Development of a new method of tracheal transplantation for clinical application

在本研究中，我们探讨了犬气管在含有海藻糖的保存液（TC溶液）中长期冷冻保存的可能性，研究了长期冷冻保存后无免疫抑制剂的犬气管异体移植的可能性，确定了气管移植的最大可能长度，并尝试了一种新的手术方法来实现移植气管移植的可靠血运重建。我们证明了气管在TC溶液中持续低温保存1个月是可能的，无免疫抑制剂的犬气管异体移植在TC溶液中持续低温保存9个月是可能的，即使有网膜固定术，也不可能使用放射移植物进行十环气管异体移植，并且称为“分裂气管移植”的新手术是一种简单可靠的延长气管切除的方法。随后，我们探讨了无免疫抑制剂犬经TC溶液冷冻保存9个月后的十环气管移植与分离气管移植相结合的可行性。然而，动物死于气管狭窄，可能是由于移植物的生存能力受损。综上所述，当低温保存既能减少异体性又能维持气管移植物的生存能力时，我们将在不久的将来使临床气管移植成为可能。

In this study, we investigated the possibility of prolonged cryoprescrvation of canine tracheas in a preservation solution containing trehalose (TC solution), examined the possibility of immnosuppressant-free canine tracheal allotransplantation after long-term cryopreservation, determined the maximum possible length of tracheal grafts, and tried a new operative proccdure to accomplish reliable revascularization of transplanted tracheal grafts. We demonstrated that consistent cryopreservation of the trachea for 1 month is possible in TC solution, immunosuppressant-free canine tracheal allotransplantation is consistently possible after 9 months of cryopreservation of the graft in TC solution, the impossibility of performing ten-ring tracheal allotransplantation using irradiated grafts even with omentopexy, and that the new proccdure called "split tracheal transplantation" is an easy and reliable way to extend tracheal resection. Thereafter, we examined the feasibility of the combination of immunosuppressant-free canine ten-ring tracheal allotransplantation after 9 months of cryopreservation with TC solution and the split tracheal transplantation. However, the animals died from tracheal stenosis presumably due to impaired viability of the grafts. In conclusion, we will make clinical tracheal allotransplantation possible in the near future, when both of reduction of allogenicity and maintenance of viability of tracheal grafts become fesible by means of cryopreservation.