title: Trachea transplantation: from laboratory to patient.
abstract: Today, tracheal lesions occupying<30%of the trachea in children and<50%in adults can be treated with primary resection, followed by end-to-end anastomosis. However, lesions larger than this require a tracheal replacement, of which there are currently few options available. The recent advancement of tissue-engineering principles in tracheal research is quickly opening up new vistas for airway reconstruction and creating a very promising future for medical science. This review discusses the main criteria required for the development of a tissue-engineered tracheal replacement. The criteria include: (a) appropriate cell types and sources; (b) biomolecules to direct the differentiation of the cells to the desired lineage; (c) a suitable scaffold for a cellular matrix; and (d) a bioreactor to facilitate cell attachment and proliferation and construct transport to theatre. Our group has designed and developed the world’s first synthetic tracheal replacement, using a novel nanocomposite material, also developed in our laboratory. It was implanted clinically in June 2011 with a successful outcome. The application of tissue-engineering approaches to tracheal replacement development is the first step towards the much-anticipated ‘off-the-shelf’ tissue-engineered technology, contributing extensively to the advancement in treatment and rehabilitation of patients afflicted with tracheal pathology.
authors.forename: Claire
authors.initials: C
authors.lastname: Crowley
authors.forename: Martin
authors.initials: M
authors.lastname: Birchall
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Seifalian
mesh_terms: D000328:Adult; D000818:Animals; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D006801:Humans; D053761:Nanocomposites; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D014132:Trachea; D014133:Tracheal Diseases / Q000601:surgery*