Reconstruction of the Central Airways: From the Aorta to the Trachea

In this issue ofJAMA, Martinod and colleagues report the results of a prospective, single-institution safety and feasibility trial of airway transplantation to reconstruct long-segment defects of the trachea and central bronchi. Over 6.5 years, 13 of 20 patients with end-stage tracheal lesions or proximal lung tumors requiring a pneumonectomy were enrolled in the study and underwent airway reconstruction with cryopreserved aortic allografts following definitive resection. Custom-made stents to support the allografts were used initially to prevent airway collapse but were removed at a postoperative mean duration of 18 months. A single patient undergoing carinal transplantation died postoperatively. With a median follow-up of nearly 4 years, 76.9% (10 of 13) of patients were alive and 80% (8 of 10) were breathing normally. Histological and molecular analysis of follow-up endobronchial biopsies showed regeneration of respiratory epithelium and de novo generation of cartilage within the aortic allografts from recipient cells.
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research