Decellularized tracheal prelamination implant: A proposed bilateral double organ technique,Artificial Organs

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Decellularized tracheal prelamination implant: A proposed bilateral double organ technique
Artificial Organs ( IF 2.2 ) Pub Date : 2021-07-26 , DOI: 10.1111/aor.14043
Néstor J Martínez-Hernández ₁ , Ana Díaz-Cuevas ₂ , Lara Milián-Medina ₃ , María Sancho-Tello ₂ , Joan Roselló-Ferrando ₄ , Alfonso Morcillo-Aixelá ₅ , José Luis Campo-Cañaveral ₆ , Amparo Roig-Bataller ₁ , Manuel Mata-Roig _{3,

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Affiliation

In tracheal replacement transplantation, prelamination is a critical stage. Nowadays, the most widely used prelamination technique is the prethoracic fascia flap with lateral thoracic artery. We propose a flap based on the internal thoracic artery, which allows a relatively non-aggressive double organ implant, and we have tested its efficacy in decellularized tracheas. Tracheas of albino New Zealand rabbits were decellularized following a protocol that uses detergents and cryogenization, sterilized with 1kGy gamma radiation, and tutorized with a stent. Bilateral pedicled flaps made of pectoral fascia and a muscular component were harvested through a longitudinal 3-cm central thoracic incision, wrapping the tracheas with them in 16 rabbits, remaining them implanted for 2, 4, 8, and 12 weeks. The tracheas were then studied histologically using standard stainings plus immunohistochemistry (CD31). The models were adjusted with Bayesian statistics using ordinal regression; results as odds ratios and credibility intervals. All analysis were performed using R software. Acute inflammatory cell invasion was observed at 2 weeks, which almost disappeared at week 8 after implant. Only macrophages and giant cells increased between Weeks 8 and 12 (OR 10.487, CI [1.603-97.327]). The cartilage maintained its structure, with slight signs of ischemia in a few cases. New CD31-positive vessels were observed from Week 2 and increasing thereafter, reaching a maximum peak at Week 8. We propose a bilateral implant technique that is viable and effective as a prelamination option for two concurrent tracheas, achieving perfect vascularization and integration of the organ with hardly any inflammatory response in the medium or long term.

中文翻译：

脱细胞气管预层压植入物：提议的双侧双器官技术

在气管置换移植中，预层压是一个关键阶段。目前应用最广泛的预层压技术是胸外侧动脉胸前筋膜瓣。我们提出了一种基于胸廓内动脉的皮瓣，该皮瓣允许进行相对非侵袭性的双器官植入，并且我们已经测试了其在脱细胞气管中的功效。白化新西兰兔的气管按照使用清洁剂和低温化的方案进行脱细胞，用 1kGy 伽马辐射消毒，并用支架进行指导。通过纵向 3 厘米的胸廓中央切口收获由胸筋膜和肌肉成分制成的双侧带蒂皮瓣，用它们包裹 16 只兔子的气管，植入 2、4、8 和 12 周。然后使用标准染色加免疫组织化学（CD31）对气管进行组织学研究。使用序数回归对模型进行贝叶斯统计调整；结果为优势比和可信区间。所有分析均使用 R 软件进行。2周观察到急性炎症细胞侵袭，植入后8周几乎消失。在第 8 周和第 12 周之间只有巨噬细胞和巨细胞增加（OR 10.487，CI [1.603-97.327]）。软骨保持其结构，在少数情况下有轻微的缺血迹象。从第 2 周开始观察到新的 CD31 阳性血管，此后增加，在第 8 周达到最大峰值。我们提出了一种可行且有效的双侧植入技术，作为两个并发气管的预层压选择，

更新日期：2021-07-26

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