Tissue-engineered allograft tracheal cartilage using fibrin/hyaluronan composite gel and its in vivo implantation.
OBJECTIVE
Treatment and management of tracheal defects remain challenging in head and neck surgery. Various reconstruction techniques have been used, with no consensus on the best approach. The purpose of this study was to explore a novel strategy to fabricate tissue-engineered trachea by using fibrin/hyaluronic acid (HA) composite gel and evaluate the feasibility of creating tracheal cartilage.


METHODS
A preliminary animal experiment.


METHODS
Chondrocytes from rabbit cartilage were expanded and seeded into a culture dish at high density to form mechanically stable allograft tracheal cartilage using fibrin/HA composite gel. After a longitudinal cervical skin incision, the trachea was exposed and a rectangular defect (1 x 0.5 cm) was created on the cervical trachea by scalpel on six rabbits. Tissue-engineered cartilage using fibrin/HA composite was trimmed and fixed to defect boundaries with Tissucol (Baxter International, Deerfield, IL). Postoperatively, the site was evaluated endoscopically, histologically, radiologically, and functionally.


RESULTS
Postoperatively, rigid telescopic examination showed that the implanted scaffolds in all cases were completely covered with regenerated mucosa without granulation or stenosis. Histologic data showed ciliated epithelium regenerated at the operated site from 2 months postoperatively. Ciliary beat frequency of ciliated epithelium on implants was very similar to normal respiratory mucosa. Computed tomography images revealed fine luminal contour of the regenerated site. However, allograft cartilage implanted was found to be partially preserved on the postoperative specimen.


CONCLUSIONS
The tracheal luminal contour and functional epithelial regeneration without graft rejection and inflammation were observed after repair of a tracheal resection using allogeneic implants with chondrocytes cultured with fibrin/HA.
Kim
Dong Young
DY
Department of Otorhinolaryngology, Graduate School of Medicine, Gachon University of Medicine and Science, Incheon, South Korea.
Pyun
JungHee
J
Choi
Jae Won
JW
Kim
Jang-Hee
JH
Lee
Jin Seok
JS
Shin
Hyang Ae
HA
Kim
Hyun-Jun
HJ
Lee
Ha-Neul
HN
Min
Byoung-Hyun
BH
Cha
Heung Eok
HE
Kim
Chul-Ho
CH
D000818:Animals; D002356:Cartilage / Q000637:transplantation*; D002358:Cartilage, Articular / Q000601:surgery; D002478:Cells, Cultured; D019902:Chondrocytes / Q000166:cytology; D002923:Cilia / Q000502:physiology; D004724:Endoscopy; D005260:Female; D005337:Fibrin; D005782:Gels; D006820:Hyaluronic Acid; D008855:Microscopy, Electron, Scanning; D011817:Rabbits; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D014132:Trachea / Q000166:cytology / Q000637:transplantation*; D014184:Transplantation, Homologous
D005782:Gels; D005337:Fibrin; D006820:Hyaluronic Acid