Preclinical and clinical orthotopic transplantation of decellularized/engineered tracheal scaffolds: A systematic literature review
Elena Stocco, Silvia Barbon, Marco Mammana, Giovanni Zambello, Martina Contran, Pier Paolo Parnigotto, Veronica Macchi, Maria Teresa Conconi, Federico Rea, Raffaele De, Andrea Porzionato
Abstract
Severe tracheal injuries that cannot be managed by mobilization and end-to-end anastomosis represent an unmet clinical need and an urgent challenge to face in surgical practice; within this scenario, decellularized scaffolds (eventually bioengineered) are currently a tempting option among tissue engineered substitutes. The success of a decellularized trachea is expression of a balanced approach in cells removal while preserving the extracellular matrix (ECM) architecture/mechanical properties. Revising the literature, many Authors report about different methods for acellular tracheal ECMs development; however, only few of them verified the devices effectiveness by an orthotopic implant in animal models of disease. To support translational medicine in this field, here we provide a systematic review on studies recurring to decellularized/bioengineered tracheas implantation. After describing the specific methodological aspects, orthotopic implant results are verified. Furtherly, the only three clinical cases of compassionate use of tissue engineered tracheas are reported with a focus on outcomes.