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J Thorac Cardiovasc Surg 1995;110:728-0737
© 1995 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

Experimental tracheal allograft revascularization and transplantation

Leuven, Belgium

Supported by a grant from the N.F.W.O. (No. S 2/5-ID. F 214).Cyclosporine was a generous contribution of Sandoz Pharmaceuticals, E.Hannover, N.J.

Received for publication Oct. 26, 1994. Accepted for publication Jan. 12, 1995. Address for reprints: Pierre R. Delaere, MD, Department of Oto-Rhino-Laryngology, University Hospital St. Rafael, K.U. Leuven, Kapueijnenvoer 33, B-3000 Leuven, Belgium.

Abstract

The feasibility of tracheal allotransplantation with a fascial vascular carrier was examined in three groups with varied dose sequences of immunosuppression. A control group (group 1) received no medication. The three experimental groups were given daily cyclosporine intramuscular doses of 5 mg/kg (group 2), 5 mg/kg plus 3 mg/kg methylprednisolone (Solu-Medrol) (group 3), and 10 mg/kg (group 4) for 6 weeks or until death. Grafts were assessed by silicone dye infusion of the artery of the fascial flap to examine their microcirculation and by quantitative histologic study. Group 1 evidenced complete rejection after a heterotopic revascularization period of 14 days. The allografts of the experimental groups remained viable after 14 days of revascularization and could be transplanted orthotopically after this period. After transplantation, the viability of group 2 tracheas was unpredictable with changes ranging from mild to complete rejection. Group 3 evidenced well-preserved transplant viability with infection-induced necrosis at the anastomoses caused by the corticosteroid component. All group 4 animals survived the follow-up period with normal allograft viability. Cyclosporine in a dosage of 10 mg/kg per day can effectively suppress the immune response after transplantation of vascularized tracheal allografts. This experimental model will allow future studies to examine airway wall immunogenicity. (J THORAC CARDIOVASC SURG 1995;110: 728-37)

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