Tissue-Engineered Tracheal Replacement in a Child

A 4-Year Follow-Up Study

N. J. Hamilton, M. Kanani, D. J. Roebuck, R. J. Hewitt, R. Cetto, E. J. Culme-Seymour, E. Toll, A. J. Bates, A. P. Comerford, C. A. McLaren, C. R. Butler, C. Crowley, D. McIntyre, N. J. Sebire, S. M. Janes, C. O'Callaghan, C. Mason, P. De Coppi, M. W. Lowdell, M. J. Elliott & 1 others M. A. Birchall

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

In 2010, a tissue-engineered trachea was transplanted into a 10-year-old child using a decellularized deceased donor trachea repopulated with the recipient's respiratory epithelium and mesenchymal stromal cells. We report the child's clinical progress, tracheal epithelialization and costs over the 4 years. A chronology of events was derived from clinical notes and costs determined using reference costs per procedure. Serial tracheoscopy images, lung function tests and anti-HLA blood samples were compared. Epithelial morphology and T cell, Ki67 and cleaved caspase 3 activity were examined. Computational fluid dynamic simulations determined flow, velocity and airway pressure drops. After the first year following transplantation, the number of interventions fell and the child is currently clinically well and continues in education. Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity. Computational fluid dynamic analysis demonstrated increased velocity and pressure drops around a distal tracheal narrowing. Cross-sectional area analysis showed restriction of growth within an area of in-stent stenosis. This report demonstrates the long-term viability of a decellularized tissue-engineered trachea within a child. Further research is needed to develop bioengineered pediatric tracheal replacements with lower morbidity, better biomechanics and lower costs.

Original languageEnglish (US)
Pages (from-to)2750-2757
Number of pages8
JournalAmerican Journal of Transplantation
Volume15
Issue number10
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

Fingerprint

Trachea
Costs and Cost Analysis
Hydrodynamics
Stents
Chronology
Pressure
Respiratory Mucosa
Respiratory Function Tests
Mesenchymal Stromal Cells
Biomechanical Phenomena
Caspase 3
Endoscopy
Pathologic Constriction
Cross-Sectional Studies
Transplantation
Epithelial Cells
Tissue Donors
Pediatrics
Morbidity
T-Lymphocytes

Keywords

  • Graft survival
  • growth and development
  • tissue/organ engineering

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Hamilton, N. J., Kanani, M., Roebuck, D. J., Hewitt, R. J., Cetto, R., Culme-Seymour, E. J., ... Birchall, M. A. (2015). Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study. American Journal of Transplantation, 15(10), 2750-2757. https://doi.org/10.1111/ajt.13318

Tissue-Engineered Tracheal Replacement in a Child : A 4-Year Follow-Up Study. / Hamilton, N. J.; Kanani, M.; Roebuck, D. J.; Hewitt, R. J.; Cetto, R.; Culme-Seymour, E. J.; Toll, E.; Bates, A. J.; Comerford, A. P.; McLaren, C. A.; Butler, C. R.; Crowley, C.; McIntyre, D.; Sebire, N. J.; Janes, S. M.; O'Callaghan, C.; Mason, C.; De Coppi, P.; Lowdell, M. W.; Elliott, M. J.; Birchall, M. A.

In: American Journal of Transplantation, Vol. 15, No. 10, 01.10.2015, p. 2750-2757.

Research output: Contribution to journalArticle

Hamilton, NJ, Kanani, M, Roebuck, DJ, Hewitt, RJ, Cetto, R, Culme-Seymour, EJ, Toll, E, Bates, AJ, Comerford, AP, McLaren, CA, Butler, CR, Crowley, C, McIntyre, D, Sebire, NJ, Janes, SM, O'Callaghan, C, Mason, C, De Coppi, P, Lowdell, MW, Elliott, MJ & Birchall, MA 2015, 'Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study', American Journal of Transplantation, vol. 15, no. 10, pp. 2750-2757. https://doi.org/10.1111/ajt.13318
Hamilton NJ, Kanani M, Roebuck DJ, Hewitt RJ, Cetto R, Culme-Seymour EJ et al. Tissue-Engineered Tracheal Replacement in a Child: A 4-Year Follow-Up Study. American Journal of Transplantation. 2015 Oct 1;15(10):2750-2757. https://doi.org/10.1111/ajt.13318
Hamilton, N. J. ; Kanani, M. ; Roebuck, D. J. ; Hewitt, R. J. ; Cetto, R. ; Culme-Seymour, E. J. ; Toll, E. ; Bates, A. J. ; Comerford, A. P. ; McLaren, C. A. ; Butler, C. R. ; Crowley, C. ; McIntyre, D. ; Sebire, N. J. ; Janes, S. M. ; O'Callaghan, C. ; Mason, C. ; De Coppi, P. ; Lowdell, M. W. ; Elliott, M. J. ; Birchall, M. A. / Tissue-Engineered Tracheal Replacement in a Child : A 4-Year Follow-Up Study. In: American Journal of Transplantation. 2015 ; Vol. 15, No. 10. pp. 2750-2757.
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