Synthetic tracheal grafts seeded with bone marrow cells fail to generate functional tracheae : First long-term follow-up study
| Autor: | Cecilia Österholm, Raquel Themudo, Oscar E. Simonson, Karl-Henrik Grinnemo, Matthias Corbascio, Thomas Fux |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Thoracic Injuries Adenoid cystic carcinoma medicine.medical_treatment Iatrogenic Disease tracheal prosthesis Bone Marrow Cells 030204 cardiovascular system & hematology Anastomosis Dehiscence tracheal replacement Transplantation Autologous Young Adult 03 medical and health sciences Fatal Outcome 0302 clinical medicine Humans Medicine Lung transplantation Cells Cultured Bone Marrow Transplantation Retrospective Studies Tissue Engineering Tissue Scaffolds airway surgery business.industry Kirurgi Granulation tissue respiratory system medicine.disease Carcinoma Adenoid Cystic Surgery Trachea synthetic tracheal graft Treatment Outcome medicine.anatomical_structure 030228 respiratory system Carcinoma Mucoepidermoid Female Tracheal Neoplasms Bone marrow Segmental resection Cardiology and Cardiovascular Medicine Airway business |
| Popis: | Objective Synthetic tracheal grafts seeded with autologous bone marrow–mononuclear cells (BM-MNCs) have been described as becoming living and functional grafts representing a promising option for tracheal replacement for pathologies unamenable by segmental resection or autologous repair. This study aimed to present the first long-term follow-up of these procedures in humans. Methods We retrospectively analyzed 3 patients who received synthetic tracheal grafts seeded with BM-MNCs implanted. Results Patient 1 was a 37-year-old man with mucoepidermoid carcinoma, the first-ever human to receive a synthetic tracheal graft seeded with BM-MNCs. Patient 2 was a 30-year-old man with adenoid cystic carcinoma, and patient 3 was a 22-year-old woman with an iatrogenic tracheal injury. All patients developed graft-related complications necessitating multiple surgical reinterventions. Patient 1 was hospitalized for 8 months before dying from respiratory failure secondary to graft dehiscence 32 months after implantation. Patient 2 died 3.5 months after implantation from undisclosed causes. Patient 3 received a second synthetic tracheal graft after 11 months and an allogeneic trachea and lung transplantation 45 months after the primary implantation. Patient 3 underwent 191 surgical interventions after the primary implantation and spent 55 months in the intensive care unit before dying from airway bleeding. All patients’ bronchoscopic, histologic, and radiologic investigations demonstrated graft-associated complications, including anastomotic fistulae and obstructive granulation tissue, without graft vascularization, mucosal lining, or integration into adjacent tissues. Conclusions Synthetic tracheal grafts seeded with BM-MNCs do not become living functional tracheal grafts and lead to debilitating complications and death. |
| Databáze: | OpenAIRE |
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