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J Thorac Cardiovasc Surg 2002;124:231-240
© 2002 The American Association for Thoracic Surgery

Cardiothoracic Transplantation (TX)

Failure of airway healing in an ovine autotransplantation model that includes basic fibroblast growth factor

From the Klinik für Viszeral und Transplantationschirurgie^a and the Institut für Pathologie,^b Medical School Hannover, Hannover, Germany.

Received for publication April 15, 2001. Revisions requested Aug 25, 2001; revisions received Sept 4, 2001. Accepted for publication Sept 14, 2001. Address for reprints: Matthias Behrend, MD, PD, Universitätsklinikum Freiburg, Abt. Thoraxchirurgie, Hugstetter Str 55, 79106 Freiburg, Germany (E-mail: Matthias{at}Mbehrend.net).

Objective: Basic fibroblast growth factor is among the most potent promoters of angiogenesis. Its ability to enhance the blood supply to ischemic airways or nonvascularized tracheal autograft has been demonstrated. Its cumulative effect with muscular wrapping and its efficacy in a noncanine large animal model remain unknown. Treatment with basic fibroblast growth factor and muscular wrapping were compared with no special treatment and with muscular wrapping alone in an ovine tracheal autotransplantation model.
Methods: All sheep underwent orthotopic tracheal transplantation with 5 to 8 ring autografts in the cervical trachea. Fifteen sheep were classified randomly into the following three groups: no treatment (group A, n = 5), muscular wrapping with the right sternomastoid muscle (group B, n = 5), and topical administration of fibrin glue enriched with 2 µg/cm² basic fibroblast growth factor (group C, n = 5).
Results: Devascularized tracheal autografts were unable to maintain their structural integrity without other treatment (group A). However, the grafts were surrounded by well-vascularized connective tissue. In the muscular wrapping group (group B), infections occurred around the grafts, and the muscular wrapping was subject to necrosis. No neovascularization of the grafts occurred. Therapy with basic fibroblast growth factor (group C) led to improved muscular wrapping circulation and to adherence to the tracheal stumps. However, no success was achieved in validating the circulation in the grafts.
Conclusions: In contrast to the results achieved by other authors with canine models, the neovascularization of tracheal autografts was not achieved in sheep with the topical administration of basic fibroblast growth factor. Cranially pediculated muscular wrapping led to poorer circulation in the tissue around the graft than did no therapy at all.

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