J. Li et al., SUCCESSFUL TRACHEAL AUTOTRANSPLANTATION WITH 2-STAGE APPROACH USING THE GREATER OMENTUM, The Annals of thoracic surgery, 64(1), 1997, pp. 199-202
Background. Although many studies on reconstruction of extensive circu
mferential tracheal defects with a segmental trachea have been done, u
p to date, no reliable and satisfactory tracheal transplantation proce
dure has been developed. We conducted this experiment to investigate f
easibility and efficacy of a staged tracheal transplantation approach
for tracheal reconstruction. Methods. Twelve dogs were divided equally
into groups I and II. A segment of cervical tracheas (six rings) was
harvested as an autograft and implanted heterotopically into the great
er omentum. Two weeks later, the autografts with their omental pedicle
s were transplanted orthotopically to the cervical (group I) or the th
oracic portion of the trachea (group II). Bronchoscopic examination we
re performed monthly during a 5-month follow-up period. After sacrific
ing the dogs, we had the grafts examined macroscopically and microscop
ically. Results. The dogs of both groups survived well until the end o
f the follow-up. No abnormal findings were observed through bronchosco
py. The grafts had normal appearance, without shrinkage, granulation,
or necrosis by postmortem gross examination. Histologic examination sh
owed the structures of the grafts were intact. Conclusions. We conclud
e that the two-stage tracheal transplantation approach using the great
er omentum is feasible, and can facilitate the survival of a tracheal
graft as well.