ORIGINAL ARTICLES  THORACIC SECTION 

The Journal of Cardiovascular Surgery 2002 April;43(2):275-9

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Tissue engineered tracheal prosthesis with acceleratedly cultured homologous chondrocytes as an alternative of tracheal reconstruction

Lee C. J., Moon K. D., Choi H., Woo J. I. *, Min B. H., Lee K. B. **

From the Department of Thoracic and Cardiovascular Surgery *Department of Orthopedic Surgery **Department of Pathology Ajou University School of Medicine Paldalgu, Suwon, Korea

Background. Autologous tis­sue is an ­ideal sub­stit­ue for an exten­sive tra­cheal recon­struc­tion, but it is rare­ly fea­sible in clin­i­cal sit­u­a­tions. Many tra­cheal pros­the­sis had ­been ­used for ­such an instanc­es, but unfor­tu­nate­ly it is ­still prob­le­mat­ic. Dislocation, ­local infec­tion, hemor­rage, and lumi­nal sten­o­sis can ­cause pros­thet­ic fail­ure. To ­achieve clin­i­cal­ly avail­able autol­o­gous tra­cheal pros­the­sis, it is nec­es­sa­ry ­that we ­have to get phe­no­typ­ical­ly func­tion­ing chon­droc­y­tes, rap­id dif­fe­ren­ti­a­tion of har­vest­ed autol­o­gous chon­droc­y­tes, and the sur­vi­val of ­free graft­ed cul­tured chon­droc­y­tes.
Methods. In ­this ­study, we inves­ti­gat­ed iso­la­tion and cul­ture meth­od of the chon­droc­y­tes ­using the rab­bit ­costal car­til­age, and the ­cells ­were char­ac­ter­ized micro­scop­i­cal­ly and bio­chem­i­cal­ly ­first. Then we ­have ­used cul­tured rab­bit chon­droc­y­tes to inves­ti­gate the ­role of ­growth fac­tors ­upon the pro­life­ra­tion and reg­u­la­tion of the cul­tured chon­droc­y­tes. We ­have exam­ined the ­effect of pep­tide ­growth fac­tors on DNA and pro­te­og­ly­can syn­the­sis to the rab­bit chon­dro­cyte. The ­effects of IGF-I and ­basic FGF ­were inves­ti­gat­ed indi­vid­u­al­ly. Secondly, accel­er­at­ed­ly cul­tured chon­droc­y­tes ­were embed­ed to poly­mer (­PLGA) sca­ffold in bio­reac­tor, and implant­ed to defect­ed rab­bit tra­chea. Six ­weeks lat­er, the rab­bits ­were sac­ri­ficed and exam­ined ­their his­to­log­ic char­ac­ter­is­tics.
Results. The har­vest­ed chon­droc­y­tes ­from ­costal ­arch ­grew ­well and ­were ampli­fied suc­cess­ful­ly mai­tain­ing ­their own phe­no­types. Its embed­ding to ­PLGA sca­ffold was accom­plished suc­cess­ful­ly. The implant­ed tra­cheal pros­the­sis main­tains its phys­i­cal integ­rity ­well, but the his­to­log­ic exam­ina­tion ­revealed non-­viable chon­droc­y­tes. The epi­the­lial lin­ings ­were ­good.
Conclusions. The tis­sue engi­neered tra­cheal pros­the­sis can be a promising alter­na­tive of ­good func­tion­al air way ­tube in ­short ­term experi­ment, but bio­log­i­cal­ly not ­vital yet. Further inves­ti­ga­tions are nec­es­sary to see the sur­vi­val of ­free graft­ed chon­droc­y­tes and the ­long ­term ­results.