ArticlesFetal tissue engineering: In utero tracheal augmentation in an ovine model☆
Section snippets
Materials and methods
The Harvard Medical School animal management program is sanctioned by the American Association for the Accreditation of Laboratory Animal Care (AAALAC, file # 000009) and meets National Institutes of Health standards as set forth in the Guide for the Care and Use of Laboratory Animals (National Research Council Publication, Revised 1996).
Results
Fetal survival rates were 80% (12 of 15) and 100% (5 of 5) for groups I and II, respectively (P =.54). Of those allowed to reach term, postnatal survival rates were 100% (5 of 5) in group I and 90% (4 of 5) in group II (P = 1.0). Similarly, of the lambs permitted to reach term, 5 of 5 in the engineered group (group I) and 4 of 5 in the free graft group (group II) were able to breathe spontaneously at birth without mechanical ventilation (P = 1.0). Stridor was present in 3 of 5 animals in group
Discussion
Given the current limitations of fetal intervention, the use of fetal tissue engineering techniques, with or without in utero repair, can only be justified for life-threatening anomalies. Long-segment tracheal atresia and stenosis meet this criterion. Currently, mortality rates are high, reaching up to 77% for long-segment tracheal stenosis and nearly 100% for long-length tracheal atresia.6, 7, 8 To date, the optimal method and material for tracheal grafting and replacement have yet to be
Acknowledgements
The authors thank Jeffrey Petitt for his excellence in laboratory assistance.
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