Abstract
Long segmental repair of trachea stenosis is an intractable condition in the clinic. The reconstruction of an artificial substitute by tissue engineering is a promising approach to solve this unmet clinical need. 3D printing technology provides an infinite possibility for engineering a trachea. Here, we 3D printed a biodegradable reticular polycaprolactone (PCL) scaffold with similar morphology to the whole segment of rabbits’ native trachea. The 3D-printed scaffold was suspended in culture with chondrocytes for 2 (Group I) or 4 (Group II) weeks, respectively. This in vitro suspension produced a more successful reconstruction of a tissue-engineered trachea (TET), which enhanced the overall support function of the replaced tracheal segment. After implantation of the chondrocyte-treated scaffold into the subcutaneous tissue of nude mice, the TET presented properties of mature cartilage tissue. To further evaluate the feasibility of repairing whole segment tracheal defects, replacement surgery of rabbits’ native trachea by TET was performed. Following postoperative care, mean survival time in Group I was 14.38 ± 5.42 days, and in Group II was 22.58 ± 16.10 days, with the longest survival time being 10 weeks in Group II. In conclusion, we demonstrate the feasibility of repairing whole segment tracheal defects with 3D printed TET.
Highlights
Trachea stenosis is a rare but life-threatening condition in patients
In our center alone we have nearly ten-years’ experience with the surgical management of congenital tracheal stenosis; still we find current surgical strategies have major limitations regarding the location and length of trachea stenosis, as well as postoperative problems with tracheomalacia and granulation formation[3]
With the progress of 3D printing techniques, it is possible to design an individualized tracheal model that is suitable for the host in morphology, as well as properly support force to maintain the shape of the TET10, 11
Summary
Trachea stenosis is a rare but life-threatening condition in patients. In adults, it is usually caused by prolonged endotracheal intubation, tracheostomy, trauma, trachea cancer and inflammation[1]. Several authors have attempted to make trachea scaffolds through the combination of Tissue-Engineering and 3D-Printing techniques[12,13,14,15,16]. These studies only aimed to fix the anterior-end defects of tracheas and further studies are needed in order to demonstrate similar technologies could be employed for whole segment tracheal replacement. We 3D-printed a scaffold of the whole segment of rabbit trachea, which had similar morphology to that of the native trachea as well as the proper support force to maintain the lumen. We presented a convenient method to achieve cartilage tissue regeneration and TET reconstruction, and used these TETs to replace the native rabbit trachea, in vivo, to demonstrate the feasibility and potential problems associated with these TETs
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