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tracheal transplant

Irem Serifoglu, Balam Er Dedekarginoglu, Serife Savas Bozbas, Sule Akcay, Mehmet Haberal
OBJECTIVES: Acinetobacter baumannii, depending on the immune status of the host, may result in one of the most serious hospital infections. Infections involving A. baumannii infection have been recently rising. However, little is known about the clinical features of A. baumannii infection in solid-organ transplant recipients. We aimed to share our clinical experiences with A. baumannii infection in our transplant recipients. MATERIALS AND METHODS: Between 2011 and 2017, 41 solid-organ transplant patients developed A...
March 2018: Experimental and Clinical Transplantation
Joe L Hsu, Olga V Manouvakhova, Karl V Clemons, Mohammed Inayathullah, Allen B Tu, Raymond A Sobel, Amy Tian, Hasan Nazik, Venkata R Pothineni, Shravani Pasupneti, Xinguo Jiang, Gundeep S Dhillon, Harmeet Bedi, Jayakumar Rajadas, Hubertus Haas, Laure Aurelian, David A Stevens, Mark R Nicolls
Invasive pulmonary disease due to the mold Aspergillus fumigatus can be life-threatening in lung transplant recipients, but the risk factors remain poorly understood. To study this process, we used a tracheal allograft mouse model that recapitulates large airway changes observed in patients undergoing lung transplantation. We report that microhemorrhage-related iron content may be a major determinant of A. fumigatus invasion and, consequently, its virulence. Invasive growth was increased during progressive alloimmune-mediated graft rejection associated with high concentrations of ferric iron in the graft...
February 21, 2018: Science Translational Medicine
Harry Etienne, Dominique Fabre, Abel Gomez Caro, Frederic Kolb, Sacha Mussot, Olaf Mercier, Delphine Mitilian, Francois Stephan, Elie Fadel, Philippe Dartevelle
Tracheal reconstruction is one of the greatest challenges in thoracic surgery when direct end-to-end anastomosis is impossible or after this procedure has failed. The main indications for tracheal reconstruction include malignant tumours (squamous cell carcinoma, adenoid cystic carcinoma), tracheoesophageal fistula, trauma, unsuccessful surgical results for benign diseases and congenital stenosis. Tracheal substitutes can be classified into five types: 1) synthetic prosthesis; 2) allografts; 3) tracheal transplantation; 4) tissue engineering; and 5) autologous tissue composite...
February 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Takuya Tsuji, Ryosuke Nakamura, Tatsuya Katsuno, Yo Kishimoto, Atsushi Suehiro, Masaru Yamashita, Ryuji Uozumi, Tatsuo Nakamura, Ichiro Tateya, Koichi Omori
BACKGROUND: Planar cell polarity (PCP) coordinates the patterning and orientation of cells and their structures along tissue planes, and although its acquisition during the formation of airway epithelium has been described, the mechanisms for its maintenance and reconstruction are poorly understood. We aimed to clarify whether ambient environment change by orthotropic autologous transplantation affected PCP at the cellular level. METHODS: We performed orthotropic autologous transplantation by inverting tracheal segments in rats, and then performed morphological evaluation by microscopy...
February 2, 2018: Respiratory Research
Jianbo Li, Chengdi Wang, Nan Chen, Jiulin Song, Yan Sun, Qin Yao, Lunan Yan, Jiayin Yang
RATIONALE: Immediate postoperative tracheal extubation (IPTE) is one of the most important subject in recovery after surgery (ERAS) for liver transplantation. However, the criteria for IPTE is not uniform at present. PATIENT CONCERNS: We reported a successful IPTE in a liver transplant recipient with encephalopathy and a high Mayo end-stage liver disease (MELD) score of 41, which beyond the so-called criteria reported in the literature. The patient was 48-year-old man, admitted in September 2016 for end-stage liver cirrhosis secondary to hepatitis B...
November 2017: Medicine (Baltimore)
P C Cui
The length of tracheal defect or stenosis exceeded 5 cm could not be treated by simple resection and end-to-end anastomosis of the remaining trachea. Various ways of tracheal replacement had appeared sequentially, such as radial forearm free flap with cartilage grafts, tracheal tissue-engineering and tracheal allotransplantation. Among these methods, tracheal allotransplantation displayed a better long-term result. In this review, we are focused on recent advances in tracheal allotransplantation, particularly on revascularization and reepithelialization of graft, as well as on the application of immunosuppressive agents...
January 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Margot Den Hondt, Bart M Vanaudenaerde, Eric K Verbeken, Jan J Vranckx
OBJECTIVES: Prerequisites for successful trachea transplantation include the use of a biocompatible construct, submucosal vascularization and an epithelial covering. Implantation of non-epithelialized tracheal scaffolds may lead to stenosis. However, epithelial grafting or seeding can only be attempted onto a well-vascularized submucosal bed. Our aim was to investigate a method to prevent stenosis during prelamination of non-epithelialized, gently decellularized rabbit tracheae and to evaluate whether grafting of revascularized constructs with buccal mucosa is feasible...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
Daisuke Taniguchi, Keitaro Matsumoto, Tomoshi Tsuchiya, Ryusuke Machino, Yosuke Takeoka, Abdelmotagaly Elgalad, Kiyofumi Gunge, Katsunori Takagi, Yasuaki Taura, Go Hatachi, Naoto Matsuo, Naoya Yamasaki, Koichi Nakayama, Takeshi Nagayasu
OBJECTIVES: Currently, most of the artificial airway organs still require scaffolds; however, such scaffolds exhibit several limitations. Alternatively, the use of an autologous artificial trachea without foreign materials and immunosuppressants may solve these issues and constitute a preferred tool. The rationale of this study was to develop a new scaffold-free approach for an artificial trachea using bio-3D printing technology. Here, we assessed the circumferential tracheal replacement using scaffold-free trachea-like grafts generated from isolated cells in an inbred animal model...
January 15, 2018: Interactive Cardiovascular and Thoracic Surgery
Fabio Gava Aoki, Henrique Takachi Moriya
Tissue engineered (or bioengineered) tracheas are alternative options under investigation when the resection with end-to-end anastomosis cannot be performed. One approach to develop bioengineered tracheas is a complex process that involves the use of decellularized tissue scaffolds, followed by recellularization in custom-made tracheal bioreactors. Tracheas withstand pressure variations and their biomechanics are of great importance so that they do not collapse during respiration, although there has been no preferred method of mechanical assay of tracheas among several laboratories over the years...
December 11, 2017: Artificial Organs
Jae Yeon Lee, Jeong Hun Park, Soo Jin Son, Mina Han, Gonhyung Kim, Seong Soo Kang, Seok Hwa Choi, Dong-Woo Cho
The objective of this study was to evaluate the use of immunosuppressive therapy with high-dose cyclosporine, high-dose azathioprine, and a combination of low-dose cyclosporine and azathioprine after tracheal reconstruction by using a trachea-mimetic graft of polycaprolactone (PCL) bellows-type scaffold in a rabbit model. Twenty-four healthy New Zealand white rabbits were used in the study. All underwent circumferential tracheal replacement using tissue-engineered tracheal graft, prepared from PCL bellows scaffold reinforced with silicone ring, collagen hydrogel, and human turbinate mesenchymal stromal cell (hTMSC) sheets...
2017: BioMed Research International
Elizabeth F Maughan, Robert E Hynds, Toby J Proctor, Sam M Janes, Martin Elliott, Martin A Birchall, Mark W Lowdell, Paolo De Coppi
Purpose of Review: There is no consensus on the best technology to be employed for tracheal replacement. One particularly promising approach is based upon tissue engineering and involves applying autologous cells to transplantable scaffolds. Here, we present the reported pre-clinical and clinical data exploring the various options for achieving such seeding. Recent Findings: Various cell combinations, delivery strategies, and outcome measures are described. Mesenchymal stem cells (MSCs) are the most widely employed cell type in tracheal bioengineering...
2017: Current Stem Cell Reports
Tao Lu, Yiwei Huang, Yulei Qiao, Yongxing Zhang, Yu Liu
OBJECTIVES: The first tissue-engineered clinical tracheal transplant prepared using the detergent-enzymatic method resulted in graft stenosis, possibly from detergent-enzymatic method-induced graft non-viability. We reported on the transplantation of de-epithelialized tracheal allografts while maintaining cartilage viability in dogs. No lethal stenosis occurred in allografts. Herein, on the basis of previous experimentation, we assessed cartilage viability in detergent-treated cartilages...
March 1, 2018: European Journal of Cardio-thoracic Surgery
Egi Kardia, Rafeezul Mohamed, Badrul Hisham Yahaya
Airway stem/progenitor epithelial cells (AECs) are notable for their differentiation capacities in response to lung injury. Our previous finding highlighted the regenerative capacity of AECs following transplantation in repairing tracheal injury and reducing the severity of alveolar damage associated acute lung injury in a rabbit model. The goal of this study is to further investigate the potential of AECs to re-populate the tracheal epithelium and to study their stimulatory effect on inhibiting pro-inflammatory cytokines, epithelial cell migration and proliferation, and epithelial-to-mesenchymal transition (EMT) process following tracheal injury...
September 15, 2017: Scientific Reports
Won Shik Kim, Jae Won Chang, Woo Soon Jang, Young Joon Seo, Mi-Lan Kang, Hak-Joon Sung, Da Hee Kim, Jung Min Kim, Jae Hong Park, Myung Jin Ban, Gina Na, Seung Ho Shin, Hyung Kwon Byeon, Yoon Woo Koh, Se-Heon Kim, Hong Koo Baik, Eun Chang Choi
Although there are various methods for tracheal reconstruction, such as a simple approximation with suturing and coverage with adjacent soft tissue or muscle, large defects >50% of the tracheal length still present a clinical challenge. Tissue engineering, a recent promising way to possibly resolve this problem, requires a long preparatory period for stem cell seeding on a scaffold and relatively invasive procedures for stem cell harvesting. As an alternative, we used a vascularized myofascial flap for tracheal reconstruction...
August 30, 2017: Scientific Reports
Tao Lu, Yiwei Huang, Yu Liu, Yaxing Shen, Yulei Qiao, Yongxing Zhang
BACKGROUND: Prolonged cryopreservation (~8-10 months) has been shown to reduce the antigenicity of tracheal allografts due to subsequent denuding of epithelium. In the present study, tracheal epithelium was assessed after variable periods of cryopreservation. Immunosuppressant-free allotransplantation was then undertaken to evaluate the impact of cryopreservation on tracheal antigenicity in dogs. METHODS: Tracheal rings [7-8] were removed from mongrel adult dogs for cryopreservation (1-10 months, -85 °C) and grafting...
July 2017: Journal of Thoracic Disease
Michinobu Ohno, Yasushi Fuchimoto, Huai-Che Hsu, Masataka Higuchi, Makoto Komura, Tetsuji Yamaoka, Akihiro Umezawa, Shin Enosawa, Tatsuo Kuroda
PURPOSE: Tracheal cartilage reconstruction is an essential approach for the treatment of tracheal congenital abnormalities or injury. Here, we evaluated the use of allogeneic decellularized tracheas as novel support scaffolds. METHODS: Six weaned pigs (4-week-old domestic males) were transplanted with allogeneic tracheal graft patches (three decellularized and three fresh tracheal scaffolds) onto artificial defects (approximately 15 × 15 mm). After 11 weeks, the tracheas were evaluated by bronchoscopy and histological studies...
October 2017: Pediatric Surgery International
Elizabeth F Maughan, Colin R Butler, Claire Crowley, Gui Zhen Teoh, Margot den Hondt, Nicholas J Hamilton, Robert E Hynds, Peggy Lange, Tahera Ansari, Luca Urbani, Samuel M Janes, Paolo de Coppi, Martin A Birchall, Martin J Elliott
OBJECTIVES/HYPOTHESIS: Despite surgical advances, childhood tracheal stenosis is associated with high morbidity and mortality. Various tracheal scaffold strategies have been developed as the basis for bioengineered substitutes, but there is no consensus on which may be superior in vivo. We hypothesized that there would be no difference in morbidity and mortality between three competing scaffold strategies in rabbits. STUDY DESIGN: Pilot preclinical study. METHODS: Tracheal scaffolds were prepared by three methods that have been applied clinically and reported: preserved cadaveric ("Herberhold") allografts, detergent-enzymatically decellularized allografts, and synthetic scaffolds (nanocomposite polymer [polyhedral oligomeric silsesquioxane poly(carbonate-urea) urethane (POSS-PCU)])...
December 2017: Laryngoscope
Siddhartha G Kapnadak, Gregory A Kicska, Kathleen J Ramos, Desiree A Marshall, Tamara Y Carroll, Sudhakar N Pipavath, Michael S Mulligan, Christopher H Goss, Moira L Aitken
BACKGROUND: Tracheal diverticula (TD) are rare anomalies that may harbor infected secretions, posing potential risk to patients with lung disease. In an end-stage cystic fibrosis (CF) cohort, we describe the characteristics and associated post-lung transplant (LTx) outcomes of TD. METHODS: Pre-transplant computed tomography (CT)'s were reviewed in CF patients undergoing LTx. TD were characterized radiographically and on autopsy when available. Pre-transplant clinical variables and post-transplant outcomes were compared by TD status...
July 27, 2017: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
M Den Hondt, B M Vanaudenaerde, E F Maughan, C R Butler, C Crowley, E K Verbeken, S E Verleden, J J Vranckx
Successful tissue-engineered tracheal transplantation relies on the use of non-immunogenic constructs, which can vascularize rapidly, support epithelial growth, and retain mechanical properties to that of native trachea. Current strategies to assess mechanical properties fail to evaluate the trachea to its physiological limits, and lead to irreversible destruction of the construct. Our aim was to develop and evaluate a novel non-destructive method for biomechanical testing of tracheae in a rabbit decellularization model...
July 21, 2017: Acta Biomaterialia
Shin Tanaka, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Motomu Kobayashi, Takahiro Oto
A successful outcome after lung transplant was achieved using lungs donated from a teenage boy who underwent prolonged mechanical ventilation. The donor experienced hypoxic brain damage and was declared brain dead 324 days after tracheal intubation. At the time of referral, the donor's lungs revealed diffuse radiologic infiltration and atelectasis but excellent function, with a PaO2/FiO2 ratio of 450. The lungs were transplanted to a 10-year-old girl with bronchiolitis obliterans. She developed grade 2 primary graft dysfunction, but recovered quickly...
August 2017: Annals of Thoracic Surgery
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