To summarize the so far applied clinical methods of tracheal replacement, comparing pros and cons of conventional and tissue-engineered approaches.
Several strategies have been most recently described to replace the trachea-like aortic homografts, allotransplantation, and tissue engineering. Allotransplantation requires lifelong immunosuppression and this may be ethically questioned being not a lifesaving procedure. Tissue-engineered tracheal transplantation has been clinically applied using biological or bioartificial tubular or bifurcated scaffolds reseeded with mesenchymal stromal cells, and bioactive molecules boosting regeneration and promoting neovascularization.
Tracheal tissue engineering may be a promising alternative to conventional allotransplantation in adults and children. Different methods have been developed and are currently under active clinical investigation, and await long-term results.
Division of Ear, Nose, and Throat, Department of Clinical Science, Intervention and Technology (CLINTEC), Advanced Center of Translational Regenerative Medicine, Karolinska Institutet, University Hospital, Stockholm, Sweden
Correspondence to Paolo Macchiarini, MD, PhD, ACTREM, Division of Ear, Nose, and Throat (CLINTEC), Karolinska Institutet, Alfred Nobel Allé 8, Huddinge, S-14186 Stockholm, Sweden. Tel: +46 8 585 87353; e-mail: email@example.com