Reconstruction of Anterior Tracheal Defects Using a Bioengineered Graft in a Porcine Model

Adnan M Al-Ayoubi; Sadiq S Rehmani; Catherine F Sinclair; Robert S Lebovics; Faiz Y Bhora

doi:10.1016/j.athoracsur.2016.10.034

Back

Reconstruction of Anterior Tracheal Defects Using a Bioengineered Graft in a Porcine Model

Journal article

Open access

Peer reviewed

Reconstruction of Anterior Tracheal Defects Using a Bioengineered Graft in a Porcine Model

Adnan M Al-Ayoubi, Sadiq S Rehmani, Catherine F Sinclair, Robert S Lebovics and Faiz Y Bhora

The Annals of thoracic surgery, Vol.103(2), pp.381-389

02/01/2017

DOI: 10.1016/j.athoracsur.2016.10.034

PMID: 27983955

Files and links (1)

url

https://doi.org/10.1016/j.athoracsur.2016.10.034View

Published (Version of record) Open Access

Abstract

Reconstruction of long-segment tracheal defects can be challenging and a suitable tracheal substitute remains lacking. We sought to create a bioengineered tracheal graft to repair such lesions using acellullar bovine dermis extracellular matrix (ECM) and male human mesenchymal stem cells (hMSCs) and implant it in a porcine model. hMSCs were seeded on the ECM and incubated for 1 week with chondrogenic factors. An anterior 4 cm × 3 cm defect was surgically created in the trachea of 4-week-old female Yorkshire pigs. The defect was reconstructed using the bioengineered graft (n = 7) or control (n = 3, ECM only). The study duration was 3 months. Survival ranged from 7 days (n = 3) to 3 months (n = 7). Early death was due to graft malacia (n = 1, control), graft infection (n = 1, bioengineered), and pneumonia (n = 1, bioengineered). There was substantial animal growth at 3 months (>200% weight). Surveillance bronchoscopy showed patent airway, mild stenosis, and integration of the graft with the native trachea. On histology, luminal epithelialization and neovascularization with scant submucosa were observed in both the bioengineered graft and control groups. Chondrogenesis was seen only in the bioengineered graft. The neocartilage was less mature and organized compared to native cartilage. SRY immunostain was positive in the neocartilage but not control or native trachea. We demonstrate the feasibility of the bioengineered graft for reconstruction of long anterior tracheal defects with favorable short-term outcomes. Furthermore, we show its ability to facilitate chondrogenesis, neovascularization, and epithelialization. Importantly, it supported rapid animal growth offering potential solutions for both pediatric and adult applications.

Acellular Dermis

Animals

Cattle

Disease Models, Animal

Feasibility Studies

Female

Humans

Male

Reconstructive Surgical Procedures - methods

Swine

Tissue Engineering - methods

Tissue Scaffolds

Trachea - surgery

Tracheal Stenosis - surgery

Details

Title: Subtitle: Reconstruction of Anterior Tracheal Defects Using a Bioengineered Graft in a Porcine Model
Creators: Adnan M Al-Ayoubi - Icahn School of Medicine at Mount Sinai
Sadiq S Rehmani - Mount Sinai Health System
Catherine F Sinclair - Mount Sinai Health System
Robert S Lebovics - Mount Sinai Health System
Faiz Y Bhora - Mount Sinai Health System
Resource Type: Journal article
Publication Details: The Annals of thoracic surgery, Vol.103(2), pp.381-389
DOI: 10.1016/j.athoracsur.2016.10.034
PMID: 27983955
ISSN: 0003-4975
eISSN: 1552-6259
Language: English
Date published: 02/01/2017
Academic Unit: Cardiothoracic Surgery
Record Identifier: 9984701724902771

Metrics

4 Record Views

17 Times Cited - Web of Science

See more details