An early study suggests it may be feasible to use human aortic grafts preserved by freezing to rebuild windpipe and airway sections removed because of disease.
Why The Research Is Interesting: Airway replacement could potentially benefit many patients with lung cancer and be an option for patients with end-stage tracheobronchial disease.
Who and When: 20 patients with lung tumors or tracheal lesions, of which 13 patients had diseased airway sections removed and underwent airway transplantation (5 tracheal, 7 bronchial and 1 carinal, which is where the trachea divides into the bronchi of the lungs); study conducted from October 2009 through February 2017, with final patient follow-up in November 2017
What (Study Measures): Airway transplantation using a cryopreserved aortic graft and custom-made stent inserted into the graft to keep the airway from collapsing but was later removed (exposure); 90-day morality (primary outcome)
How (Study Design): This was a cohort study where people were followed over time.
Authors: Emmanuel Martinod, M.D., Ph.D., Assistance Publique-Hopitaux de Paris, Bobigny, France, and coauthors
- Overall 90-day mortality among initial 20 patients was 5% because one patient who underwent carinal transplantation died
- No deaths after 90 days among patients who underwent tracheal or bronchial reconstruction
- 10 of 13 patients who underwent transplantation alive after nearly four years
- 8 of 10 breathing normally through newly formed airways after stent removal
- New generation of cartilage was observed in transplanted areas
Study Limitations: Limited number of patients in this feasibility study at a single center without a comparison group; larger studies needed to further assess effectiveness and safety
Study Conclusions: This study demonstrated the feasibility for complex tracheal and bronchial reconstruction.