A reassessment of tracheal substitutes—a systematic review

Udelsman, Brooks V.; Mathisen, Douglas J.; Ott, Harald C.

doi:10.21037/acs.2018.01.17

Cited by 58 publications

(63 citation statements)

References 35 publications

(50 reference statements)

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“…There are different types of cells, growth factors, and scaffold of different materials: Interactions among appropriate growth factors, cells, and scaffolds will regenerate a desired tissue (Ott, Weatherly, & Detamore, ). Currently, the problem or challenge is to find the appropriate growth factors, cells, and scaffolds to regenerate an appropriate tissue (Arnason, ; Law, Liau, Aminuddin, & Ruszymah, ; Udelsman, Mathisen, & Ott, ). In the following section, different cells, growth factors, and scaffold will be discussed, which influence the tracheal tissue regeneration.…”

Section: Tracheal Tissue Engineeringmentioning

confidence: 99%

Biomedical grafts for tracheal tissue repairing and regeneration “Tracheal tissue engineering: an overview”

Dhasmana

Singh

2020

J Tissue Eng Regen Med

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Airway system is a vital part of the living being body. Trachea is the upper respiratory portion that connects nostril and lungs and has multiple functions such as breathing and entrapment of dust/pathogen particles. Tracheal reconstruction by artificial prosthesis, stents, and grafts are performed clinically for the repairing of damaged tissue. Although these (above-mentioned) methods repair the damaged parts, they have limited applicability like small area wounds and lack of functional tissue regeneration. Tissue engineering helps to overcome the abovementioned problems by modifying the traditional used stents and grafts, not only repair but also regenerate the damaged area to functional tissue. Bioengineered tracheal replacements are biocompatible, nontoxic, porous, and having 3D biomimetic ultrastructure with good mechanical strength, which results in faster and better tissue regeneration. Till date, the bioengineered tracheal replacements studies have been going on preclinical and clinical levels. Besides that, still many researchers are working at advance level to make extracellular matrix-based acellular, 3D printed, cell-seeded grafts including living cells to overcome the demand of tissue or organ and making the ready to use tracheal reconstructs for clinical application. Thus, in this review, we summarized the tracheal tissue engineering aspects and their outcomes. K E Y W O R D S biocompatible, chondrocytes, ECM, in vivo, tissue engineering, trachea

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Section: Tracheal Tissue Engineeringmentioning

confidence: 99%

Biomedical grafts for tracheal tissue repairing and regeneration “Tracheal tissue engineering: an overview”

Dhasmana

Singh

2020

J Tissue Eng Regen Med

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“…The Journal of Thoracic and Cardiovascular Surgery c June 2020 Tracheal replacement to restore functional integrity of a long segmental defect or a complex airway stenosis remains a surgical challenge. 1 A variety of surgical techniques have been reported clinically, including transplantation of autologous 2 or heterologous 3 tissue flaps, direct 4,5 or indirect 6 cadaveric tracheal allografting, and interposition of a "regenerated" trachea. 7 In this issue of the Journal, Fux and colleagues 8 from the Karolinska Institute in Stockholm publish a very detailed and well-illustrated long-term follow-up of 3 patients who received a "bioengineered tracheal allograft seeded with bone marrow cells" resulting in numerous complications and finally fatal outcome.…”

Section: Conflict Of Interest Statementmentioning

confidence: 99%

“…[2][3][4][5] Different strategies have been developed to treat segmental tracheal pathologies. 1,4,[6][7][8][9][10] In adults, tracheal resection with end-to-end anastomosis may be considered for tracheal pathologies extending for up to half of the tracheal length. For more extensive pathologies, tracheal reconstruction or replacement is required.…”

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confidence: 99%

“…6,9 The major challenges in tracheal replacement are vascularization and the permanent interface between the graft and the microbe-contaminated lumen of the respiratory tract. 1,4,[10][11][12][13] Without revascularization, the graft with its specialized epithelium cannot survive or integrate into adjacent tissues and the barrier function to the outside world will be lost, resulting in chronic infection. Shortage of donor organs and the need for immunosuppression are further concerns when considering allogeneic tracheal transplantation.…”

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confidence: 99%

“…Shortage of donor organs and the need for immunosuppression are further concerns when considering allogeneic tracheal transplantation. 1,7 Synthetic tracheal grafts seeded with autologous bone marrow-mononuclear cells (BM-MNCs) in combination with locally and systemically applied growth factors have been described to generate living, functional grafts with sitespecific epithelialization that integrate into adjacent tissues. [14][15][16][17] This would represent a paradigm shift not just within tracheal surgery and organ transplantation but also within the field of regenerative medicine by circumventing the need for immunosuppression and allow for rapid manufacturing of tailor-made organs.…”

mentioning

confidence: 99%

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Synthetic tracheal grafts seeded with bone marrow cells fail to generate functional tracheae: First long-term follow-up study

Fux

Österholm

Themudo

et al. 2020

The Journal of Thoracic and Cardiovascular Surgery

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Objective: Synthetic tracheal grafts seeded with autologous bone marrowmononuclear cells (BM-MNCs) have been described as becoming living and functional grafts representing a promising option for tracheal replacement for pathologies unamenable by segmental resection or autologous repair. This study aimed to present the first long-term follow-up of these procedures in humans. Methods: We retrospectively analyzed 3 patients who received synthetic tracheal grafts seeded with BM-MNCs implanted. Results: Patient 1 was a 37-year-old man with mucoepidermoid carcinoma, the first-ever human to receive a synthetic tracheal graft seeded with BM-MNCs. Patient 2 was a 30-year-old man with adenoid cystic carcinoma, and patient 3 was a 22-year-old woman with an iatrogenic tracheal injury. All patients developed graft-related complications necessitating multiple surgical reinterventions. Patient 1 was hospitalized for 8 months before dying from respiratory failure secondary to graft dehiscence 32 months after implantation. Patient 2 died 3.5 months after implantation from undisclosed causes. Patient 3 received a second synthetic tracheal graft after 11 months and an allogeneic trachea and lung transplantation 45 months after the primary implantation. Patient 3 underwent 191 surgical interventions after the primary implantation and spent 55 months in the intensive care unit before dying from airway bleeding. All patients' bronchoscopic, histologic, and radiologic investigations demonstrated graft-associated complications, including anastomotic fistulae and obstructive granulation tissue, without graft vascularization, mucosal lining, or integration into adjacent tissues.

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Biomimetic Trachea Engineering via a Modular Ring Strategy Based on Bone‐Marrow Stem Cells and Atelocollagen for Use in Extensive Tracheal Reconstruction

Dai

Zhu

et al. 2021

Advanced Materials

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The fabrication of biomimetic tracheas with a architecture of cartilaginous rings alternately interspersed between vascularized fibrous tissue (CRVFT) has the potential to perfectly recapitulate the normal tracheal structure and function. Herein, the development of a customized chondroitin‐sulfate‐incorporating type‐II atelocollagen (COL II/CS) scaffold with excellent chondrogenic capacity and a type‐I atelocollagen (COL I) scaffold to facilitate the formation of vascularized fibrous tissue is described. An efficient modular ring strategy is then adopted to develop a CRVFT‐based biomimetic trachea. The in vitro engineering of cartilaginous rings is achieved via the recellularization of ring‐shaped COL II/CS scaffolds using bone marrow stem cells as a mimetic for native cartilaginous ring tissue. A CRVFT‐based trachea with biomimetic mechanical properties, composed of bionic biochemical components, is additionally successfully generated in vivo via the alternating stacking of cartilaginous rings and ring‐shaped COL I scaffolds on a silicone pipe. The resultant biomimetic trachea with pedicled muscular flaps is used for extensive tracheal reconstruction and exhibits satisfactory therapeutic outcomes with structural and functional properties similar to those of native trachea. This is the first study to utilize stem cells for long‐segmental tracheal cartilaginous regeneration and this represents a promising method for extensive tracheal reconstruction.

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A reassessment of tracheal substitutes—a systematic review

Cited by 58 publications

References 35 publications

Biomedical grafts for tracheal tissue repairing and regeneration “Tracheal tissue engineering: an overview”

Biomedical grafts for tracheal tissue repairing and regeneration “Tracheal tissue engineering: an overview”

Synthetic tracheal grafts seeded with bone marrow cells fail to generate functional tracheae: First long-term follow-up study

Biomimetic Trachea Engineering via a Modular Ring Strategy Based on Bone‐Marrow Stem Cells and Atelocollagen for Use in Extensive Tracheal Reconstruction

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