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Tracheal autograft revascularization and transplantation
P R Delaere1, Z Liu, L Feenstra
1Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital, Leuven, Belgium.
Archives of Otolaryngology--Head & Neck Surgery
|October 1, 1994
Summary
Tracheal grafts revascularized with a lateral thoracic fascial flap show optimal viability between 16 and 20 days post-isolation. This allows for successful reimplantation, preserving airway clearance function.
Area of Science:
- Regenerative Medicine
- Surgical Innovation
- Tissue Engineering
Background:
- Direct microvascular suture is not feasible for tracheal graft revascularization.
- Tracheal transplantation requires a reliable method for graft survival and function.
Purpose of the Study:
- To perform a morphometric analysis of epithelial regeneration, submucosal revascularization, and mucosal thickness in isolated tracheal segments revascularized by a lateral thoracic fascial flap.
- To determine the optimal period for tracheal graft viability after isolation and revascularization.
- To assess the success of reimplanting revascularized tracheal autografts.
Main Methods:
- Excised tracheal segments (n=30) were wrapped in lateral thoracic fascia.
- Grafts were histologically and morphometrically evaluated 2-28 days post-isolation, with arterial injection of blue silicone dye.
- Twelve grafts were reimplanted (6 in original, 6 in opposite direction).
- Airway clearance was assessed via carbon particle movement observation.
Main Results:
- Optimal tracheal autograft viability was observed 16-20 days after isolation.
- Successful reimplantation was achieved after this 16-day revascularization period.
- Original direction of mucosal clearance was maintained post-reimplantation; 180-degree rotation did not affect survival.
Conclusions:
- Lateral thoracic fascial flap revascularization supports tracheal autograft viability and regeneration.
- A 16-day revascularization period is sufficient for successful tracheal autograft reimplantation.
- Tracheal airway clearance function is preserved after revascularization and reimplantation.