Tracheal transplantation for carinal reconstruction in dogs.
BACKGROUND
Experimental carinal allotransplantation has been performed with tracheocarinal Y-shaped allografts in dogs. In this study we tried canine carinal reconstruction with cylindrical allografts.


METHODS
Carinal reconstruction was performed with allotransplantation of cylindrical trachea in dogs, and graft healing was evaluated by bronchoscopic observation, mucosal blood flow measurement, and histologic examination. A section of the recipient carina containing five tracheal rings and two main stem bronchi was removed, and a donor trachea seven rings long was inserted between the recipient trachea and the left main stem bronchus; then side-to-end anastomosis was performed between the graft midportion and recipient right main stem bronchus (new carina). The grafts were wrapped with pedicled omentum. Fresh grafts were transplanted into one group of dogs (n=8 ), and grafts cryopreserved for 1 week were transplanted into another group (n=7).


RESULTS
No anastomotic leakage occurred in any dog. Excellent healing of grafts and graft anastomoses was observed by fiberoptic bronchoscopy in six dogs (75%) in the fresh graft group and in four dogs (57%) in the cryopreserved graft group. The mucosal blood flow in the new carina decreased remarkably and, although it recovered, mucosal blood flow remained under the preoperative level on day 28 after the operation.


CONCLUSIONS
Cylindrical tracheal allotransplantation is useful for carinal reconstruction, and the method of side-to-end anastomosis between the donor trachea and recipient bronchus is a feasible and accessible procedure in dogs.
Kawahara
K
K
Second Department of Surgery, Fukuoka University School of Medicine, Japan.
Inutsuka
K
K
Hiratsuka
M
M
Makihata
S
S
Okabayashi
K
K
Shiraishi
T
T
Shirakusa
T
T
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D001980:Bronchi / Q000601:surgery; D015925:Cryopreservation; D004285:Dogs; D005240:Feasibility Studies; D006085:Graft Survival; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009092:Mucous Membrane / Q000098:blood supply; D019651:Plastic Surgery Procedures / Q000379:methods; D012039:Regional Blood Flow / Q000502:physiology; D016559:Tacrolimus / Q000627:therapeutic use; D014132:Trachea / Q000098:blood supply / Q000637:transplantation*; D014184:Transplantation, Homologous; D014945:Wound Healing / Q000502:physiology
D007166:Immunosuppressive Agents; D016559:Tacrolimus