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Allowable warm ischemic time to tracheal extraction for allotransplantation of cryopreserved trachea

  • Yasuhiro Kitamura
  • Nobuyoshi Shimizu
  • Motoi Aoe
  • Hiroshi Date
  • Itaru Nagahiro
  • Akio Andou
Original Article

Abstract

Objective: The allowable warm ischemic time from circulatory arrest to tracheal extraction for allotransplantation of cryopreserved tracheal grafts from cadaveric donors was examined in adult mongrel dogs. Subjects and Methods: The animals were divided into 4 groups (n=28) according to the warm ischemic time of less than 1 hour, 3 hours, 6 hours, and 12 hours, after transplantation, and comparisons were made. The grafts were cryopreserved for at least 2 months and were evaluated by extraction from the recipients generally 2 months after transplantation. Results: All the grafts with a warm ischemic time of less than 1 hour were viable and did not show stenosis. This group did not differ significantly from the groups with a warm ischemic time of 3 and 6 hours in terms of viability. However, all of the grafts with a warm ischemic time of 12 hours showed stenosis, and there was a significantly lower viability rate. Histological examination of the grafts showed that warm ischemia caused necrosis of the tracheal cartilage. Conclusion: Based on these results, it was concluded that 6 hours was the maximum allowable warm ischemic time for cryopreserved tracheal transplantation, and that necrosis of the tracheal cartilage due to warm ischemia reduced the viability of the grafts.

Key words

warm ischemic time tracheal allotransplantation cryopreservation 

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References

  1. 1.
    Elliot MJ, Haw MP, Jacobs JP, Bailey CM. Tracheal reconstruction in children using cadaveric homograft trachea. Eur J Cardiothorac Surg 1996; 10: 707–12.CrossRefGoogle Scholar
  2. 2.
    Jacobs JP, Elliot MJ, Haw MP, Bailey CM, Herber-hold C. Pediatric tracheal homograft reconstruction: A novel approach to complex tracheal stenoses in children. J Thorac Cardiovasc Surg 1996; 112: 1549–60.PubMedCrossRefGoogle Scholar
  3. 3.
    Grillo HC. Tracheal replacement. Ann Thorac Surg 1990; 49: 864–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Dingman RO, Argenta LC. Reconstruction of the chest wall. Ann Thorac Surg 1981; 32: 202–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Alonso WA, Bridger GP, Bordley JE. Tracheal transplantation in dogs. Laryngoscope 1972; 82: 204–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Yokomise H, Inui K, Wada H, Ueda M, Hitomi S. Long-term cryopreservation can prevent rejection of canine tracheal allografts with preservation of graft viability. J Thorac Cardiovasc Surg 1996; 111:930–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Kawahara K, Inutsuka K, Hiratsuka M, Makihata S, Okabayashi K, Shiraishi T. Tracheal transplantation for carinal reconstruction in dogs. J Thorac Cardiovasc Surg 1998; 116:397–401.PubMedCrossRefGoogle Scholar
  8. 8.
    Yokomise H, Inui K, Wada H, Hasegawa S, Ohno N, Hitomi S. Reliable cryopreservation of trachea for one month in a new trehalose solution. J Thorac Cardiovasc Surg 1995; 110: 382–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Nakanishi R, Hashimoto M, Muranaka H, Umesue M, Kohno H, Yasumoto K. Maximal period of cryopreservation with the Bicell biofreezing vessel for rat tracheal isografts. J Thorac Cardiovasc Surg 1999; 117: 1070–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Tojo T, Kitamura S, Gojo S, Kushibe K, Nezu K, Taniguchi S. Epithelial regeneration and preservation of tracheal cartilage after tracheal replacement with cryopreserved allograft in the rat. J Thorac Cardiovasc Surg 1998; 116: 624–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Hare GM, Evans PJ, Mackinnon SE, Nakao Y, Midha R, Wade JA, et al. Effect of cold preservation on lymphocyte migration into peripheral nerve allografts in sheep. Transplantation 1993; 56:154–62.PubMedCrossRefGoogle Scholar
  12. 12.
    Flesch BK, Entenmann H, Milde K, Bretzel RG, Federlin K. Islet transplantation in experimental diabetes of the rat. III. Cryopreservation reduces MHC class II but not class I antigens of rat pancreatic islets. Horm Metab Res 1991; 23: 1–6.PubMedCrossRefGoogle Scholar
  13. 13.
    Kawabe N, Yoshinao M. Cryopreservation of cartilage. IntOrthop 1990; 14: 231–5.Google Scholar
  14. 14.
    Mukaida T, Shimizu N, Aoe M, Andou A, Date H. New simple method of tracheal cryopreservation for clinical transplantation. Organ Biology 1997; 4:59–63.Google Scholar
  15. 15.
    Mukaida T, Shimizu N, Aoe M, Andou A, Date H, Okabe K, et al. Experimental study of tracheal allotransplantation with cryopreserved grafts. J Thorac Cardiovasc Surg 1998; 116:262–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Moriyama S, Shimizu N, Teramoto S. Experimental tracheal allotransplantation using omentopexy. Transplant Proc 1986; 21: 2596–600.Google Scholar
  17. 17.
    Mukaida T, Shimizu N, Aoe M, Andou A, Date H, Moriyama S. Origin of regenerated epithelium in cryopreserved tracheal allotransplantation. Ann Thorac Surg 1998; 66: 205–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Inutsuka K, Kawahara K, Takachi T, Okabayashi K, Shiraishi T, Shirakusa T. Reconstruction of trachea and carina with immediate or cryopreserved allografts in dogs. Ann Thorac Surg 1996; 62:1480–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Yokomise H, Inui K, Wada H, Ueda M, Hitomi S. Long-term cryopreservation can prevent rejection of canine tracheal allografts with preservation of graft viability. J Thorac Cardiovasc Surg 1996; 111:930–4.PubMedCrossRefGoogle Scholar
  20. 20.
    Neville WE, Bolanowiski PJ, Soltanzadeth L. The effects of variation of cryopreservation protocols on the immunogenicity of allogenic skin grafts. Cryobiology 1993; 30: 443–58.CrossRefGoogle Scholar
  21. 21.
    Kushibe K, Tojo T, Sakaguchi H, Takahama M, Nishizaki K, Nezu K, et al. Effects of warm ischemia and cryopreservation on cartilage viability of tracheal allografts. Ann Thorac Surg 2000; 70: 1876–9.PubMedCrossRefGoogle Scholar

Copyright information

© Japanese Association for Thoracic Surgery 2004

Authors and Affiliations

  • Yasuhiro Kitamura
    • 1
  • Nobuyoshi Shimizu
    • 1
  • Motoi Aoe
    • 1
  • Hiroshi Date
    • 1
  • Itaru Nagahiro
    • 1
  • Akio Andou
    • 1
  1. 1.From Department of Cancer and Thoracic SurgeryOkayama University Graduate School of Medicine and DentistryOkayamaJapan

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