BAPS Paper
Patch tracheoplasty in body tissue engineering using collagenous connective tissue membranes (biosheets)

https://doi.org/10.1016/j.jpedsurg.2015.10.068Get rights and content

Abstract

Background

Collagenous connective tissue membranes (biosheets) are useful for engineering cardiovascular tissue in tissue engineering. The aim was to evaluate the use of biosheets as a potential tracheal substitute material in vivo in a rabbit model.

Methods

Group 1: Rectangular-shaped Gore-Tex (4 × 7 mm) was implanted into a 3 × 6 mm defect created in the midventral portion of the cervical trachea. Group 2: Rectangular-shaped dermis was implanted into a tracheotomy of similar size. Group 3: Biosheets were prepared by embedding silicone moulds in dorsal subcutaneous pouches in rabbits for 1 month.

Rectangular-shaped biosheets were implanted into a tracheotomy of similar size in an autologous fashion. All groups (each containing 10 animals) were sacrificed 4 weeks after implantation.

Main Results

All materials maintained airway structure for up to 4 weeks after implantation. Regenerative cartilage in implanted Biosheets in group 3 was confirmed by histological analysis. Tracheal epithelial regeneration occurred in the internal lumen of group 3. There were significant differences in the amounts of collagen type II and glycosaminoglycan between group 3 and group 1 or 2.

Conclusion

We confirm that cartilage can self-regenerate onto an airway patch using Biosheets.

Section snippets

Background

Kimura and associates at Kobe Children's Hospital in Japan first achieved success in patch tracheoplasty in 1982 by insertion into rib cartilage [1]. Re-epithelialization was found at the graft site in every case. However, an ongoing degenerative process was recognized in the graft [2]. Idriss and colleagues in 1984 reported pericardial patch tracheoplasty at the Children's Memorial Hospital in Chicago [3]. In addition, the clinical course of pericardial patch tracheoplasty required tracheal

Materials and methods

All procedures for the present experiments were approved by the animal care committee of Tokyo University (protocol no. P-13-101).

Results

Four weeks after implantation of a silicon tube into the subcutaneous pouch, collagenous connective tissue membranes surrounding the silicone tube were established (Fig. 1a). These connective tissues were white, thin, flexible sheets. In addition, on histological examination, fibrous tissues were recognized by H&E staining (Fig. 1b).

Tracheoplasty using each material was performed without technical difficulty. All rabbits survived and all materials maintained airway structure for 4 weeks after

Discussion

The present study documents that biosheets, which are collagenous connective tissue membranes produced by in-body tissue architecture technology, can maintain airway structure for up to 4 weeks after implantation. The most striking feature of patch tracheoplasty with biosheets was the self-generating capacity of airway cartilage and mucosal epithelium in the region of the patch after 4 weeks of tracheoplasty in a rabbit model. Use of dermis and artificial membranes in patch tracheoplasty could

Acknowledgement

This study was supported by grants from Kawano Masanori Memorial Foundation for Promotion of Pediatrics 2013 and a grant entitled “Study for complex airway reproduction by the new scaffold material using biotube”, JSPS KAKEN Grant Number 25462780. We appreciate the English language review of this article by NAI Inc., Yokohama, Japan.

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