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Heterotopic and Orthotopic Tracheal Transplantation in Mice used as Models to Study the Development of Obliterative Airway Disease
Published on: January 20, 2010
Human tracheal allotransplant with greater omentum for revascularization
Lin Xu1, Shijie Zhang, Jian Li
1From the Department of Thoracic Surgery, The First Hospital of Peking University, Beijing, China.
Objectives:
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.
Materials And 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.
