生物工程气管和支气管重建的可行性
Emmanuel Martinod1,2, Kader Chouahnia3, Dana M Radu1,2
1Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Chirurgie Thoracique et Vasculaire, Université Paris 13, Sorbonne Paris Cité, UFR Santé, Médecine et Biologie Humaine, Bobigny, France.
JAMA
|May 26, 2018
概括
使用大动脉矩阵的呼吸道生物工程可用于气管和支气管重建. 这种创新技术对患有复杂的呼吸道疾病的患者来说是有前途的,
科学领域:
- 复原医学
- 胸部手术
- 生物材料工程
背景情况:
- 呼吸道移植是近距离肺部瘤或末期气管支气管疾病患者的潜在选择.
- 目前的呼吸道移植方法存在争议,
研究的目的:
- 评估使用支架大动脉矩阵进行呼吸道重建的生物工程可行性.
- 在需要复杂气管或支气管置换的患者中评估该技术的潜力.
主要方法:
- 一项包括20名终端气管病变或近位肺瘤患者的队列研究.
- 使用冷保存的人类大动脉移植与定制支架的呼吸道重建.
- 在特定情况下进行肺节能支气管移植.
主要成果:
- 13名患者接受了呼吸道移植 (气管,支气管或心脏).
- 整体90天死亡率为5%;气管/支气管重建患者没有死亡.
- 在3年11个月的中位随访期内,76. 9%的移植患者仍然活着,80%的患者在移植后呼吸正常.
- 观察到甲状腺母体内表皮再生和新生软骨形成的证据.
结论:
- 使用支架的大动脉矩阵的气道生物工程证明了复杂的气道重建的可行性.
- 这种技术可以改善严重呼吸道损害的患者的治疗结果.
- 需要进一步的研究来确定有效性和安全性.
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