Abstract
Transplantation of a cryopreserved tracheal allograft is considered to be a useful strategy in treating congenital tracheal stenosis. Recent reports of tracheal transplant experiments have shown that the antigenicity of the trachea is decreased by cryopreservation, making transplantation of the trachea possible. However, we reported that cryopreserved tracheal allografts exhibited favorable patency, but no significant growth in an animal model. In this study, we hypothesize that an immune reaction may play a role in the failure of an allograft’s growth. Each allograft was harvested from 90- to 120-day-old Japanese rabbits, immersed in preservation solution, stored in a programmable freezer until it reached −80˚C, and then kept for 1 month. Orthotopic tracheal transplantation of four tracheal rings in an end-to-end fashion was performed in age-matched young rabbits. Ten recipients were classified into three groups: a group provided with tacrolimus (FK-506) as an immunosuppressant (n = 6), a group receiving a graft irradiated before transplantation (n = 2), and a control group (n = 2). All grafts were evaluated 4–8 weeks after transplantation (tacrolimus group: 3–13 weeks). Body weight gain of the tacrolimus group was less than that of the other two groups. All grafts were well incorporated with the recipients macroscopically, but the grafts showed no growth in diameter. Microscopic examination showed inflammation in the tacrolimus and control groups temporarily. The irradiated allografts had marked fibrosis in the subepithelium. Although calcification of the tracheal cartilage was present in all transplanted allografts, the difference between groups was not significant. Patency of the cryopreserved tracheal allografts was favorable but no growth occurred even with an immunosuppressant. Further studies are required to address the growth of the tracheal allograft.
Similar content being viewed by others
References
Kimura K, Mukohara N, Tsugawa C, Matsumoto Y, Sugimura C, Murata H, Itoh H (1982) Tracheoplasty for congenital stenosis of the entire trachea. J Pediatr Surg 17:869–871
Tanaka H, Maeda K, Okita Y (2003) Transplantation of the cryopreserved tracheal allograft in growing rabbits. J Pediatr Surg 38:1707–1711
Maeda M, Grillo HC (1972) Tracheal growth following anastomosis in puppies. J Thorac Cardiovasc Surg 64:304–313
Murakawa T, Nakajima J, Motomura N, Murakami A, Takamoto S (2002) Successful allotransplantation of cryopreserved tracheal grafts with preservation of the pars membranacea in nonhuman primates. J Thorac Cardiovasc Surg 123:153–160
Moriyama H, Sasajima T, Hirata S, Yamazaki K, Yatsuyanagi E, Kubo Y (2000) Revascularization of canine cryopreserved tracheal allografts. Ann Thorac Surg 69:1701–1706
Deschamps C, Trastek VF, Ferguson JL, Martin WJ, Colby TV, Pairolero PC, Payne WS (1989) Cryopreservation of canine trachea: functional and histological changes. Ann Thorac Surg 47:208–212
Messineo A, Filler RM, Smith C, Bahoric A (1993) Cryopreservation of pig trachea. Pediatr Surg Int 8:476–479
Yokomise H, Inui K, Wada H, Hitomi S (1996) The infeasibility of using ten-ring irradiated grafts for tracheal allotransplantation even with omentopexy. Surg Today 26:427–430
Jacobs JP, Quintessenza JA, Andrews T, Burke RP, Spektor Z, Delius RE, Smith RJ, Elliott MJ, Herberhold C (1999) Tracheal allograft reconstruction: the total North American and worldwide pediatric experiences. Ann Thorac Surg 68:1043–1052
Acknowledgments
The work was funded by a grant from Kobe University Graduate School of Medicine Alumni Association.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hisamatsu, C., Maeda, K., Tanaka, H. et al. Transplantation of the cryopreserved tracheal allograft in growing rabbits: effect of immunosuppressant. Pediatr Surg Int 22, 881–885 (2006). https://doi.org/10.1007/s00383-006-1757-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-006-1757-x