Rehmani Sadiq S, Al-Ayoubi Adnan M, Ayub Adil, Barsky Michael, Lewis Erik, Flores Raja, Lebovics Robert, Bhora Faiz Y
Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York.
Department of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York.
Ann Thorac Surg. 2017 Sep;104(3):998-1004. doi: 10.1016/j.athoracsur.2017.03.051. Epub 2017 Jun 11.
We aimed to develop a process using three-dimensional (3D) printing to create bioengineered tracheal grafts (BETGs) for reconstruction of anterior tracheal defects in a large-animal model (porcine) that would have translational relevance for potential human use.
Preoperative computed tomographic scans were used to create virtual 3D models of the animal airways. Anatomically scaled tracheal grafts were subsequently developed using 3D-printed polycaprolactone and extracellular matrix. A 4-cm anterior tracheal defect (about 50% of the length of the subject trachea) was surgically created in 4-week-old female Yorkshire pigs and reconstructed using the customized grafts. Gross and microscopic analyses of the grafts were performed.
The BETGs were implanted in 7 animals. There was adequate graft-native trachea size match at the operation. The trachea was successfully reconstructed in all cases. Gross examination at autopsy showed a structurally intact, well-incorporated graft. Histologic evaluation showed respiratory mucosal coverage and vascularity of the graft. Five of 7 animals outlived the 3-month study period. The animals had approximately 100% growth during the study period.
We report of a 3D-printed BETG to repair long-segment anterior tracheal defects in a large-animal model. Although the study duration is short, this work presents an efficient strategy for tracheal graft bioengineering with potential translational relevance for human use.
我们旨在开发一种利用三维（3D）打印技术制造生物工程气管移植物（BETG）的方法，用于在大型动物模型（猪）中重建气管前部缺损，这对于潜在的人类应用具有转化意义。
术前计算机断层扫描用于创建动物气道的虚拟3D模型。随后使用3D打印的聚己内酯和细胞外基质制作解剖学比例的气管移植物。在4周龄的雌性约克夏猪中手术制造一个4厘米长的气管前部缺损（约为受试气管长度的50%），并使用定制的移植物进行重建。对移植物进行大体和显微镜分析。
将BETG植入7只动物体内。手术时移植物与天然气管的尺寸匹配良好。所有病例的气管均成功重建。尸检时的大体检查显示移植物结构完整，整合良好。组织学评估显示移植物有呼吸道黏膜覆盖且有血管分布。7只动物中有5只存活超过了3个月的研究期。在研究期间，这些动物的生长率约为100%。
我们报道了一种用于修复大型动物模型中长段气管前部缺损的3D打印BETG。尽管研究持续时间较短，但这项工作为气管移植物生物工程提供了一种有效的策略，对人类应用具有潜在的转化意义。
