Airway Transplantation: a Challenge for Regenerative Medicine

Overview

Journal Eur J Med Res

Publisher Biomed Central

Specialty General Medicine

Date 2013 Sep 25

PMID 24059453

Citations 10

Authors

Emmanuel Martinod

Agathe Seguin

Dana M Radu

Guillaume Boddaert

Kader Chouahnia

Anne Fialaire-Legendre

Herve Dutau

Nicolas Venissac

Charles-Hugo Marquette

Christophe Baillard

Dominique Valeyre

Alain Carpentier

Affiliations

Soon will be listed here.

Abstract

After more than 50 years of research, airway transplantation remains a major challenge in the fields of thoracic surgery and regenerative medicine. Five principal types of tracheobronchial substitutes, including synthetic prostheses, bioprostheses, allografts, autografts and bioengineered conduits have been evaluated experimentally in numerous studies. However, none of these works have provided a standardized technique for the replacement of the airways. More recently, few clinical attempts have offered encouraging results with ex vivo or stem cell-based engineered airways and tracheal allografts implanted after heterotopic revascularization. In 1997, we proposed a novel approach: the use of aortic grafts as a biological matrix for extensive airway reconstruction. In vivo regeneration of epithelium and cartilage were demonstrated in animal models. This led to the first human applications using cryopreserved aortic allografts that present key advantages because they are available in tissue banks and do not require immunosuppressive therapy. Favorable results obtained in pioneering cases have to be confirmed in larger series of patients with extensive tracheobronchial diseases.

Citing Articles

Long-Term Survival and Regeneration Following Transplantation of 3D-Printed Biodegradable PCL Tracheal Grafts in Large-Scale Porcine Models.

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Alginate Improves the Chondrogenic Capacity of 3D PCL Scaffolds In Vitro: A Histological Approach.

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Current Strategies for Tracheal Replacement: A Review.

Damiano G, Palumbo V, Fazzotta S, Curione F, Lo Monte G, Brucato V Life (Basel). 2021; 11(7).

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Feasibility of chondrogenesis for the entire umbilical cord in preliminary preparation for tracheal graft.

Shai S, Lai Y, Huang B, Yu K, Hsieh C, Chen Y Am J Transl Res. 2021; 13(3):1307-1321.

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Bioengineered carina reconstruction using In-Vivo Bioreactor technique in human: proof of concept study.

Xu Y, Guo Z, Liu R, Wang H, Wang S, Weder W Transl Lung Cancer Res. 2020; 9(3):705-712.

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References

Seguin A, Radu D, Holder-Espinasse M, Bruneval P, Fialaire-Legendre A, Duterque-Coquillaud M . Tracheal replacement with cryopreserved, decellularized, or glutaraldehyde-treated aortic allografts. Ann Thorac Surg. 2009; 87(3):861-7. DOI: 10.1016/j.athoracsur.2008.11.038. View

Martinod E, Aupecle B, Zegdi R, Fornes P, Azorin J, Fabiani J . [Segmentary replacement of the trachea with an aortic autograft: the "trachea-aorta"]. Presse Med. 1999; 28(30):1638. View

Bader A, Macchiarini P . Moving towards in situ tracheal regeneration: the bionic tissue engineered transplantation approach. J Cell Mol Med. 2010; 14(7):1877-89. PMC: 3823270. DOI: 10.1111/j.1582-4934.2010.01073.x. View

Makris D, Holder-Espinasse M, Wurtz A, Seguin A, Hubert T, Jaillard S . Tracheal replacement with cryopreserved allogenic aorta. Chest. 2009; 137(1):60-7. DOI: 10.1378/chest.09-1275. View

BELSEY R . Resection and reconstruction of the intrathoracic trachea. Br J Surg. 1950; 38(150):200-5. DOI: 10.1002/bjs.18003815008. View

Jaillard S, Holder-Espinasse M, Hubert T, Copin M, Duterque-Coquillaud M, Wurtz A . Tracheal replacement by allogenic aorta in the pig. Chest. 2006; 130(5):1397-404. DOI: 10.1378/chest.130.5.1397. View

Vacanti C, Paige K, Kim W, Sakata J, Upton J, Vacanti J . Experimental tracheal replacement using tissue-engineered cartilage. J Pediatr Surg. 1994; 29(2):201-4; discussion 204-5. DOI: 10.1016/0022-3468(94)90318-2. View

Seguin A, Martinod E, Kambouchner M, Campo G, Dhote P, Bruneval P . Carinal replacement with an aortic allograft. Ann Thorac Surg. 2006; 81(3):1068-74. DOI: 10.1016/j.athoracsur.2005.07.079. View

Martinod E, Zegdi R, Zakine G, Aupecle B, Fornes P, DAudiffret A . A novel approach to tracheal replacement: the use of an aortic graft. J Thorac Cardiovasc Surg. 2001; 122(1):197-8. DOI: 10.1067/mtc.2001.114346. View

10.

Radu D, Seguin A, Bruneval P, Fialaire Legendre A, Carpentier A, Martinod E . Bronchial replacement with arterial allografts. Ann Thorac Surg. 2010; 90(1):252-8. DOI: 10.1016/j.athoracsur.2010.03.079. View

11.

Martinod E, Seguin A, Radu D, Marquette C, Carpentier A . [Advances in tracheal surgery: are we close to finding the ideal tracheal substitute?]. Rev Mal Respir. 2010; 27(6):554-64. DOI: 10.1016/j.rmr.2010.04.001. View

12.

Tsukada H, Gangadharan S, Garland R, Herth F, Decamp M, Ernst A . Tracheal replacement with a bioabsorbable scaffold in sheep. Ann Thorac Surg. 2010; 90(6):1793-7. DOI: 10.1016/j.athoracsur.2010.07.074. View

13.

Martinod E, Radu D, Chouahnia K, Seguin A, Fialaire-Legendre A, Brillet P . Human transplantation of a biologic airway substitute in conservative lung cancer surgery. Ann Thorac Surg. 2011; 91(3):837-42. DOI: 10.1016/j.athoracsur.2010.11.013. View

14.

Martinod E, Zakine G, Fornes P, Zegdi R, DAudiffret A, Aupecle B . [Metaplasia of aortic tissue into tracheal tissue. Surgical perspectives]. C R Acad Sci III. 2000; 323(5):455-60. DOI: 10.1016/s0764-4469(00)00150-5. View

15.

Mimeault M, Hauke R, Batra S . Stem cells: a revolution in therapeutics-recent advances in stem cell biology and their therapeutic applications in regenerative medicine and cancer therapies. Clin Pharmacol Ther. 2007; 82(3):252-64. DOI: 10.1038/sj.clpt.6100301. View

16.

Macchiarini P, Jungebluth P, Go T, Asnaghi M, Rees L, Cogan T . Clinical transplantation of a tissue-engineered airway. Lancet. 2008; 372(9655):2023-30. DOI: 10.1016/S0140-6736(08)61598-6. View

17.

Elliott M, De Coppi P, Speggiorin S, Roebuck D, Butler C, Samuel E . Stem-cell-based, tissue engineered tracheal replacement in a child: a 2-year follow-up study. Lancet. 2012; 380(9846):994-1000. PMC: 4487824. DOI: 10.1016/S0140-6736(12)60737-5. View

18.

Seguin A, Baccari S, Holder-Espinasse M, Bruneval P, Carpentier A, Taylor D . Tracheal regeneration: evidence of bone marrow mesenchymal stem cell involvement. J Thorac Cardiovasc Surg. 2012; 145(5):1297-1304.e2. DOI: 10.1016/j.jtcvs.2012.09.079. View

19.

Martinod E, Seguin A, Holder-Espinasse M, Kambouchner M, Duterque-Coquillaud M, Azorin J . Tracheal regeneration following tracheal replacement with an allogenic aorta. Ann Thorac Surg. 2005; 79(3):942-8. DOI: 10.1016/j.athoracsur.2004.08.035. View

20.

Delaere P, Vranckx J, Verleden G, De Leyn P, Van Raemdonck D . Tracheal allotransplantation after withdrawal of immunosuppressive therapy. N Engl J Med. 2010; 362(2):138-45. DOI: 10.1056/NEJMoa0810653. View