IMPROVED AIRWAY HEALING USING BASIC FIBROBLAST GROWTH-FACTOR IN A CANINE TRACHEAL - AUTOTRANSPLANTATION MODEL

Objective We studied 22 dogs to examine the effect of basic fibroblast growth factor (bFGF) alone, in comparison with omental or muscular wr apping on airway healing in a tracheal autotransplantation model. Summ ary Background Data Basic fibroblast growth factor is one of the most potent promoters of angiogenesis and has an ability to enhance blood s upply to the ischemic airway. Topical administration of a fibrin glue enriched with 5 mu g/cm(2) bFGF, determined as a proportion of surface area of the tracheal grafts, improved revascularization of orthotopic canine tracheal autografts in a previous study, Methods All animals r eceived orthotopic tracheal transplantation using 6-ring autografts th at occupied a distal part of the thoracic trachea. Twenty-two animals were classified randomly into the following four groups: no treatment (Group G1, n = 4), muscular wrapping (Group G2, n = 4), omental wrappi ng (Group G3, n = 4), and topical administration of fibrin glue enrich ed with 5 mu g/cm(2) bFGF (Group G4, n = 10), Autografts were harveste d 60 days after transplantation and assessed by the percent patency an d histology. Results Devascularized tracheal autografts could not main tain their structural integrity without other treatments (Group G1). I n contrast, more than half of ail autografts receiving treatments rema ined viable, as demonstrated by gross and histologic findings (Groups G2, G3, and G4). Treatments with bFGF and omentum showed significantly better graft viability than no treatment. However, there was no stati stical difference in the viability of tracheal autografts among the th ree treatment groups. In terms of the time performance ratio, bFGF was the best treatment for the devascularized autografts, Conclusions Top ical administration of bFGF was superior to the omental or muscular wr apping in terms of the time performance ratio. Clinical trials will be necessary to determine whether these findings are applicable to human s.