Experimental tracheal transplantation. Review of the literature and proposal of an original surgical technique

The reconstruction of the trachea after wide resections remains a critical surgical problem.Our aim has been to replace trachea with a tissue easy to be vascularized, that permits a simple reconstruction, not requiring an immunosupressive regimen. We have used a segment of cryopreserved aorta. In the first phase the thoracic aorta of 10 rabbits was excised obtaining 20 segments that were cryopreserved. Ten segments were implanted in the omentum of 10 rabbits that were sacrificed on postoperative day 7,14 and 21. The histologic examination of the grafts showed the presence of neovascularization after 7 days with obliteration of the lumen by fibroblasts after 14 days. In the next phase the cryopreserved aorta replaced an excised segment of trachea. The survived animals were sacrificed 7 and 14 days after the operation. The histologie examination showed the neovascularization of the graft and the absence of rejection.