title: Human tracheal allotransplant with greater omentum for revascularization.
abstract: OBJECTIVE
  Human tracheal allotransplant is an option for treating long-segment tracheal defects, but no reliable and satisfactory tracheal transplant procedure has been developed. The purpose of this study is to review the results of 2-stage tracheal reconstruction in human tracheal allotransplant for tracheal defects > 5 cm with the use of greater omentum for revascularization.
  
  
  METHODS
  There were 3 patients who had tracheal allograft. In stage 1, a segment of donor trachea (6 cm) was excised and wrapped in the recipient greater omentum. In stage 2, at 3 to 5 weeks after stage 1, the tracheal allograft and omental pedicle were orthotopically transplanted to the cervical part of the trachea. All patients received immunosuppression with tacrolimus, mycophenolate mofetil, and methylprednisolone. Fiberoptic bronchoscopy was performed monthly during the 6 months after stage 2.
  
  
  RESULTS
  In all 3 patients, no major postoperative complication was observed. Transverse section of the donor trachea showed a mechanically stable chondral framework. Histologic sections stained with hematoxylin-eosin showed complete cartilage rings covered by intact respiratory epithelium.
  
  
  CONCLUSIONS
  A 2-stage procedure for human tracheal transplant with greater omentum is a safe and effective technique for tracheal reconstruction.
authors.affiliation: From the Department of Thoracic Surgery, The First Hospital of Peking University, Beijing, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Xu
authors.forename: Shijie
authors.initials: S
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Jingwei
authors.initials: J
authors.lastname: Liu
authors.forename: Haibo
authors.initials: H
authors.lastname: Liu
authors.forename: Weiming
authors.initials: W
authors.lastname: Huang
authors.forename: Xueqian
authors.initials: X
authors.lastname: Shang
mesh_terms: D001999:Bronchoscopy / Q000379:methods; D064595:Composite Tissue Allografts; D004359:Drug Therapy, Combination; D005336:Fiber Optic Technology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D009852:Omentum / Q000098:blood supply* / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology / Q000637:transplantation*; D014134:Tracheal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D063986:Vascularized Composite Allotransplantation / Q000009:adverse effects / Q000379:methods*
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D008775:Methylprednisolone