Department of Otolaryngology and Head and Neck , University Hospital Leuven, Leuven, Belgium.
N Engl J Med. 2010 Jan 14;362(2):138-45. doi: 10.1056/NEJMoa0810653.
Reconstruction of long-segment tracheal defects requires a vascularized allograft. We report successful tracheal allotransplantation after indirect revascularization of the graft in a heterotopic position. Immunosuppressive therapy was administered before the operation, and the tracheal allograft was wrapped in the recipient's forearm fascia. Once revascularization was achieved, the mucosal lining was replaced progressively with buccal mucosa from the recipient. At 4 months, the tracheal chimera was fully lined with mucosa, which consisted of respiratory epithelium from the donor and buccal mucosa from the recipient. After withdrawal of immunosuppressive therapy, the tracheal allograft was moved to its correct anatomical position with an intact blood supply. No treatment-limiting adverse effects occurred.
重建长段气管缺损需要血管化的同种异体移植物。我们报告了在异位间接再血管化供体后成功进行的气管同种异体移植。在手术前进行了免疫抑制治疗，并且将供体的气管包裹在受者的前臂筋膜中。一旦实现再血管化，就用来自受者的颊黏膜逐渐替换黏膜衬里。在 4 个月时，气管嵌合体完全被黏膜覆盖，其由供体的呼吸上皮和受者的颊黏膜组成。在停止免疫抑制治疗后，气管同种异体移植物在完整的血液供应下被移至其正确的解剖位置。没有发生治疗受限的不良反应。
