SUCCESSFUL TRACHEAL AUTOTRANSPLANTATION WITH 2-STAGE APPROACH USING THE GREATER OMENTUM

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.