Transplant of trachea in a porcine model with decellularized allografts and regenerated in omentum

Abstract

Trachea transplantation is a therapeutic option when end-to-end resection and anastomosis is not possible, the disadvantages such as organ availability, histocompatibility, immunosuppressive therapy, revascularization and regeneration of epithelium are intended to be overcome using decellularized and regenerated grafts in porcine models. Five transplants were performed in pigs, two with decellularized grafts, one native cryopreserved, another decellularized and reinforced with polymer, respiratory epithelial cells and prostaglandins, and one autologous. All were regenerated in the omentum of the recipient pigs before transplantation, except the autologous graft. The survival and characteristics of the grafts were evaluated. All the animals died in the first eight days after the transplant. The grafts prior to the transplant presented little rigidity, with good vascularity, except the reinforced one and the autologous presented normal characteristics. After the transplant, the grafts lost rigidity, vascularity and respiratory epithelium, presented necrosis and stenosis. Inflammation in the graft with polymer and the cryopreserved. The pigs died of respiratory failure due to the collapse of the trachea because of the lack of stiffness of the grafts, necrosis and stenosis due to the lack of revascularization and epithelial regeneration post-transplant. The inflammation was due to the polymer and the immunogenicity in the cryopreserved graft. The failure of the autologous demonstrates that revascularization and regeneration of epithelium is still not resolved and does not depend on graft conditions prior to transplantation.