Open AccessStem Cell–Coated Tracheal Replacement in a Rabbit Model
Author(s) -
Wood Megan W.,
Wright Stephen C.
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a126
Subject(s) - stem cell , fibrin glue , medicine , tracheal stenosis , cadaveric spasm , surgery , ex vivo , regenerative medicine , in vivo , airway , biology , genetics , microbiology and biotechnology
Objective Design a single‐stage stem‐cell based tracheal replacement technique to expand tracheal reconstructive options. Method A pilot study using 4 rabbits was performed in October through December of 2011 at Wake Forest Institute of Regenerative Medicine. Two procedures were performed on cadaveric animals, and 2 survival surgeries were performed on live animals. Our technique combined a segment of fixed, cell‐free cadaveric donor trachea and adipose or marrow derived stem cells harvested from the recipient animal. These acellular donor conduits were seeded with host stem cells and implanted. Results Tracheal reconstruction for tracheal stenosis is an evolving field. Recent success using a stem‐cell based engineered trachea required a prolonged incubation ex vivo in a novel “bioreactor.” Taking this idea a step further, a single‐stage method would be optimal. After completion of both cadaveric surgeries, the surgical procedure was optimized. The following 2 live‐animal procedures were successful demonstrations of the ability to suspend stem cells in fibrin glue, seed the conduit, and replace a segment of trachea. Although both animals were euthanized following completion according to approved IACUC protocol, the final animal was extubated prior to euthanasia, and demonstrated comfortable, spontaneous respiration. Conclusion Based on pilot study technical success of short segment tracheal replacement with the use of fixed donor trachea and stem cell support, additional animal studies with extended follow‐up will provide the necessary data to improve tracheal reconstruction in a single‐stage surgical model.