Fetal esophageal transplantation in rats: a treatment option for long-gap esophageal atresia.
OBJECTIVE
The aim of this study is to determine if fetal esophageal transplantation can create viable esophageal tissue that may be used for treating long gap esophageal atresia.


METHODS
Fetuses of gestational age 19 to 20 days were obtained by hysterotomy of pregnant 15-week-old Lewis rats. A 10-mm long segment of esophagus was obtained from each fetus by thoracolaparotomy and transplanted by wrapping it in a pouch created in the distal omentum of a 5-week-old Lewis rat (syngeneic transplantation: n = 15). Transplanted fetal esophageal grafts were harvested 10 days post-transplantation and fixed in 10% formalin and embedded in paraffin. H&E was used for histological examination, and PGP 9.5 (a neuronal antibody) was used for immunohistochemistry. Esophageal segments obtained from 10-day-old Lewis rats were used as controls.


RESULTS
Thirteen of 15 (87%) grafts were transplanted successfully. The successfully transplanted graft could be mobilized to the thoracic cavity without tension or compromising of vascularity, because of the long omental pedicle. H&E staining and PGP 9.5 immunohistochemistry showed normal esophageal structure with intact esophageal nervous system, comparable with control specimens.


CONCLUSIONS
Fetal esophageal transplantation produces viable esophageal tissue that may find application for treating long gap esophageal atresia providing rejection can be controlled adequately.
Yamataka
A
A
Department of Pediatric Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Kato
Y
Y
Ohshiro
K
K
Miyazaki
E
E
Wang
K
K
Miyano
T
T
D000818:Animals; D004933:Esophageal Atresia / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004947:Esophagus / Q000473:pathology / Q000637:transplantation*; D005260:Female; D016332:Fetal Tissue Transplantation / Q000379:methods* / Q000401:mortality; D006085:Graft Survival; D007150:Immunohistochemistry; D051381:Rats; D011917:Rats, Inbred Lew; D015996:Survival Rate; D016896:Treatment Outcome