Allowable warm ischemic time to tracheal extraction for allotransplantation of cryopreserved trachea
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Updated: Aug 24, 2026
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Published on: October 31, 2025
Yasuhiro Kitamura1, Nobuyoshi Shimizu, Motoi Aoe
1Department of Cancer and Thoracic Surgery, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata, Okayama 700-8558, Japan.
Objective:
The allowable warm ischemic time from circulatory arrest to tracheal extraction for allotransplantation of cryopreserved tracheal grafts from cadaveric donors was examined in adult mongrel dogs.
Subjects And Methods:
The animals were divided into 4 groups (n = 28) according to the warm ischemic time of less than 1 hour, 3 hours, 6 hours, and 12 hours, after transplantation, and comparisons were made. The grafts were cryopreserved for at least 2 months and were evaluated by extraction from the recipients generally 2 months after transplantation.
Results:
All the grafts with a warm ischemic time of less than 1 hour were viable and did not show stenosis. This group did not differ significantly from the groups with a warm ischemic time of 3 and 6 hours in terms of viability. However, all of the grafts with a warm ischemic time of 12 hours showed stenosis, and there was a significantly lower viability rate. Histological examination of the grafts showed that warm ischemia caused necrosis of the tracheal cartilage.
Conclusion:
Based on these results, it was concluded that 6 hours was the maximum allowable warm ischemic time for cryopreserved tracheal transplantation, and that necrosis of the tracheal cartilage due to warm ischemia reduced the viability of the grafts.
