Regeneration of Trachea Graft with Cartilage Support, Vascularization, and Epithelization

Abstract

The repair and functional reconstruction of long-segment tracheal defects is always a great challenge in the clinic. Finding an ideal substitute for tracheal transplantation is the only way to solve this problem. To address these problems, the current study proposed a series of novel strategies. For large-volume cartilage regeneration, a cartilage sheet technique (without any extra materials) was adopted to avoid the inflammatory reaction triggered by the materials and form homogeneous, mature cartilage in autologous goat model. For vascularization, the flat trapezius fascia flap with double blood supply was separated by microsurgical techniques to achieve stable pre-vascularization of the regenerated cartilage and grafted epithelium simultaneously. Finally, transplantation of the oral mucosal epithelium was used to realize epithelialization. By integrating the above strategies, a vascularized and epithelialized tracheal tissue with tubular cartilage support was successfully constructed in a goat model, which provides an ideal tracheal substitute for the repair and permanent functional reconstruction of long-segment tracheal defects. Funding: This research was supported by The National Key Research and Development Program of China (2017YFC1103900), The Key Research and Development Program of Shandong (2016GGB14002), National Natural Science Foundation of China (31400830, 31700837 and 81571823), Shanghai Science and Technology Committee (16QB1400600), and Program for Shanghai Outstanding Medical Academic Leader, Graduate Student Innovation Fund of Shanghai Jiao Tong University School of Medicine (BXJ201831, to Zongqi Yin.), and PUMC Youth Fund and the Fundamental Research Funds for the Central Universities (3332014047). Declaration of Interest: We declare that we have no conflicts of interest. Ethical Approval: Animal experiments were approved by the Shanghai Jiao Tong University Committee on Animal Care and were conducted by the Key Laboratory of Tissue Engineering at Shanghai Ninth People’s Hospital, affiliated with Shanghai Jiao Tong University in China. All experiments involving animals were performed in accordance with the approved guidelines.