Category Archives: Allogenic Aorta

Tracheal Replacement by Allogenic Aorta in the Pig: Conclusion

Early results showing no evidence of ischemia or acute rejection were encouraging, despite the absence of blood or tissue compatibility, and without any IT. As in sheep, major inflammatory reactions in the graft were observed within the first 3 months. Subsequent fate of AA followed a similar pattern as in sheep, but over a longer period of time. Evidence of AA progressively vanished, but, microscopically, … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig: Discussion

Recently, Martinod et al’ and Seguin et al showed, in sheep, that heterotopic transplantation of fresh aortic homo, but also allografts, produced a respiratory conduit sharing fundamental elements of the trachea. No acute or chronic graft rejection was observed, a finding consistent with the experience of orthotopic aortic transplantation, in which only discrete immunologic reactions were noted despite the absence of any IT.> More intriguing … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig: PCR for the SRY Gene on Trachea and Graft

Gender prediction on SRY gene assay revealed positive results for samples from a male control minipig and negative results for the female control minipig. IGF1 amplification, used as a positive control of the PCR assay, was positive in both controls. SRY gene amplification was positive in the two aorta grafted into male minipigs studied at 10 months and 11 months, respectively (Fig 6). Enormous progress … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig: Pathology Findings

Macroscopic examination showed a typical whitish graft in early deaths (< 3 months). Later on, grafts consistently showed a thickened, pink, and flaccid aspect resembling an esophagus. In most cases, there was up to 50% longitudinal contraction of the graft. A cleavage plane could be found between the graft and the surrounding mediastinal tissue in the four animals examined > 9 months postoperatively. At that … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig: Clinical Evaluation

Two of the 14 pigs that underwent replacement of the extrathoracic trachea died within the first week, one from cervicitis due to anastomotic dehiscence and the other immediately after stent dislodgement. Despite fixation with absorbable sutures, the next five pigs also had stent migration and died after 2, 3, 4, 9, and 10 weeks, respectively. Improved fixation of the stent in the following 14 pigs … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig: Polymerase Chain Reaction for the SRY Gene on Trachea and Graft

Transplantation of a female aorta to into a male recipient enabled us to analyze the newly formed tissues, and especially cartilage, using the polymerase chain reaction (PCR) technique for detection of the SRY gene (attesting to the presence of the Y chromosome). Tracheal cartilage biopsy samples were obtained from male and female control minipigs. Biopsy samples were also obtained from the graft in areas grossly … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig: Histologic Examination

Follow-up and Evaluation: Pulse oximetry was measured throughout the surgical procedure. Clinical examination was performed daily thereafter. Follow-up bronchoscopies were performed as previously described on a monthly basis and at any other time if the animals showed signs of respiratory distress. Animal deaths were planned at 3, 6, and 12 months for macroscopic and microscopic evaluation and genetic study. Euthanasia was performed under general anesthesia … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig: Intrathoracic Tracheal Replacement

Since experience with the cervical trachea may not necessarily apply to the thoracic portion, we decided to replace the intrathoracic trachea. Pigs invariably have a cranial lobe including bronchus, vein, and artery originating from the right side of the trachea, approximately four to six rings above the main carina. Therefore, resection of the cranial lobe via right thoracotomy had to be performed first. Since ventilation … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig: Harvest of the AA

A 10-cm-long segment of the descending thoracic aorta was harvested under general anesthesia through a left thoracotomy in 21 female, large white-landrace piglets weighing 35 to 45 kg. The AAs were placed in isotonic sterile saline solution and transplanted within 2 h of harvesting. Matching of blood and tissue compatibility between recipient and donor was not attempted. Anesthesia: The animals were premedicated IM with midazolam … Continue reading

Tracheal Replacement by Allogenic Aorta in the Pig

Pathologic processes involving the trachea and the carina pose major difficulties for chest physicians. Although techniques have been developed enabling primary resection and reconstruction, extensive tracheal resections remains challenging and many nonresectable tumors are still managed palliatively by stenting and radiation. Fifteen years ago, at a time of major advances in organ transplantation, Hermes Grillo2 said “we have to remain very imaginative and open-minded about … Continue reading