .…”

Section: Introductionmentioning

confidence: 99%

Light-emitting diode effects on combined decellularization of tracheae. A novel approach to obtain biological scaffolds

et al. 2014

View full text Add to dashboard Cite

PURPOSE:To obtain a decellularized tracheal scaffold associating traditional approaches with the novel light-emitting diode (LED) proposal. METHODS:This study was performed with New Zealand adult rabbits weighing 3.0 -4.0 kg. Different protocols (22) were used combining physical (agitation and LED irradiation), chemical (SDS and Triton X-100 detergents), and enzymatic methods (DNase and RNase). RESULTS:Generally, the cells surrounding soft tissues were successfully removed, but none protocol removed cells from the tracheal cartilage. However, longer protocols were more effective. The cost-benefits relation of the enzymatic processes was not favorable. It was possible to find out that the cartilaginous tissue submitted to the irradiation with LED 630nm and 475 nm showed an increased number of gaps without cells, but several cells were observed to be still present. CONCLUSION:The light-emitting diode is a promising tool for decellularization of soft tissues.

show abstract

Tracheal Regeneration Following Tracheal Replacement With an Allogenic Aorta

Cited by 97 publications

References 33 publications

Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study

Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study

Development of surgical protocol for implantation of tracheal prostheses in sheep

Light-emitting diode effects on combined decellularization of tracheae. A novel approach to obtain biological scaffolds

Contact Info

Product

Resources

About