Department of Otolaryngology-Head and Neck Surgery, Department of Neurosurgery, Department of Immunology and Immunotherapy, The Icahn School of Medicine at Mount Sinai.
Institute for Airway Sciences, Co-Scientific Director, Center for Epithelial and Airway Biology and Regeneration, Basic Science Research, Otolaryngology, Director, Developmental Origins of Health and Disease, Department of Otolaryngology, Department of Cell, Developmental and Regenerative Biology, Department of Pathology, Molecular and Cell Based Medicine, Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Curr Opin Organ Transplant. 2024 Dec 1;29(6):407-411. doi: 10.1097/MOT.0000000000001180. Epub 2024 Oct 9.
The purpose of this review is to explore the lessons learned from experimental and human tracheal transplantation to determine if this information may be applied to lung transplantation.
Experimental work in animal models and the recent human tracheal transplantation suggests that a robust tracheal vascular supply prevents anastomotic complications. Further, this work demonstrates that tracheal allografts undergo a progressive chimerism as recipient epithelium repopulates the allograft. In contrast to most vascularized composite allografts such as hand and face transplantation that experience high rates of rejection, the tracheal allograft did not demonstrate rejection. This may suggest that tissue chimerism plays a role in evading immune-mediated allograft rejection.
While anastomotic complications and chronic allograft rejection are the most common complications related to lung transplantation, the findings associated with tracheal transplantation may have implications for both reducing complications associated with lung transplantation.
本综述旨在探讨从实验和人类气管移植中获得的经验教训，以确定这些信息是否可应用于肺移植。
动物模型的实验工作和最近的人类气管移植表明，强健的气管血管供应可预防吻合口并发症。此外，这项工作表明，随着受者上皮细胞再殖入同种异体移植物，气管同种异体移植物经历渐进性嵌合。与大多数血管化复合同种异体移植物（如手和面部移植）的高排斥率形成对比的是，气管同种异体移植物并未表现出排斥反应。这可能表明组织嵌合在逃避免疫介导的同种异体移植物排斥中发挥作用。
尽管吻合口并发症和慢性同种异体移植物排斥是与肺移植相关的最常见并发症，但与气管移植相关的发现可能对减少肺移植相关并发症具有重要意义。
