Tracheal allograft reconstruction: the total North American and worldwide pediatric experiences

Jacobs, Jeffrey P.; Quintessenza, James A.; Andrews, Tom; Burke, Redmond P.; Spektor, Zorik; Delius, Ralph E.; Smith, Richard J.H.; Elliott, Martin J.; Herberhold, C.

doi:10.1016/s0003-4975(99)00878-4

Cited by 119 publications

(85 citation statements)

References 35 publications

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“…Current surgical options include the following: (1) resection and primary anastomosis; (2) patch tracheoplasty with nontracheal autologous tissue (costal cartilage, pericardium); (3) slide tracheoplasty; and (4) tracheal transplant with cadaveric tracheal homograft. [47][48][49] Only the most frequently used techniques are described here.…”

Section: Surgical Techniques and Outcomesmentioning

confidence: 99%

Management of Congenital Tracheal Stenosis

Hofferberth¹,

Watters

Rahbar

et al. 2015

PEDIATRICS

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Congenital tracheal stenosis (CTS) is a serious and rare condition. In most cases, stenotic lesions are composed of complete tracheal rings of cartilage. The severity of symptoms correlates with the length of affected trachea, the presence of concomitant respiratory conditions, degree of luminal narrowing, and any bronchial involvement. Critically, CTS is a disorder that can lead to life-threatening respiratory insufficiency in children. Thus, it is a clinical entity that demands timely diagnosis and treatment. This review will firstly discuss the anatomy and pathophysiology of CTS and outline the various clinical presentations associated with the disorder. In addition, methods of diagnosis and treatment strategies will be reviewed, with a focus on contemporary surgical techniques. Finally, postoperative care of patients with CTS will be reviewed, and a contemporary multidisciplinary management approach will be presented.

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Section: Surgical Techniques and Outcomesmentioning

confidence: 99%

Management of Congenital Tracheal Stenosis

Hofferberth¹,

Watters

Rahbar

et al. 2015

PEDIATRICS

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“…This report was written just 9 weeks after the operation; and, strangely, there was no follow-up report. More than 30 years have since passed, and some limited successes have been reported in pediatric surgery 20,21 and with regard to reduction of immunosuppressive therapy. 22 However, clinical tracheal transplantation has not yet become established as a routine procedure.…”

Section: History Of Tracheal Transplantation and Reconstruction With mentioning

confidence: 99%

Tissue-engineered airway and “in situ tissue engineering”

Nakamura

Ohmori

Kanemaru

2011

Gen Thorac Cardiovasc Surg

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Since the 1980s, tissue engineering has become one of the major areas of endeavor in medical research, applying the principles of biology and engineering to the development of functional substitutes for damaged tissue. Using this technology, various attempts have been made to create and apply a tissue-engineered prosthetic trachea, or airway. In addition to the conventional tissue engineering approach, a new substantially different concept has been advocated in Japan since 2000. This is "in situ tissue engineering," where a tissue is created not in vitro but in vivo, exploiting the potential of the living body for wound healing. An artificial trachea created by in situ tissue engineering has already been applied in human patients for reconstruction of airway defects, and promising results have been obtained. This article reviews recent progress in the relatively new field of airway reconstruction employing tissue engineering.

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“…Jacobs and colleagues [9] reviewed the pediatric experience with tracheal allograft reconstruction as treatment for 37 patients with tracheal stenosis. In that study, the growth potential of the graft was not known.…”

Section: Discussionmentioning

confidence: 99%

Transplantation of the cryopreserved tracheal allograft in growing rabbits: effect of immunosuppressant

et al. 2006

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Transplantation of a cryopreserved tracheal allograft is considered to be a useful strategy in treating congenital tracheal stenosis. Recent reports of tracheal transplant experiments have shown that the antigenicity of the trachea is decreased by cryopreservation, making transplantation of the trachea possible. However, we reported that cryopreserved tracheal allografts exhibited favorable patency, but no significant growth in an animal model. In this study, we hypothesize that an immune reaction may play a role in the failure of an allograft's growth. Each allograft was harvested from 90- to 120-day-old Japanese rabbits, immersed in preservation solution, stored in a programmable freezer until it reached -80 C, and then kept for 1 month. Orthotopic tracheal transplantation of four tracheal rings in an end-to-end fashion was performed in age-matched young rabbits. Ten recipients were classified into three groups: a group provided with tacrolimus (FK-506) as an immunosuppressant (n = 6), a group receiving a graft irradiated before transplantation (n = 2), and a control group (n = 2). All grafts were evaluated 4-8 weeks after transplantation (tacrolimus group: 3-13 weeks). Body weight gain of the tacrolimus group was less than that of the other two groups. All grafts were well incorporated with the recipients macroscopically, but the grafts showed no growth in diameter. Microscopic examination showed inflammation in the tacrolimus and control groups temporarily. The irradiated allografts had marked fibrosis in the subepithelium. Although calcification of the tracheal cartilage was present in all transplanted allografts, the difference between groups was not significant. Patency of the cryopreserved tracheal allografts was favorable but no growth occurred even with an immunosuppressant. Further studies are required to address the growth of the tracheal allograft.

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Tracheal allograft reconstruction: the total North American and worldwide pediatric experiences

Cited by 119 publications

References 35 publications

Management of Congenital Tracheal Stenosis

Management of Congenital Tracheal Stenosis

Tissue-engineered airway and “in situ tissue engineering”

Transplantation of the cryopreserved tracheal allograft in growing rabbits: effect of immunosuppressant

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