Experimental Tracheal Replacement: Angiogenesis and Null Apoptosis Promote Stenosis

J. Alfredo Santibáñez-Salgado; Avelina Sotres-Vega; Miguel O. Gaxiola-Gaxiola; Jaime Villalba-Caloca; Karen Bobadilla Lozoya; Joaquín A. Zúñiga-Ramos

doi:10.5090/jcs.20.146

Current Strategies for Tracheal Replacement: A Review

Life ◽

10.3390/life11070618 ◽

2021 ◽

Vol 11 (7) ◽

pp. 618

Author(s):

Giuseppe Damiano ◽

Vincenzo Davide Palumbo ◽

Salvatore Fazzotta ◽

Francesco Curione ◽

Giulia Lo Monte ◽

...

Keyword(s):

Three Dimensional ◽

Neck Region ◽

Vascular Supply ◽

Dimensional Structure ◽

Tracheal Resection ◽

Biological Scaffolds ◽

Biological Substrate ◽

Immunological Reactions ◽

Tracheal Replacement ◽

Current Lines

Airway cancers have been increasing in recent years. Tracheal resection is commonly performed during surgery and is burdened from post-operative complications severely affecting quality of life. Tracheal resection is usually carried out in primary tracheal tumors or other neoplasms of the neck region. Regenerative medicine for tracheal replacement using bio-prosthesis is under current research. In recent years, attempts were made to replace and transplant human cadaver trachea. An effective vascular supply is fundamental for a successful tracheal transplantation. The use of biological scaffolds derived from decellularized tissues has the advantage of a three-dimensional structure based on the native extracellular matrix promoting the perfusion, vascularization, and differentiation of the seeded cell typologies. By appropriately modulating some experimental parameters, it is possible to change the characteristics of the surface. The obtained membranes could theoretically be affixed to a decellularized tissue, but, in practice, it needs to ensure adhesion to the biological substrate and/or glue adhesion with biocompatible glues. It is also known that many of the biocompatible glues can be toxic or poorly tolerated and induce inflammatory phenomena or rejection. In tissue and organ transplants, decellularized tissues must not produce adverse immunological reactions and lead to rejection phenomena; at the same time, the transplant tissue must retain the mechanical properties of the original tissue. This review describes the attempts so far developed and the current lines of research in the field of tracheal replacement.

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Stem-cell-based, tissue engineered tracheal replacement in a child: a 2-year follow-up study

The Lancet ◽

10.1016/s0140-6736(12)60737-5 ◽

2012 ◽

Vol 380 (9846) ◽

pp. 994-1000 ◽

Cited By ~ 280

Author(s):

Martin J Elliott ◽

Paolo De Coppi ◽

Simone Speggiorin ◽

Derek Roebuck ◽

Colin R Butler ◽

...

Keyword(s):

Stem Cell ◽

Follow Up Study ◽

Tracheal Replacement

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Tracheal Replacement Using an In-Body Tissue-Engineered Collagenous Tube “BIOTUBE” with a Biodegradable Stent in a Beagle Model: A Preliminary Report on a New Technique

European Journal of Pediatric Surgery ◽

10.1055/s-0038-1673709 ◽

2018 ◽

Vol 29 (01) ◽

pp. 090-096 ◽

Cited By ~ 4

Author(s):

Yasuhide Nakayama ◽

Satoshi Umeda ◽

Yuichi Takama ◽

Takeshi Terazawa ◽

Hiroomi Okuyama ◽

...

Keyword(s):

Internal Surface ◽

Body Tissue ◽

Histological Evaluation ◽

Biodegradable Stent ◽

Tracheal Reconstruction ◽

Tracheal Epithelial Cells ◽

Biodegradable Stents ◽

Tracheal Replacement ◽

A New Technique ◽

Novel Scaffold

Introduction Tracheal reconstruction for long-segment stenosis remains challenging. We investigate the usefulness of BIOTUBE, an in-body tissue-engineered collagenous tube with a biodegradable stent, as a novel tracheal scaffold in a beagle model. Materials and Methods We prepared BIOTUBEs by embedding specially designed molds, including biodegradable stents, into subcutaneous pouches in beagles. After 2 months, the molds were filled with ingrown connective tissues and were harvested to obtain the BIOTUBEs. The BIOTUBEs, cut to 10- or 20-mm lengths, were implanted to replace the same-length defects in the cervical trachea of five beagles. Endoscopic and fluoroscopic evaluations were performed every week until the lumen became stable. The trachea, including the BIOTUBE, was harvested and subjected to histological evaluation between 3 and 7 months after implantation. Results One beagle died 28 days after 20-mm BIOTUBE implantation because of insufficient expansion and retention force of the stent. The remaining four beagles were implanted with a BIOTUBE reinforced by a strong stent, and all survived the observation period. Endoscopy revealed narrowing of the BIOTUBEs in all four beagles, due to an inflammatory reaction, but patency was maintained by steroid application at the implantation site and balloon dilatation against the stenosis. After 2 months, the lumen gradually became wider. Histological analyses showed that the internal surface of the BIOTUBEs was completely covered with tracheal epithelial cells. Conclusion This study demonstrated the usefulness of the BIOTUBE with a biodegradable stent as a novel scaffold for tracheal regeneration.

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Successful Total Tracheal Replacement by Cryopreserved Aortic Allograft in a Patient Post-COVID-19 Infection

CHEST Journal ◽

10.1016/j.chest.2021.08.037 ◽

2021 ◽

Vol 160 (6) ◽

pp. e613-e617

Author(s):

Cecilia Menna ◽

Claudio Andreetti ◽

Mohsen Ibrahim ◽

Anna Maria Ciccone ◽

Antonio D’Andrilli ◽

...

Keyword(s):

Aortic Allograft ◽

Tracheal Replacement

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Tracheal replacement for primary tracheal cancer

Current Opinion in Otolaryngology & Head & Neck Surgery ◽

10.1097/moo.0b013e32835e212b ◽

2013 ◽

Vol 21 (2) ◽

pp. 171-177 ◽

Cited By ~ 12

Author(s):

Johannes C. Haag ◽

Philipp Jungebluth ◽

Paolo Macchiarini

Keyword(s):

Tracheal Replacement

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Vascularization strategies for tissue engineering for tracheal reconstruction

Regenerative Medicine ◽

10.2217/rme-2020-0091 ◽

2021 ◽

Author(s):

Fei Sun ◽

Yi Lu ◽

Zhihao Wang ◽

Hongcan Shi

Keyword(s):

Tissue Engineering ◽

Cell Metabolism ◽

Microvascular Network ◽

Related Factors ◽

Engineering Technology ◽

Term Survival ◽

Tracheal Reconstruction ◽

Tracheal Replacement ◽

Therapy Strategies

Tissue engineering technology provides effective alternative treatments for tracheal reconstruction. The formation of a functional microvascular network is essential to support cell metabolism and ensure the long-term survival of grafts. Although several tracheal replacement therapy strategies have been developed in the past, the critical significance of the formation of microvascular networks in 3D scaffolds has not attracted sufficient attention. Here, we review key technologies and related factors of microvascular network construction in tissue-engineered trachea and explore optimized preparation processes of vascularized functional tissues for clinical applications.

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