Abstract
Since the 1980s, tissue engineering has become one of the major areas of endeavor in medical research, applying the principles of biology and engineering to the development of functional substitutes for damaged tissue. Using this technology, various attempts have been made to create and apply a tissue-engineered prosthetic trachea, or airway. In addition to the conventional tissue engineering approach, a new substantially different concept has been advocated in Japan since 2000. This is “in situ tissue engineering,” where a tissue is created not in vitro but in vivo, exploiting the potential of the living body for wound healing. An artificial trachea created by in situ tissue engineering has already been applied in human patients for reconstruction of airway defects, and promising results have been obtained. This article reviews recent progress in the relatively new field of airway reconstruction employing tissue engineering.
Similar content being viewed by others
References
Langer R, Vacanti JP. Tissue engineering. Science 1993;260:920–926.
Rob CG, Baterman GH. Reconstruction of the trachea and cervical oesophagus. Br J Surg 1949;37:202.
Neville WE, Bolanowski JP, Kotia GG. Clinical experience with the silicone tracheal prosthesis. J Thorac Cardiovasc Surg 1990;99:604–612; discussion 612–3.
Matsubara Y, Kosaba S, Ikeda S, Hanawa T, Shiota T, Ishida H, et al. Experimental and clinical results of tracheal prosthesis. Kyobu Geka 1990;43:368–373; discussion 373–4.
Ikeda S, Matsubara Y, Kosaba S, Yagi K, Hanawa T, Enokibori T, et al. The present state and future of prosthetic reconstruction of trachea and bifurcation. JJSB (Journal of the Japan Society for Bronchology) 1986;8:421–431.
Theman TE, Kerr JH, Nelems JM, Pearson FG. Carinal resection: a report of two cases and a description of the anesthetic technique. J Thorac Cardiovasc Surg 1976;71:314–320.
Grillo HC. Reconstruction of the trachea: experience in 100 consecutive cases. Thorax 1973;28:667–679.
Wright CD, Grillo HC, Wain JC, Wong DR, Donahue DM, Gaissert HA, et al. Anastomotic complications after tracheal resection: prognostic factors and management. J Thorac Cardiovasc Surg 2004;128:731–739.
Grillo HC. Tracheal replacement: a critical review. Ann Thorac Surg 2002;73:1995–2004.
Grillo HC, Dignan EF, Miura T. Extensive resection and reconstruction of mediastinal trachea without prosthesis or graft: an anatomical study in man. J Thorac Cardiovasc Surg 1964;48:741–749.
Mulliken JB, Grillo HC. The limits of tracheal resection with primary anastomosis: further anatomical studies in man. J Thorac Cardiovasc Surg 1968;55:418–421.
Sakata J, Vacanti CA, Schloo B, Healy GB, Langer R, Vacanti JP. Tracheal composites tissue engineered from chondrocytes, tracheal epithelial cells, and synthetic degradable scaffolding. Transplant Proc 1994;26:3309–3310.
Rainer C, Wechselberger G, Bauer T, Neumeister MW, Lille S, Mowlavi A, et al. Transplantation of tracheal epithelial cells onto a prefabricated capsule pouch with fibrin glue as a delivery vehicle. J Thorac Cardiovasc Surg 2001;121:1187–1193.
Vacanti CA, Paige KT, Kim WS, Sakata J, Upton J, Vacanti JP. Experimental tracheal replacement using tissue-engineered cartilage. J Pediatr Surg 1994;29:201–204; discussion 204–5.
Kojima K, Bonassar LJ, Roy AK, Vacanti CA, Cortiella J. Autologous tissue-engineered trachea with sheep nasal chondrocytes. J Thorac Cardiovasc Surg 2002;123:1177–1184.
Langer R, Vacanti JP. Tissue engineering. Science 1993;260:920–926.
Kojima K, Ignotz RA, Kushibiki T, Tinsley KW, Tabata Y, Vacanti CA. Tissue engineered trachea from sheep marrow stromal cells with transforming growth factor beta2 released from biodegradable microspheres in a nude rat recipient. J Thorac Cardiovasc Surg 2004;128:147–153.
Moiemen NS, Elliot D. Composite graft replacement of digital tips. 2. A study in children. J Hand Surg [Br] 1997;22:346–352.
Rose K-G, Sesterhenn K, Wustrow F. Tracheal allotransplantation in man. Lancet 1979;1:433.
Jacobs JP, Quintessenza JA, Andrews T, Burke RP, Spektor Z, Delius RE, et al. Tracheal allograft reconstruction: the total North American and worldwide pediatric experiences. Ann Thorac Surg 1999;68:1043–1051.
Elliott MJ, Haw MP, Jacobs JP, Bailey CM, Evans JN, Herberhold C. Tracheal reconstruction in children using cadaveric homograft trachea. Eur J Cardiothorac Surg 1996;10:707–712.
Delaere P, Vranckx J, Verleden G, De Leyn P, Van Raemdonck D. Tracheal allotransplantation after withdrawal of immunosuppressive therapy. N Engl J Med 2010;362:138–145.
Macchiarini P, Walles T, Biancosino C, Mertsching H. First human transplantation of a bioengineered airway tissue. J Thorac Cardiovasc Surg 2004;128:638–641.
Macchiarini P, Jungebluth P, Go T, Asnaghi MA, Rees LE, Cogan TA, et al. Clinical transplantation of a tissue-engineered airway. Lancet 2008;13:2023–2030.
Martinod E, Seguin A, Holder-Espinasse M, Kambouchner M, Duterque-Coquillaud M, Azorin JF, et al. Tracheal regeneration following tracheal replacement with an allogenic aorta. Ann Thorac Surg 2005;79:942–949.
Seguin A, Radu D, Holder-Espinasse M, Bruneval P, Fialaire-Legendre A, Duterque-Coquillaud M, et al. Tracheal replacement with cryopreserved, decellularized, or glutaraldehydetreated aortic allografts. Ann Thorac Surg 2009;87:861–868.
Makris D, Holder-Espinasse M, Wurtz A, Seguin A, Hubert T, Jaillard S, et al. Tracheal replacement with cryopreserved allogenic aorta. Chest 2010;137:60–67.
Wurtz A, Prote H, Conti M, Desbordes J, Copin MC, Azorin J, et al. Tracheal replacement with aortic allografts. N Engl J Med 2006;355:1938–1940.
Cahan WG. Carcinoma of intrathoracic trachea: excision and repair of tantalum gauze-fascia lata graft: report of a case. J Thorac Surg 1952;23:513–527.
Poticha SM, Lewis FJ. Experimental replacement of the trachea. J Thorac Cardiovasc Surg 1966;52:61–67.
Moghissi K. Tracheal reconstruction with a prosthesis of Marlex mesh and pericardium. J Thorac Cardiovasc Surg 1975;69:499–506.
Pearson FG, Henderson RD, Gross AE, Ginsberg RJ, Stone RM. The reconstruction of circumferential tracheal defects with a porous prosthesis. J Thorac Cardiovasc Surg 1968;55:605–616.
Beall AC, Harrington OB, Greenberg SD, Morris GC, Usher FC. Tracheal reconstruction with heavy Marlex mesh. Arch Surg 1963;86:112–120.
Jacobs JR. Investigations into tracheal prosthetic reconstruction. Laryngoscope 1988;98:1239–1245.
Shimizu Y, Tamura K, Kato H, Teramatsu T, Hino T. Study of artificial trachea using mesh. Jpn J Artif Organs 1983;12:486–489.
Natsume T, Ike O, Okada T, Takimoto N, Shimizu Y, Ikada Y. Porous collagen sponge for esophageal replacement. J Biomed Mater Res 1993;27:867–875.
Pearson FG, Henderson RD, Gross AE, Ginsberg RJ, Stone RM. The reconstruction of circumferential tracheal defects with a porous prosthesis: an experimental and clinical study using heavy Marlex mesh. J Thorac Cardiovasc Surg 1968;55:605–616.
Hori Y, Nakamura T, Kimura D, Kaino K, Kurokawa Y, Satomi S, et al. Experimental study on tissue engineering of the small intestine by mesenchymal stem cell seeding. J Surg Res 2002;102:156–160.
Okamoto T, Yamamoto Y, Gotoh M, Huang CL, Nakamura T, Shimizu Y, et al. Slow release of bone morphogenetic protein 2 from a gelatin sponge to promote regeneration of tracheal cartilage in a canine model. J Thorac Cardiovasc Surg 2004;127:329–334.
Kawaguchi S, Nakamura T, Shimizu Y, Masuda T, Takigawa T, Liu Y, et al. Mechanical properties of artificial tracheas composed of a mesh cylinder and a spiral stent. Biomaterials 2001;22:3085–3090.
Nakamura T, Teramachi M, Sekine T, Kawanami R, Fukuda S, Yoshitani M, et al. Artificial trachea and long term followup in carinal reconstruction in dogs. Int J Artif Organs 2000;23:718–724.
Okumura N, Nakamura T, Natsume T, Tomihata K, Ikada Y, Shimizu Y. Experimental study on a new tracheal prosthesis made from collagen-conjugated mesh. J Thorac Cardiovasc Surg 1994;108:337–345.
Teramachi M, Okumura N, Nakamura T, Yamamoto Y, Kiyotani T, Takimoto Y, et al. Intrathoracic tracheal reconstruction with a collagen-conjugated prosthesis: evaluation of the efficacy of omental wrapping. J Thorac Cardiovasc Surg 1997;113:701–711.
Sekine T, Nakamura T, Liu Y, Ueda H, Matsumoto K, Shimizu Y. Collagen coated Y-shaped prosthesis for carinal replacement promotes regeneration of the tracheal epithelium. ASAIO J 2000;46:421–425.
Sekine T, Nakamura T, Matsumoto K, Liu Y, Ueda H, Tamura N, et al. Carinal reconstruction with a Y-shaped collagen-conjugated prosthesis. J Thorac Cardiovasc Surg 2000;119:1162–1168.
Sato T, Araki M, Nakajima N, Omori K, Nakamura T. Biodegradable polymer coating promotes the epithelialization of tissue-engineered airway prostheses. J Thorac Cardiovasc Surg 2010;139:26–31.
Omori K, Tada Y, Suzuki T, Nomoto Y, Matsuzuka T, Kobayashi K, et al. Clinical application of in situ tissue engineering using a scaffolding technique for reconstruction of the larynx and trachea. 2008;117:673–678.
Omori K, Nakamura T, Kanemaru S, Asato R, Yamashita M, Tanaka S, et al. Regenerative medicine of the trachea: the first human case. Ann Otol Rhinol Laryngol 2005;114:429–433.
Nakamura T, Sato T, Araki M, Ichihara S, Nakada A, Yoshitani M, et al. In situ tissue engineering for tracheal reconstruction using a luminar remodeling type of artificial trachea. J Thorac Cardiovasc Surg 2009;138:811–819.
Nakagawa M, Koyanagi M, Tanabe K, Takahashi K, Ichisaka T, Aoi T, et al. Generation of induced pluripotent stem cells without Myc from mouse and human fibroblasts. Nat Biotechnol 2008;26:101–106.
Rubio D, Garcia-Castro J, Martin MC, de la Fuente R, Cigudosa JC, Lloyd AC, et al. Spontaneous human adult stem cell transformation. Cancer Res 2005;65:3035–3039.
Pittenger MF, Mackay AM, Beck SC, Jaiswal RK, Douglas R, Mosca JD, et al. Multilineage potential of adult human mesenchymal stem cells. Science 1999;284:143–147.
Suzuki T, Kobayashi K, Tada Y, Suzuki Y, Wada I, Nakamura T, et al. Regeneration of the trachea using a bioengineered scaffold with adipose-derived stem cells. Ann Otol Rhinol Laryngol 2008;117:453–463.
Nakada A, Fukuda S, Ichihara S, Sato T, Itoi S, Inada Y, et al. Regeneration of central nervous tissue using a collagen scaffold and adipose-derived stromal cells. Cells Tissues Organs 2009;190:326–335.
Adachi N, Ochi M, Deie M, Ito Y. Transplant of mesenchymal stem cells and hydroxyapatite ceramics to treat severe osteochondral damage after septic arthritis of the knee. J Rheumatol 2005;32:1615–1618.
Sato T, Nakamura T. Tissue-engineered airway replacement. Lancet 2008;372:2003–2004.
Author information
Authors and Affiliations
Corresponding author
Additional information
This review was submitted at the invitation of the editorial committee.
Rights and permissions
About this article
Cite this article
Nakamura, T., Ohmori, K. & Kanemaru, Si. Tissue-engineered airway and “in situ tissue engineering”. Gen Thorac Cardiovasc Surg 59, 91–97 (2011). https://doi.org/10.1007/s11748-010-0677-9
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-010-0677-9