title: Optimal dose of basic fibroblast growth factor for long-segment orthotopic tracheal autografts.
abstract: When a primary anastomosis of the trachea is not feasible, extensive grafting is required. However, despite the use of omental wrapping for revascularization, long-segment tracheal grafts frequently do not maintain structural integrity because of insufficient blood supply. We examined the use of basic fibroblast growth factor for preservation of long-segment tracheal autografts after orthotopic transplantation with omental wrapping in 23 dogs. All animals received orthotopic tracheal transplantation, with 14-ring autografts that occupied a major part of the thoracic trachea, and omental wrapping. The 23 animals were classified randomly into six groups as follows: no treatment (group I, n = 3), topical administration of fibrin glue alone (group II, n = 4), fibrin glue enriched with 1 microg/cm2 basic fibroblast growth factor (group III, n = 4), fibrin glue enriched with 5 microg/cm2 basic fibroblast growth factor (group IV, n = 4), and fibrin glue enriched with 10 microg/cm2 basic fibroblast growth factor (groups V and VI, each n = 4). The omentum that was used to wrap the autografts was fed by the right gastroepiploic artery in groups I to V and by both the right gastroepiploic artery and splenic artery in group VI. All autografts in groups I and II showed dissolution. Ten of 12 autografts in groups III, V, and VI did not maintain long-term structural integrity. By contrast, all autografts in group IV showed long-term viability, as demonstrated by graft patency, epithelialization, cartilage morphology, and vascularity. We conclude that treatment with fibrin glue enriched with 5 microg/cm2 basic fibroblast growth factor in combination with omental wrapping may prolong the viability of long-segment tracheal autografts.
authors.affiliation: Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Nakanishi
authors.forename: N
authors.initials: N
authors.lastname: Nagaya
authors.forename: T
authors.initials: T
authors.lastname: Yoshimatsu
authors.forename: T
authors.initials: T
authors.lastname: Hanagiri
authors.forename: K
authors.initials: K
authors.lastname: Yasumoto
mesh_terms: D000818:Animals; D004285:Dogs; D016222:Fibroblast Growth Factor 2 / Q000627:therapeutic use*; D006085:Graft Survival; D008297:Male; D018919:Neovascularization, Physiologic / Q000187:drug effects*; D009852:Omentum / Q000601:surgery; D013524:Surgical Flaps; D014132:Trachea / Q000637:transplantation*
chemical_list: D016222:Fibroblast Growth Factor 2