Rabbits that had undergone segmental reconstruction showed good tracheal integration, had a viable epithelium with vascular support, and the cartilage was sufficiently strong to maintain a lumen when palpated. Histological examination showed the presence of variable amounts of viable epithelium, a vascularized platysma flap, and a layer of safranin O-positive cartilage along with evidence of endochondral ossification. Of the 15 structurally sound neotracheas, 11 were used for segmental reconstruction and were left in place for up to 21 days. Initially, the success rate of producing structurally sound neotracheas was impeded by physical disruption of the cartilage sheets during animal handling, but by the end of the study, 15 of 18 neotracheas (83.3%) were structurally sound. In 11 cases, neotracheas deemed sufficiently strong were used to repair segmental tracheal defects. In total, 28 rabbits were implanted and the neotracheas assessed for tissue morphology.

Neotracheas were formed in the rabbit neck by wrapping a silicone tube with consecutive layers of skin epithelium, platysma muscle and an engineered cartilage sheet, and allowing the construct to mature for 8-12 weeks.

Engineered tracheal replacements composed of autologous cells ('neotracheas') were tested in a New Zealand White rabbit model. The goal of this study is to apply tissue engineering principles for the fabrication of large segmental trachea replacements. The repair of large tracheal segmental defects remains an unsolved problem.

Baylor college of medicine email