Olmos-Zúñiga JR, Eguiza-Rubí V, Jasso-Victoria R, Sotres-Vega A, Gaxiola-Gaxiola M, Santibáñez-Salgado JA, Baltazares-Lipp M, Santillán-Doherty P, Villalba-Caloca J

Language: Spanish
References: 32
Page: 172-179
PDF size: 187.99 Kb.

ABSTRACT

Background: Tracheal transplantation of lesions larger than 6 cm fails due to ischemic complications. Growth factors and different surgical techniques, including the divided tracheal graft technique, have been used experimentally to stimulate the neoformation of blood vessels.
Objective: Assessment of the viability and macroscopic and microscopic changes of the cervical transplanted trachea in dogs, using the divided tracheal graft technique, combined with the application of basic fibroblast growth factor (bFGF) on the anastomotic site.
Material and methods: Twenty four mongrel dogs were divided in 4 study groups: Group I (n = 6): Transplantation of 9 cervical tracheal rings with the conventional surgical technique (TCTC). Group II (n = 6): TCTC combined with topical instillation of bFGF at on the anastomotic line. Group III (n = 6): Transplantation of cervical trachea using the divided tracheal graft technique (TCTD), and Group IV (n = 6): TCTD with topical application of bFGF. The animals received triple immunotherapy (azathioprine, methylprednisolone, cyclosporine) and were to have clinical, radiological and endoscopical evaluation during 4 weeks. At the end of the study, macroscopic and microscopic evaluations of the transplanted grafts were done.
Results: No animal completed the study time due to severe dyspnea during the first postoperative week. Macroscopically all grafts showed necrosis and fistulae formation. Microscopically we observed necrosis, inflammation, vasculitis, hemorrhage and destruction of cartilage in all the grafts.
Conclusion: In this study, tracheal allotransplantation longer than 6 cm with either surgical technique, with immunosuppression, with or without bFGF, is unsuccessful.

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