Development of a bioartificial trachea by tissue engineering

Prof. Haverich, MHH, Germany

The Trachea is a tubular organ situated between larynx and main bronchi responsible for air exchange between lungs and environment. Its functionality depends on cartilage rings which enforce the wall and on integrity and functionality of a high specialized epithelium that covers its lumen. Supply is achieved by a multiplicity of small vessels that also connect simultaneously esophagus and thyroid gland.

Lateral excision and segmental tracheal wall resection are most common surgical techniques used for removal of tracheal pathological processes. However, reconstruction of this defects using artifical or unvascularized tissue may lead to complete failure due to loss of air thightness or to rejection and as a consequence to a high morbidity.

(The goal of this project is the development of a primary vascularized graft based on autologous cells and tissue by means of tissue enegineering possessing the following characteristics: Laterally rigid and longitudinally flexible tubular structure To posses his own vascular pedicle or be well vascularized = 6 cm Should allow an air-tight anastomosis Should grow Non immunogenic Infections resistant).

By using an autologous vascularized matrix (AutoVaM) in form of a small intestinal segment harvested from the patient, reinforced with cryopreserved tracheal cartilage rings and reseeded with the patients own epithelial cells, a tracheal graft should be engineered which perfectly matches the properties of an ideal substitute.