Replacement of a tracheal defect with a tissue-engineered prosthesis: early results from animal experiments

J Thorac Cardiovasc Surg. 2004 Jul;128(1):124-9. doi: 10.1016/j.jtcvs.2003.09.045.


Objectives: The major problems in the development of tracheal prosthesis are anastomotic dehiscence and stenosis, caused by poor epithelialization of the prosthetic graft. We developed a novel tracheal prosthesis with viable mucosa transplanted from the oral cavity and reported excellent long-term results after thoracic tracheal replacements in dogs. In the current study, we used tissue-engineering techniques to construct a mucosal prosthetic lining from skin cells and evaluated its usefulness in tracheal replacement.

Methods: Abdominal skin patches (5 x 10 cm) were harvested from 10 adult mongrel dogs. The epithelial cells were separated, cultured in vitro for 4 weeks, and then seeded onto a porous polylactic glycolic acid scaffold (6 x 8 cm) to construct a lining mucosa. This was then mounted onto the prosthesis framework, made with polypropylene mesh reinforced with polypropylene rings. The mucosa-lined prosthesis was wrapped with the greater omentum of the same dog and placed in the peritoneal cavity for 1 week. Complete surgical resection and replacement of a thoracic tracheal segment (5 cm in length, just above the carina) was then performed using the prosthesis.

Results: The animals regained full activity and survived with normal activity. Bronchoscopy at 1 week and at 1 and 2 months revealed no stenosis in the anastomosis.

Conclusions: This highly biocompatible tracheal prosthesis could prove useful for the reconstruction of large, circumferential tracheal defects.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anastomosis, Surgical
  • Animals
  • Bronchoscopy
  • Disease Models, Animal
  • Dogs
  • Fiber Optic Technology
  • Models, Cardiovascular
  • Mouth Mucosa / transplantation
  • Omentum / transplantation
  • Postoperative Complications / etiology
  • Prosthesis Design
  • Prosthesis Implantation*
  • Severity of Illness Index
  • Time Factors
  • Tissue Engineering*
  • Trachea / pathology*
  • Trachea / surgery*