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J Thorac Cardiovasc Surg 1995;110:762-0767
© 1995 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

Experimental carinal autotransplantation and allotransplantation

Toshirou Takachi, MDa, Takayuki Shirakusa, MDa, Takeshi Shiraishi, MDa, Kan Okabayashi, MDa, Koji Inutsuka, MDa, Katsunobu Kawahara, MDa, Ryoichi Nakanishi, MDb

Fukuoka and Kitakyushu, Japan

Received for publication Sept. 29, 1994. Accepted for publication Feb. 8, 1995. Address for reprints: Toshirou Takachi, MD, Department of Surgery, Mihagino Hospital, 1-12-18, Mihagino, Kokurakitaku, Kitakyushu 802, Japan.

Abstract

Grafting is required when a primary reconstruction of a carinal defect is not feasible. A series of experiments in 21 dogs was conducted to assess the possibility of carinal reconstruction with the use of carinal autografts and allografts, with or without omentopexy. Carinal autograft transplantations were done without omentopexy in group A (n = 6) and with omentopexy in group B (n = 6). In group C (n = 9), carinal allograft transplantations were done with omentopexy and FK 506 was administered after operation. Survival of grafts was seen in 50% of group A, 83% of group B, and 44% of group C dogs. Postoperative bronchoscopy revealed inflammatory changes in the surviving grafts; the changes resolved more rapidly in the dogs with omentopexy than in the dogs without omentopexy. These experiments suggest that omentopexy is an effective method of facilitating survival and healing in carinal grafts and that carinal reconstruction with carinal allografts with FK 506 is feasible. (J THORACCARDIOVASCSURG1995;110: 762-7)




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