Twenty years of experience with the rabbit model, a versatile model for tracheal transplantation research

Abstract

Pathologies comprising more than half the length of the trachea are a challenge to the reconstructive surgeon. Innovative tracheal transplantation techniques aim to offer the patient a curative solution with a sustained improvement in quality of life. This review summarizes the authors' experience with the rabbit as a versatile model for research regarding tracheal transplantation. Because of the segmental blood supply of the trachea, it is not feasible to transplant the organ together with a well-defined vascular pedicle. As such, the key element of successful tracheal transplantation is the creation of a new blood supply. This vascularized construct is created by prelaminating the rabbit trachea heterotopically, within the lateral thoracic fascia. After prelamination, the construct and its vascular pedicle are transferred to the orthotopic position in the neck. This model has become gold standard because of the advantages of working with rabbits, the anatomy of the rabbit trachea, and the reliability of the lateral thoracic artery flap. In this paper, the key elements of surgery in the rabbit are discussed, as well as the tracheal anastomosis and the harvest of the lateral thoracic artery flap. Practical tips and tricks are presented. The data described in this review represent the fundaments of ongoing translational research in the center over the past twenty years.

An optimized non-destructive protocol for testing mechanical properties in decellularized rabbit trachea

“…Two-(n = 6), four-(n = 6) and eight-cycle decellularized rabbit tracheae of 3 cm length (n = 6) were implanted heterotopically, within the recipient's lateral thoracic artery flap, as described previously [22]. Enrofloxacin per os was given up until termination of the experiment.…”

A comparison of tracheal scaffold strategies for pediatric transplantation in a rabbit model

“…Rabbits have comparable anatomy and airway dimensions to human neonates and infants and are widely accepted as an experimental model for tracheal stenosis and transplantation . In this pilot study, all surgical control animals tolerated a long‐segment autograft replacement without any airway compromise or distress.…”

Alotrasplante parcial de tráquea con preservación del suministro vascular: estudio experimental con y sin inmunosupresión en modelos animales

“…Su tráquea mide en promedio 6,5 cm de largo y 0,5 cm de diámetro. Tienen anillos carti laginosos conectados por ligamentos en la parte anterior y el músculo traqueal en la parte posterior 1,9 . La anatomía traqueal de los humanos se le parece mucho.…”

“…Una complicación frecuente postintubación prolongada es la estenosis traqueal. La resección del segmento estenosado es una alternati va, pero puede ser un problema si este es largo, en cuyo caso al no haber tejido sufi ciente se ti ene que uti lizar prótesis o realizar trasplante 1,2,3 . Así, se han uti lizado prótesis de titanio, polieti leno, silicón, marlex y tefl ón, sin éxito, porque permiten fugas de aire, se colapsan o no permiten movilizar las secreciones bronquiales 4 .…”

“…El trasplante traqueal se ha difi cultado por tres factores: preservación, inmunosupresión y revascularización del injerto, este últi mo porque se suprime el aporte sanguíneo originado por plexos y se altera el proceso de cicatrización. Experimentalmente se ha observado que la máxima longitud traqueal resecable sin complicaciones son 4 cm (4 ó 5 anillos), pero si el trasplante es mayor ocurre necrosis, especialmente de la porción media 1,6 . Para evitar este problema, experimentalmente, se cubrieron con colgajos de omento; pero no ha funcionado en injertos mayores de 6 cm porque sólo se revascularizaron las líneas de sutura y no la porción media del injerto 6 .…”