Abstract:The use of preserved tracheal allografting is a discussed method for the reconstruction of tracheal defects. To characterize the systemic and local immunological events following the transplantation of preserved human tracheal allografts, various immunological parameters were measured before and after transplantation in 1 human tracheal transplant recipient. Peripheral mononuclear cells were obtained and prepared for cytological monitoring. Biopsies of the anastomosis region were taken to characterize the histologic changes, as well as the extent and phenotype of cellular infiltrates, as determined by immunoperoxidase labelling. The results were compared with those of another patient who underwent a tracheal resection followed by an end‐to‐end anastomosis. While the biopsies showed a slight inflammatory reaction, signs of systemic immunoactivation were not found. Moreover, the absence of signs of clinical rejection suggests that merthiolate‐preserved human tracheal allografts represent a suitable replacement material for reconstruction of large tracheal defects.