JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Google Scholar
Right arrow Articles by Nakamura, T.
Right arrow Articles by Hayakawa, K.
PubMed
Right arrow Articles by Nakamura, T.
Right arrow Articles by Hayakawa, K.
Related Collections
Right arrow Trachea and bronchi

J Thorac Cardiovasc Surg 2009;138:811-819
© 2009 The American Association for Thoracic Surgery

General Thoracic Surgery

In situ tissue engineering for tracheal reconstruction using a luminar remodeling type of artificial trachea

Tatsuo Nakamura, MDa,*, Toshihiko Satoa, Masato Araki, MDa, Satoshi Ichihara, MDa, Akira Nakada, MDa, Makoto Yoshitani, MDa, Shin-ichi Itoi, MDa, Masaru Yamashita, MDb, Shin-ichi Kanemaru, MDb, Kouichi Omori, MDc, Yoshio Hori, MDa, Katsuaki Endo, MDd, Yuji Inada, MDa, Katsumi Hayakawa, MDa

a Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan
b Department of Otolaryngology, Kyoto University, Kyoto, Japan
c Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan
d Department of Physiology, Kyoto Nerve Regeneration Research Center, Kyoto, Japan

Received for publication February 2, 2008; revisions received May 12, 2008; accepted for publication July 3, 2008.

* Address for reprints: Tatsuo Nakamura, MD, Department of Bioartificial Organs, Institute for Frontier Medical Sciences, Kyoto University, 53 Kawahara cho, Sakyo-ku, Kyoto 606-8507, Japan. (Email: nakamura{at}frontier.kyoto-u.ac.jp).

Background: After successful trials of tracheal reconstruction using mesh-type prostheses in canine models, the technique has been applied clinically to human patients since 2002. To enhance tissue regeneration, we have applied a new tissue engineering approach to this mesh-type prosthesis.

Methods: The prosthesis consists of a polypropylene mesh tube reinforced with a polypropylene spiral and atelocollagen layer. The cervical tracheas of 18 beagle dogs were replaced with the prosthesis. The collagen layer was soaked with peripheral blood in 6 of the dogs, with bone marrow aspirate in another 6, and with autologous multipotential bone marrow–derived cells (mesenchymal stem cells) in another 6. The dogs were humanely killed at 1 to 12 months after the operation.

Results: All 18 dogs survived the postoperative period. Bronchoscopically, 3 of 4 dogs in the peripheral blood group showed stenosis, whereas no stenosis was evident in all 8 of the dogs in the bone marrow and mesenchymal stem cell groups 6 months after the operation. Faster epithelialization and fewer complications, such as mesh exposure and luminal stenosis, were observed in these two groups than in the peripheral blood group. Histologically, the cells from autologous bone marrow were found to proliferate into the tracheal tissue during the first month. Cilial movement in these two groups was faster than that in the peripheral blood group and recovered to 80% to 90% of the normal level.

Conclusions: Bone marrow aspirate and mesenchymal stem cells enhance the regeneration of the tracheal mucosa on this prosthesis. This in situ tissue engineering approach may facilitate tracheal reconstruction in the clinical setting.

Abbreviations and Acronyms CBF = cilial beat frequency; MRI = magnetic resonance imaging; MSC = mesenchymal stem cell






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by The American Association for Thoracic Surgery.