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Ann Thorac Surg 2005;79:942-948
© 2005 The Society of Thoracic Surgeons

Original article: General thoracic

Tracheal Regeneration Following Tracheal Replacement With an Allogenic Aorta

Emmanuel Martinod, MD, PhDa,b,*, Agathe Seguin, MDa,b, Muriel Holder-Espinasse, MDc, Marianne Kambouchner, MDd, Martine Duterque-Coquillaud, PhDc, Jacques F. Azorin, MDb, Alain F. Carpentier, MD, PhDa

a Laboratoire d'Etude des Greffes et Prothèses Cardiaques, Hôpital Broussais, Université Paris 6, Paris, France
b Service de Chirurgie Thoracique et Vasculaire, Hôpital Avicenne, Université Paris 13, Paris, France
d Service d'Anatomo-Pathologie, Hôpital Avicenne, Université Paris 13, Paris, France
c Institut de Biologie, Lille, France

Accepted for publication August 3, 2004.

* Address reprint requests to Dr Martinod, Laboratoire d'Etude des Greffes et Prothèses Cardiaques, Hôpital Broussais, Pavillon René Leriche, 96 rue Didot, 75674 Paris Cedex 14, France (E-mail: emartinod{at}wanadoo.fr).

BACKGROUND: Tracheal replacement remains an unsolved surgical problem. Attempts to use tracheal substitutes have failed to achieve reliable results. In this study, tracheal regeneration was obtained after tracheal replacement with an allogenic aorta.

METHODS: Twenty female sheep underwent a 8-cm tracheal replacement with a fresh aortic allograft. In the six last animals, aortic grafts came from male sheep. A stent prevented airway collapse. No immunosuppressive therapy was used. Aortic segments were retrieved at regular intervals up to 16 months. A polymerase chain reaction for the SRY gene was performed in specimens with aortic grafts from male sheep.

RESULTS: All animals but one survived the operation without complications. Clearly identified between the suture lines, the aortic segments were completely transformed into a tracheal structure. Histology showed initially an inflammatory reaction with proliferation of a squamous epithelium followed by mucociliary epithelium and newly formed cartilage rings. SRY gene was not found in newly formed cartilage rings showing that the regeneration originated from recipient cells.

CONCLUSIONS: This study presents a new type of tissue regeneration and brings hopes to the treatment of extensive tracheal lesions.


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