Replacement of a Tracheal Stenosis with a Tissue-Engineered Human Trachea Using Autologous Stem Cells: A Case Report (Retracted article. See vol. 22, pg. 829, 2016)
Replacement of a Tracheal Stenosis with a Tissue-Engineered Human Trachea Using Autologous Stem Cells: A Case Report (Retracted article. See vol. 22, pg. 829, 2016)
复制标题
DOI：
10.1089/ten.tea.2012.0514
复制
发表时间：
2014-01-01
影响因子：
4.1
通讯作者：
Sumitran-Holgersson, Suchitra
中科院分区：
文献类型：
--
作者：
Berg, Malin;Ejnell, Hasse;Sumitran-Holgersson, Suchitra
涉及组织工程的基于细胞的疗法代表了治疗患有各种疾病的患者的有趣且潜在重要的策略。在这项研究中，使用洗涤剂-酶法，我们制备了一个完整的三维支架的细胞外基质来源于人尸体供体气管，我们重新填充自体干细胞，并植入到一个76岁的患者气管狭窄，包括喉的下部。尽管移植物为患者提供了开放的气道，但手术后一周，移植物的粘膜被1- 2 mm厚的真菌感染覆盖，并接受了局部和全身抗真菌治疗。术后通过纤维内窥镜控制气道腔，发现气道腔稳定且充足。然而，23天后，患者因心脏骤停死亡，但气管移植通畅、开放和稳定，并且呼吸系统完整。尸检期间移植气管移植物的组织学结果显示鳞状但非纤毛上皮、新血管形成、α-SMA阳性肌细胞束、浆液腺和神经纤维，粘膜下层中有S-100阳性神经细胞，软骨中有完整的软骨细胞。我们的研究结果表明，虽然自体干细胞工程气管基质可能代表临床气管替代的工具，需要进一步的临床前研究，以产生功能性气道移植物和长期影响，这种移植物。
Cell-based therapies involving tissue engineering represent interesting and potentially important strategies for the treatment of patients with various disorders. In this study, using a detergent-enzymatic method, we prepared an intact three-dimensional scaffold of an extracellular matrix derived from a human cadaver donor trachea, which we repopulated with autologous stem cells and implanted into a 76-year-old patient with tracheal stenosis including the lower part of the larynx. Although the graft provided the patient with an open airway, a week after the surgery, the mucous membrane of the graft was covered by a 1-2mm thick fungal infection, which was treated with local and systemic antifungal therapy. The airway lumen was postoperatively controlled by fiber endoscopy and found stable and sufficient. However, after 23 days, the patient died due to cardiac arrest but with a patent, open, and stable tracheal transplant and intact anastomoses. Histopathological results of the transplanted tracheal graft during autopsy showed a squamous but not ciliated epithelium, neovascularization, bundles of alpha-sma-positive muscle cells, serous glands, and nerve fibers with S-100-positive nerve cells in the submucosa and intact chondrocytes in the cartilage. Our findings suggest that although autologous stem cells-engineered tracheal matrices may represent a tool for clinical tracheal replacement, further preclinical studies are required for generating functional airway grafts and long-term effects of such grafts.