medigraphic.com
A partir del año 2010, la Revista Oficial del INER cambió a NCT (Neumología y Cirugía de Tórax)

 Ver actualización

2009, Number 3

<< Back Next >>

Rev Inst Nal Enf Resp Mex 2009; 22 (3)

Tracheal replacement with cryopreserved bovine aorta. Experimental study

Olmos-Zúñiga JR, Villalba-Caloca J, Sotres-Vega A, Gaxiola-Gaxiola M, Santibáñez-Salgado A, Baltazares-Lipp M, Bañuelos-Moreno M, Hernández JC, Jasso-Victoria R

Language: Spanish
References: 37
Page: 171-181
PDF size: 209.74 Kb.


ABSTRACT

Background: Tracheal replacement remains a challenge for thoracic surgeons. Synthetic and biological substitutes have been used without satisfactory results, and therefore it is necessary to find the ideal prosthesis, synthetic of biological, to reestablish tracheal continuity.
Objective: To assess the integration and macroscopic and microscopic changes of cryopreserved bovine aorta used to replace a segment of cervical trachea in dogs.
Material and methods: Twelve dogs were operated: In group I (n = 6) dogs were submitted to an 8-rings tracheal allotransplantation, and in group II (n = 6) dogs received tracheal xenotransplantation with cryopreserved bovine aorta. Animals from group I received triple immunosuppressive therapy (azathioprine, methylprednisolone, cyclosporine). Clinical, radiological and tracheoscopic evaluations were accomplished during 4 weeks. At the end of the study, macroscopic and microscopic evaluations were done on the transplanted grafts.
Results: None of the animals completed the study period. Tracheoscopy and macroscopic evaluation showed necrosis and fistulae formation in all grafts. Microscopically they had necrosis, inflammation, vasculitis, hemorrhage and cartilage destruction. Aorta grafts developed total necrosis.
Conclusion: Results from this work indicate that xenografts of cryopreserved bovine aorta are not useful for tracheal segments replacement, since ischemia or graft rejection lead to necrosis and fistulae formation. More research has to be done by modifying cryopreservation and thawing processes, as well as the application of immunosuppressive therapy in the xenograft-receiving animal.


REFERENCES

  1. Cueto LGA. Problemática que plantea la reconstrucción traqueal tras una resección extensa. Neumosur 1993;5:3-4.

  2. Grillo HC. Benign and malignant diseases of the trachea. In: Shields TW, editor. General thoracic surgery. 3rd ed. Philadelphia: Lea & Febiger; 1989.p.667-679.

  3. Yokomise H, Inui K, Wada H, Ueda M, Hitomi S. Tracheal transplantation in dogs for future clinical application. Transplant Proc 1996;28:1763-1764.

  4. Olmos-Zúñiga JR, Eguiza-Rubí V, Jasso-Victoria R, et ál. Trasplante experimental de tráquea cervical combinado con la aplicación de factor de crecimiento de fibroblastos. Rev Inst Nal Enf Resp Mex 2006;19:172-179.

  5. Salmeron J, Gannon PJ, Blackwell KE, Shaari CM, Urken ML. Tracheal transplantation: superior and inferior thyroid artery perfusion territory. Laryngoscope 1998;108:849-853.

  6. Dodge-khatami A, Backer CL, Holinger LD, Mavroudis C, Cook KE, Grawfort SE. Healing of a free tracheal autograft is enhanced by topical vascular endothelial growth factor in an experimental rabbit model. J Thorac Cardiovasc Surg 2001;122:554-561.

  7. Olmos-Zúñiga JR, Ávila-Chávez A, Jasso-Victoria R, et ál. Cambios macroscópicos, microscópicos y morfométricos del autotrasplante traqueal dividido y omentopexia en perros. Rev Vet Mex 2005;36:189-204.

  8. Ohkado A, Hachida M, Hoshi H, et ál. Problems in preservation of allogenic heart values and vessels. Transplant Proc 1999;31:2047-2048.

  9. Molina JE, Edwards J, Bianco R, et ál. Growth of fresh-frozen pulmonary allograft conduit in growing lambs. Circulation 1989;80(3 Pt 1):l183-l190.

  10. Kirklin JK, Smith D, Novick W, et ál. Long-term function of cryopreserved aortic homografts. Aten-year study. J Thorac Cardiovasc Surg 1993;106:154-166.

  11. Especificaciones técnicas para el sacrificio humanitario de los animales domésticos y silvestres. Norma Oficial Mexicana NOM-033-ZOO-1995. Diario Oficial de la Federación, 16 julio, 1996. Estados Unidos Mexicanos.

  12. Heras RY. Evaluación de la utilidad y funcionalidad de la reconstrucción de la arteria pulmonar de perros, con aloinjertos de arteria pulmonar criopreservada (tesis de Maestría en Ciencias). México, D.F: Facultad de Medicina Veterinaria y Zootecnia, UNAM; 2008.

  13. Especificaciones Técnicas para la Producción, Cuidado y Uso de Animales de Laboratorio. Norma Oficial Mexicana NOM-062-ZOO-1999. Diario Oficial de la Federación 6 dic., 1999. Estados Unidos Mexicanos.

  14. National Institutes of Health USA. Guía para el cuidado y uso de los animales de laboratorio. Department of Health and Human Services, Public Health Service, National Institutes of Health USA. Edición mexicana auspiciada por la Academia Nacional de Medicina. México, D.F; 2002.

  15. Insel P. Analgésicos, antipiréticos y antiinflamatorios y fármacos antigotosos. En: Goodman A, editor. Las bases farmacológicas de la terapéutica. México: McGraw-Hill; 1996.p.661-705.

  16. Academy of Surgical Research. Course of animal anesthesia and models. Memories of the Course of Animal Anesthesia and Models of the 12th Annual Meeting and 1st International Conference of the Academy of Surgical Research, October 1996. Muenster, Germany: Academy of Surgical Research; 1996.

  17. Davies OG, Edmiston JM, McCorkle HJ. The repair of experimental tracheal defects with fresh and preserved homologus tracheal grafts. J Thorac Surg 1952;23: 367-376.

  18. Santillan-Doherty P, Jasso-Victoria R, Sotres-Vega A, et ál. Pulmonary perfusion during lung transplant rejection and experimental pneumonia. Transplantation 1992;53:533-535.

  19. Surveillance for respiratory hazards in the occupational setting (American Thoracic Society). Am Rev Respir Dis 1982;126:952-956.

  20. Meyer CM 3rd, O’Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994;103(4 Pt 1):319-323.

  21. Tena A. Análisis de los datos. En: Hernández R, Fernández C, Baptista P, editores. Metodología de la investigación. 3ra ed. México, D.F: McGraw-Hill/Interamericana; 2003.p.492-692.

  22. Grillo HC. Trachea replacement: a critical review. Ann Thorac Surg 2002;73:1995-2004.

  23. Faggioli G, Ricotta JV. Cryopreserved vein homograft for arterial reconstruction. Eur J Vasc Surg 1994;8: 661-669.

  24. Makris D, Holder-Espinasse M, Wurtz A, et ál. Tracheal replacement with cryopreserved allogenic aorta. Chest 2010;137:60-67.

  25. Seguin A, Radu D, Holder-Espinase M, et ál. Tracheal replacement with cryopreserved decellularized, or glutaraldehyde-treated aortic allografts. Ann Thorac Surg 2009;87:861-867.

  26. Anoosh F, Hodjati H, Dehghani S, Tanideh N, Kumar PV. Tracheal replacement by autogenous aorta. J Cardiothorac Surg 2009;4:23.

  27. Martinod E, Seguin A, Holder-Espinasse M, et ál. Tracheal regeneration following tracheal replacement with an allogenic aorta. Ann Thorac Surg. 2005;79: 942-948.

  28. Rábago G, Ruiz ML, Ubilla M, et ál. Trasplante de homoinjertos valvulares cardíacos y vasculares. An Sist Sanit Navar 2006;29 Supl 2:153-161.

  29. Zhou W, Lin PH, Bush RL, et ál. A. In situ reconstruction with cryopreserved arterial allografts for management of mycotic aneurysms or aortic prosthetic grafts infections: a multi-institutional experience. Tex Heart Inst J 2006;33:14-18.

  30. Rey LR. Basic aspects and future trends in the freeze-drying of pharmaceuticals. Dev Biol Stand 1992;74:3-8.

  31. Pegg DE, Wusteman MC, Boylan S. Fractures in cryopreserved elastic arteries. Cryobiology 1997;34:183-192.

  32. Veiga-Barreiro A, Rendal-Vázquez ME, Matheu-Capó G, et ál. Cambios histopatológicos en arterias humanas sometidas a procesos de isquemia fría y criopreservación. Angiología 2004;56:97-105.

  33. Sotres-Vega A, Baltazares-Lipp M, Villalba-Caloca J, et ál. Tracheal cryopreservation: caspase-3 immunoreactivity in tracheal epithelium and mixed glands. Braz J Med Biol Res 2009;42:1156-1162.

  34. Azorin JF, Bertin F, Martinod E, Laskar M. Tracheal replacement with and aortic autograft. Eur J Cardiothorac Surg 2006;29:261-263.

  35. Martinod E, Seguin A, Pfeuty K, et ál. Long-term evaluation of the replacement of the trachea with and autologous aortic graft. Ann Thorac Surg 2003;75: 1572-1578.

  36. Salassa JR, Pearson BW, Payne WS. Gross and microscopical blood supply of the trachea. Ann Thorac Surg 1977;24:100-107.

  37. López A, Chávez C, Granados J. Función biológica del complejo principal de histocompatibilidad. Rev Invest Clin 2005;57:132-141.




2020     |     www.medigraphic.com