Hyaluronan-based scaffolds to tissue-engineer cartilage implants for laryngotracheal reconstruction.
OBJECTIVE
Donor site morbidity, including pneumothorax, can be a considerable problem when harvesting cartilage grafts for laryngotracheal reconstruction (LTR). Tissue-engineered cartilage may offer a solution to this problem. This study investigated the feasibility of using Hyalograft C combined with autologous chondrocytes to tissue engineer cartilage grafts for LTR in rabbits.


METHODS
Animal study.


METHODS
Eighteen New Zealand white rabbits underwent LTR: 12 rabbits received autologous tissue-engineered cartilage grafts and 6 animals, serving as a positive control group, native auricular cartilage. To determine any differences in response to the site of implantation and any potential immune response to the scaffold, a second piece of engineered neocartilage and a non-cell-loaded scaffold were inserted paralaryngeally into a subset of the rabbits. The rabbits were sacrificed 3, 6, 8, 10, and 12 weeks after the LTR and their larynx examined.


RESULTS
None of the 18 rabbits showed signs of respiratory distress. A smooth, noninflammatory scar was visible intraluminally. Histologically, the native auricular cartilage implants showed excellent integration without any signs of inflammation or cartilage degradation. In contrast, all tissue-engineered grafts and empty scaffolds revealed marked signs of an unspecific foreign body reaction, leading to a complete degradation of the neocartilage, whether implanted para- or intralaryngeally.


CONCLUSIONS
In contrast to the success with which Hyalograft C has been applied in articular defect repair, our results indicate that, in rabbits, Hyalograft C initiates a foreign body reaction if implanted intra- or paralaryngeally, leading to cartilage degradation and possible graft failure. These findings suggest limitations on the environment in which Hyalograft C can be applied.
Weidenbecher
Mark
M
Department of Orthopaedics, Case Western Reserve University, Cleveland, Ohio 44106, USA. m.weidenbecher@gmail.com
Henderson
James H
JH
Tucker
Harvey M
HM
Baskin
Jonathan Z
JZ
Awadallah
Amad
A
Dennis
James E
JE
D000818:Animals; D002356:Cartilage / Q000601:surgery*; D019902:Chondrocytes / Q000378:metabolism*; D004425:Ear Cartilage / Q000166:cytology / Q000637:transplantation*; D004724:Endoscopy; D006820:Hyaluronic Acid / Q000378:metabolism*; D007817:Laryngeal Cartilages / Q000601:surgery*; D008297:Male; D045170:Matrix Attachment Regions; D011817:Rabbits; D019651:Plastic Surgery Procedures / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*; D014132:Trachea / Q000601:surgery*
D006820:Hyaluronic Acid
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