title: Endoscopic management of tissue-engineered tracheal graft stenosis in an ovine model.
abstract: To evaluate the safety and efficacy of bronchoscopic interventions in the management of tissue-engineered tracheal graft (TETG) stenosis.
  
  
  
  Animal research study.
  
  
  
  TETGs were constructed with seeded autologous bone marrow-derived mononuclear cells on a bioartificial graft. Eight sheep underwent tracheal resection and orthotopic implantation of this construct. Animals were monitored by bronchoscopy and fluoroscopy at 3 weeks, 6 weeks, 3 months, and 4 months. Bronchoscopic interventions, including dilation and stenting, were performed to manage graft stenosis. Postdilation measurements were obtained endoscopically and fluoroscopically.
  
  
  
  Seven dilations were performed in six animals. At the point of maximal stenosis, the lumen measured 44.6 ± 8.4 mm2predilation and 50.7 ± 14.1 postdilation by bronchoscopy (P = 0.3517). By fluoroscopic imaging, the airway was 55.9 ± 12.9 mm2predilation and 65.9 ± 22.4 mm2postdilation (P = 0.1303). Stents were placed 17 times in six animals. Pre- and poststenting lumen sizes were 62.8 ± 38.8 mm2and 80.1 ± 54.5 mm2by bronchoscopy (P = 0.6169) and 77.1 ± 38.9 mm2and 104 ± 60.7 mm2by fluoroscopy (P = 0.0825). Mortality after intervention was 67% with dilation and 0% with stenting (P = 0.0004). The average days between bronchoscopy were 8 ± 2 for the dilation group and 26 ± 17 in the stenting group (P = 0.05). One hundred percent of dilations and 29% of stent placements required urgent follow-up bronchoscopy (P = 0.05).
  
  
  
  Dilation has limited efficacy for managing TETG stenosis, whereas stenting has a more lasting clinical effect.
  
  
  
  NA. Laryngoscope, 127:2219-2224, 2017.
authors.affiliation: Tissue Engineering Program, the Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.|Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
authors.forename: Victoria K
authors.initials: VK
authors.lastname: Pepper
authors.affiliation: Tissue Engineering Program, the Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.|Department of General Surgery, the Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
authors.forename: Ekene A
authors.initials: EA
authors.lastname: Onwuka
authors.affiliation: Tissue Engineering Program, the Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
authors.forename: Cameron A
authors.initials: CA
authors.lastname: Best
authors.affiliation: Tissue Engineering Program, the Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.|Department of General Surgery, the Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
authors.forename: Nakesha
authors.initials: N
authors.lastname: King
authors.affiliation: Tissue Engineering Program, the Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
authors.forename: Eric
authors.initials: E
authors.lastname: Heuer
authors.affiliation: Nanofibers Solutions, Inc, Columbus, Ohio, U.S.A.
authors.forename: Jed
authors.initials: J
authors.lastname: Johnson
authors.affiliation: Tissue Engineering Program, the Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.|Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, U.S.A.|Department of General Surgery, the Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Breuer
authors.affiliation: Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Grischkan
authors.affiliation: Tissue Engineering Program, the Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.|Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
authors.forename: Tendy
authors.initials: T
authors.lastname: Chiang
mesh_terms: D000818:Animals; D001705:Bioprosthesis / Q000009:adverse effects*; D001999:Bronchoscopy / Q000379:methods*; D004106:Dilatation / Q000379:methods; D005471:Fluoroscopy / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011474:Prosthesis Design / Q000379:methods; D012756:Sheep; D015607:Stents; D023822:Tissue Engineering; D014132:Trachea / Q000637:transplantation*; D014135:Tracheal Stenosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome
keywords: TETG; Tissue-engineered trachea; tissue engineering; tracheal dilation; tracheal stenosis; tracheal stenting