Improvement of tracheal autograft survival with transplantation into the greater omentum

Li, Jian; Xu, Pao; Chen, Hongyi; Yang, Zequan; Zhang, Qilian

doi:10.1016/0003-4975(95)00839-x

Cited by 34 publications

(6 citation statements)

References 14 publications

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“…The scientific dogma that the trachea, alone was not amenable to revascularization and therefore not amenable to transplantation, led to a variety of novel procedures to manage extensive airway defects. Investigators implanted trachea allografts in a staged procedure into omentum, 9 heterotopic fascia, 10,11 and muscle 12 in an attempt to achieve secondary revascularization of the tracheal allograft before transferring the graft into the airway defect. In 1979, Rose et al described tracheal allotransplantation following heterotopic revascularization of the graft in the patient's sternocleidomastoid muscle without immunosuppression 12 .…”

Section: Discussionmentioning

confidence: 99%

Vascularized Tracheal Transplantation: A Twenty Month Follow Up

et al. 2022

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Background: Tracheal transplantation has been considered the ideal option for the reconstruction of long-segment circumferential tracheal defects. Our group developed a technique for vascularized single-staged tracheal transplantation. Twenty months ago, we performed the first-in-human tracheal transplantation. Herein, we report a twenty-month follow-up.Methods: The recipient presented with a 9.0 cm airway tracheal stenosis and complete cricoid stenosis. The patient previously failed six major conventional surgical procedures. Prior to transplantation, the patient's airway was maintained with an extended tracheostomy and stent. The patient experienced repeated life-threatening airway obstruction because of mucous plugging and obstructive granulation tissue. In January 2020 the patient underwent a single-staged tracheal transplantation treated with triple-therapy immunosuppression. Organ rejection was monitored with endoscopic tracheoscopy, narrow-band imaging, free-cell DNA assessment, and histological and cytogenetic analysis of tracheal biopsies. Mucociliary function was assessed with dye motility studies.Results: Twenty months following transplantation, there has been no evidence of acute or chronic rejection. Since day 60, there has been no detectable free cell DNA, a surrogate marker for immune-mediated allograft rejection. Fluorescence in situ hybridization (FISH) cytogenetics demonstrated that the donor trachea was repopulated with recipient epithelium establishing a chimeric allograft. Narrow-band imaging demonstrates a well-vascularized epithelial mucosa and bronchoscopic biopsies demonstrate normal ciliated epithelial architecture and viable epithelial lining with functional ciliated epithelium. The patient has resumed a normal life without a stent or tracheostomy and has returned to work.Conclusions: Twenty months after single-staged vascularized tracheal transplantation, the trachea is functional and the patient breathes without the need for a tracheostomy or stent. Single-staged long-segment tracheal transplantation is a viable option for tracheal defects that are not amenable to conventional reconstructive techniques.

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Section: Discussionmentioning

confidence: 99%

Vascularized Tracheal Transplantation: A Twenty Month Follow Up

et al. 2022

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“…Therefore, it is reasonable to suppose that the omentum is capable of supporting free structures such as the trachea, oesophagus and other tissue. These structures can be then used for reconstructive purposes [60], [61], [62], [63].…”

Section: Omentum Basic Biological Principles Can Pave the Way For Futmentioning

confidence: 99%

Omentum a powerful biological source in regenerative surgery

Nicola

2019

Regenerative Therapy

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The Omentum is a large flat adipose tissue layer nestling on the surface of the intra-peritoneal organs. Besides fat storage, omentum has key biological functions in immune-regulation and tissue regeneration . Omentum biological properties include neovascularization, haemostasis, tissue healing and regeneration and as an in vivo incubator for cells and tissue cultivation. Some of these properties have long been noted in surgical practice and used empirically in several procedures. In this review article, the author tries to highlight the omentum biological properties and their application in regenerative surgery procedures. Further, he has started a process of standardisation of basic biological principles to pave the way for future surgical practice.

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“…), a midline laparotomy was performed. The thawed aortic graft was implanted intraperitoneally and wrapped with the greater omentum to regain intragraft blood supply from outside, as previously described [20]. The abdominal wall and skin were closed separately.…”

Section: Methodsmentioning

confidence: 99%

Enhancement of Cell Viability in Cryopreserved Rat Vascular Grafts by Administration of Regenerating Gene <i>(Reg)</i> Inducers

Kiji¹,

Dohi

Nishizaki³

et al. 2003

J Vasc Res

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The regenerative capacity of viable cells remaining in cryopreserved vascular allografts is still unclear. Recently, the regenerating gene (Reg) has been documented to play an important role in various regenerating tissues. Here we show the possibility of Reg induction for the enhancement of cryopreserved vascular allograft viability. Cryopreserved rat aortae were isografted or allografted heterotopically. Fresh isografts were also tested. The transplants were retrieved 3, 6, 9, and 12 days after implantation and the intragraft Reg mRNA was measured by a real-time quantitative reverse transcriptional polymerase chain reaction method. Reg expression was not detected before implantation. Reg expression in cryopreserved isografts gradually increased after transplantation, whereas in fresh isografts or cryopreserved allografts it decreased over time after initial expression. Daily administration of 0.5 g/kg nicotinamide (an agent known to be a potent inducer of Reg) induced intragraft Reg mRNA in cryopreserved allografts (p < 0.05) accompanied by augmentation of the intragraft cell population. Daily administration of 0.5 mg/kg FK506 (an immunosuppressant) induced intragraft Reg mRNA both in cryopreserved isografts and allografts (p < 0.01). We conclude that Reg-inductive therapy shows promise as a novel strategy for enhancing the viability of vascular allografts. Moreover, FK506 may be involved in tissue regeneration as well as immunosuppression.

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Improvement of tracheal autograft survival with transplantation into the greater omentum

Cited by 34 publications

References 14 publications

Vascularized Tracheal Transplantation: A Twenty Month Follow Up

Vascularized Tracheal Transplantation: A Twenty Month Follow Up

Omentum a powerful biological source in regenerative surgery

Enhancement of Cell Viability in Cryopreserved Rat Vascular Grafts by Administration of Regenerating Gene <i>(Reg)</i> Inducers

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