title: Long-term functional reconstruction of segmental tracheal defect by pedicled tissue-engineered trachea in rabbits.
abstract: Due to lack of satisfactory tracheal substitutes, reconstruction of long segmental tracheal defects (>6 cm) is always a major challenge in trachea surgery. Tissue-engineered trachea (TET) provides a promising approach to address this challenge, but no breakthrough has been achieved yet in repairing segmental tracheal defect. The longest survival time only reached 60 days. The leading reasons for the failure of segmental tracheal defect reconstruction were mainly related to airway stenosis (caused by the overgrowth of granulation tissue), airway collapse (caused by cartilage softening) and mucous impaction (mainly caused by lack of epithelium). To address these problems, the current study proposed an improved strategy, which involved in vitro pre-culture, in vivo maturation, and pre-vascularization of TET grafts as well as the use of silicone stent. The results demonstrated that the two-step strategy of in vitro pre-culture plus in vivo implantation could successfully regenerate tubular cartilage with a mechanical strength similar to native trachea in immunocompetent animals. The use of silicone stents effectively depressed granulation overgrowth, prevented airway stenosis, and thus dramatically enhanced the survival rate at the early stage post-operation. Most importantly, through intramuscular implantation and transplantation with pedicled muscular flap, the TET grafts established stable blood supply, which guaranteed maintenance of tubular cartilage structure and function, accelerated epithelialization of TET grafts, and thus realized long-term functional reconstruction of segmental tracheal defects. The integration of all these improved strategies finally realized long-term survival of animals: 60% of rabbits survived over 6 months. The current improved strategy provided a promising approach for long-term functional reconstruction of long segmental tracheal defect.
authors: Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Tissue Engineering, Shanghai Stem Cell Institute, Shanghai, PR China.
authors: Xusong
authors: X
authors: Luo
authors: Yi
authors: Y
authors: Liu
authors: Zhiyong
authors: Z
authors: Zhang
authors: Ran
authors: R
authors: Tao
authors: Yu
authors: Y
authors: Liu
authors: Aijuan
authors: A
authors: He
authors: Zongqi
authors: Z
authors: Yin
authors: Dan
authors: D
authors: Li
authors: Wenjie
authors: W
authors: Zhang
authors: Wei
authors: W
authors: Liu
authors: Yilin
authors: Y
authors: Cao
authors: Guangdong
authors: G
authors: Zhou
mesh_terms: D000818:Animals; D002478:Cells, Cultured; D019902:Chondrocytes / Q000378:metabolism / Q000473:pathology; D011182:Postoperative Care; D011817:Rabbits; D019651:Plastic Surgery Procedures; D016019:Survival Analysis; D013997:Time Factors; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D014132:Trachea / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome