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J Thorac Cardiovasc Surg 1998;116:397-401
© 1998 Mosby, Inc.

Cardiothoracic Transplantation

Tracheal transplantation for carinal reconstruction in dogs

From the Second Department of Surgery, Fukuoka University School ofMedicine, Fukuoka, Japan.

Received for publication Jan. 19, 1998; revisions requested March 25,1998; revisions received April 20, 1998; accepted for publication April 21,1998. Address for reprints: Katsunobu Kawahara, MD, Second Department ofSurgery, Fukuoka University School of Medicine, Jyohnannku Nanakuma 7-45-1,814-01, Fukuoka, Japan.

Background: Experimental carinalallotransplantation has been performed with tracheocarinal Y-shaped allograftsin dogs. In this study we tried canine carinal reconstruction with cylindricalallografts.
Material and methods: Carinal reconstruction wasperformed with allotransplantation of cylindrical trachea in dogs, and grafthealing was evaluated by bronchoscopic observation, mucosal blood flowmeasurement, and histologic examination. A section of the recipient carinacontaining five tracheal rings and two main stem bronchi was removed, and adonor trachea seven rings long was inserted between the recipient trachea andthe left main stem bronchus; then side-to-end anastomosis was performed betweenthe graft midportion and recipient right main stem bronchus (new carina). Thegrafts were wrapped with pedicled omentum. Fresh grafts were transplanted intoone group of dogs (n = 8 ), and graftscryopreserved for 1 week were transplanted into another group (n = 7).
Results:No anastomotic leakage occurred in any dog. Excellent healing of grafts andgraft anastomoses was observed by fiberoptic bronchoscopy in six dogs (75%)in the fresh graft group and in four dogs (57%) in the cryopreservedgraft group. The mucosal blood flow in the new carina decreased remarkably and,although it recovered, mucosal blood flow remained under the preoperative levelon day 28 after the operation.
Conclusion:Cylindrical tracheal allotransplantation is useful for carinal reconstruction,and the method of side-to-end anastomosis between the donor trachea andrecipient bronchus is a feasible and accessible procedure in dogs. (J ThoracCardiovasc Surg 1998;116:397-401)

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