Pr. Delaere et al., EXPERIMENTAL TRACHEAL ALLOGRAFT REVASCULARIZATION AND TRANSPLANTATION, Journal of thoracic and cardiovascular surgery, 110(3), 1995, pp. 728-737
The feasibility of tracheal allotransplantation with a fascial vascula
r carrier was examined in three groups with varied dose sequences of i
mmunosuppression. A control group (group 1) received no medication. Th
e three experimental groups were given daily cyclosporine intramuscula
r doses of 5 mg/kg (group 2), 5 mg/kg plus 3 mg/kg methylprednisolone
(Solu-Medrol) (group 3), and 10 mg/kg (group 4) for 6 weeks or until d
eath. Grafts were assessed by silicone dye infusion of the artery of t
he fascial flap to examine their microcirculation and by quantitative
histologic study, Group 1 evidenced complete rejection after a heterot
opic revascularization period of 14 days. The allografts of the experi
mental groups remained viable after 14 days of revascularization and c
ould be transplanted orthotopically after this period. After transplan
tation, the viability of group 2 tracheas was unpredictable with chang
es ranging from mild to complete rejection. Group 3 evidenced well-pre
served transplant viability with infection-induced necrosis at the ana
stomoses caused by the corticosteroid component. All group 4 animals s
urvived the follow-up period with normal allograft viability, Cyclospo
rine in a dosage of 10 mg/kg per day can effectively suppress the immu
ne response after transplantation of vascularized tracheal allografts.
This experimental model will allow future studies to examine airway w
all immunogenicity.