Division of Thoracic Surgery, Department of Surgery, Taipei City Hospital Zhongxiao Branch, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2023 Sep;122(9):940-946. doi: 10.1016/j.jfma.2023.03.006. Epub 2023 Mar 29.
The use of tracheal implants for tracheal reconstruction remains a challenge in thoracic medicine due to the complex structure of the trachea in mammalian organisms, including smooth muscles, cartilage, mucosa, blood vessels, cilia, and other tissues, and the difficulty in achieving tracheal regeneration using implants from either allografts or synthetic biomaterials.
This project used the Lee-Sung strain pig, a swine breed local to Taiwan, as the experimental subject. The aorta of the pig was harvested, decellularized to form the scaffold, and transplanted into the trachea of allogeneic pigs together with growth factors. Postoperative physiological function and tissue changes were observed. The postoperative physiological parameters of the LSP were monitored, and they were sacrificed after a certain period to observe the pathological changes in the tracheal epithelial cells and cartilages.
Overall, six LSP tracheal transplantations were performed between March 4, 2020, and March 10, 2021. These included aortic patch anastomosis for pig 1 and aortic segmental anastomosis for pigs 2-6. The shortest and longest survival periods were 1 day and 147 days, respectively. Excluding the pig that survived for only 1 day due to a ruptured graft anastomosis, all other subjects survived for over 1 month on average.
In this study, we grafted a decellularized porcine aorta into a recipient pig with a tracheal defect. We found cryopreservation of the allogeneic aorta transplantation was a feasible and safe method for the management of airway disease, and immunosuppressants were unnecessary during the treatment course.
由于哺乳动物气管的复杂结构，包括平滑肌、软骨、黏膜、血管、纤毛和其他组织，以及使用同种异体移植物或合成生物材料实现气管再生的困难，气管植入物在胸医学中的应用仍然是一个挑战。
本项目以台湾本地的 Lee-Sung 猪种作为实验对象。猪的主动脉被采集下来，经过去细胞化处理形成支架，并与生长因子一起移植到同种异体猪的气管中。观察术后生理功能和组织变化。监测 LSP 的术后生理参数，并在一定时间后将其处死，观察气管上皮细胞和软骨的病理变化。
总体而言，2020 年 3 月 4 日至 2021 年 3 月 10 日期间共进行了 6 例 LSP 气管移植，包括猪 1 的主动脉补丁吻合术和猪 2-6 的主动脉节段吻合术。最短和最长的存活期分别为 1 天和 147 天。除了因移植物吻合口破裂而仅存活 1 天的猪外，其余所有动物的平均存活时间均超过 1 个月。
在这项研究中，我们将去细胞化的猪主动脉移植到患有气管缺损的受体猪体内。我们发现同种异体主动脉移植的冷冻保存是一种可行且安全的气道疾病管理方法，在治疗过程中不需要免疫抑制剂。
