NARUKE Yoshiki Yamagata Univ, Med, Instructor, 医学部, 助手 (30301071)
FUJISHIMA Tsukasa Yamagata Univ, Med, Instructor, 医学部, 助手 (90292424)
SHIMAZAKI Yasuhisha Yamagata Univ, Med, Professor, 医学部, 教授 (60116043)
|Budget Amount *help
¥3,400,000 (Direct Cost : ¥3,400,000)
Fiscal Year 1999 : ¥500,000 (Direct Cost : ¥500,000)
Fiscal Year 1998 : ¥2,900,000 (Direct Cost : ¥2,900,000)
Objective : We have previously reported that removal of some cartilage rings (CR) of thee graft and omentopexy provided sufficient blood flow to the graft for successful extended autotransplantation and allotransplantation with immunosupression. We evaluated the feasibility of removal of CR in allotransplantation about the cryopreserved trachea a mongrel dogs without immunosuppression.
Methods : 1) Tracheal transplantation : Eighteen 10 CR length of the trachea were harvested. In group A (n=6), central 6 CR were removed. In group B (n=6), CR were removed in segmental fashion. In group C(n=6), CR were not removed. In 18 dogs, a 10 CR length of the trachea was allotransplanted. 2) Carinal transplantation : Ten allografts (tracheal carina) were harvested. In group A (n=5), CR were removed in segmental fashion. In group B(n=5), CR were not removed. In 10 dogs, a tracheal carina was allotransplanted
Results : 1) Tracheal transplantation : In group A, 3 dogs died of graft stenosis within 4 weeks after. Among 6 dogs of the group B, 2 grafts showed stenosis, but survived for more than 4 weeks. In group C, all dogs died of graft stenosis within 4 weeks after surgery. 2) Carinal transplantation : In Amp A, 2 dogs showed severe graft stenosis, 1 showed moderate, and stenosis was mild in 2. In group B, 3 dogs showed severe graft stenosis, and stenosis was moderate in 2. within 9 weeks, one dying of pneumonia, and only one (13%) survived for more than one year, until being sacrificed. In group C, all six dogs died of graft stenosis within 6 weeks.
Conclusions : Segmental removal of cartilage rings, in cryopreserved tracheal allotransplantation without immunosuppression may enable tracheal allografts to remain viable over longer periods, but stenosis can not be avoided in many instances.