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Vol. 33. Issue 11.
Pages 572-576 (December 1997)
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Vol. 33. Issue 11.
Pages 572-576 (December 1997)
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La perfusión tisular del donante mejora la conservación del injerto en el trasplante traqueal heterotópico
Donor tissue perfusion improves graft preservation in heterotopic tracheal transplantation
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M.F. Jiménez*
Sección de Cirugía Torácica, Hospital Universitario y Facultad de Medicina. Universidad de Salamanca
A. Gómez-Alonsoa, M.D. Ludeñab, J. García-Criadoa
a Departamento de Cirugía, Hospital Universitario y Facultad de Medicina. Universidad de Salamanca
b Departamento de Biología Celular y Patología. Hospital Universitario y Facultad de Medicina. Universidad de Salamanca
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El objetivo de este estudio ha sido valorar el efecto de la perfusión con solución de Collins de los tejidos peritraqueales del donante antes de la extracción y la inmunosupresión del receptor sobre la conservación de la tráquea trasplantada.

Se realizó un estudio experimental en 36 conejos albinos con injertos traqueales en situación heterotópica cervical revascularizados con epiplón. Los animales se dividieron en 4 grupos: a los del grupo I (n=9) y III (n=9) se les trasplantó un injerto traqueal de donante no perfundido y a los animales de los grupos II (n=9) y IV (n=9) se les trasplantó un injerto de donante perfundido con solución de Collins. Se realizó terapia inmunosupresora con esteroides y ciclosporina durante 21 días en los grupos III y IV. Se evaluó mediante microscopia óptica el grado de inflamación o necrosis de la circunferencia traqueal en la porción medial y se estableció una gradación de la lesión traqueal de 0 a 9, mediante la suma del grado de lesión en mucosa, submucosa y cartílago.

El grupo IV presentó una valoración media de la lesión traqueal, inferior a la del resto de los grupos, con una probabilidad de azar menor del 5%.

La perfusión con solución de Collins de los tejidos peritraqueales del donante junto a la terapia inmunosupresora disminuye la lesión de la tráquea trasplantada.

Palabras clave:
Trasplante traqueal
Solución de Collins
Inmunosupresión

To assess the effect on tracheal graft preservation of perfusion of donor tissue with a Collins solution before extraction and immunosuppression of the recipient.

An experimental study was performed in 36 albino rabbits with revascularized heterotopic cervical reconstruction of the trachea with omentum. The animals were distributed in four groups. Groups 1 (n=9) and III (n=9) were transplanted with non perfused donor tissue. Animals in groups II (n=9) and IV (n=9) received grafts perfused with Collins solution. Immunosuppression with steroids and cyclosporin was continued for 21 days in groups III and IV. In a mid portion of the trachea viewed under optical microscope, the degree of inflammation or circumferential necrosis was assessed on a scale of 0 to 9 by adding the scores for mucosa, submucosa and cartilage.

The mean score for tracheal lesion was lower in group IV, with a likelihood of random difference of less than 5%.

Perfusion of peritracheal tissues with Collins solution in the donor, in addition to immunosuppression decreases the extent of tissue damage in the tracheal graft.

Key words:
Tracheal transplantation
Collins solution
Immunosuppresion
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Bibliografía
[1.]
K. Moghissi.
Tracheal reconstruction with a prosthesis of marlex mesh and pericardium.
J. Thorac Cardiovasc Surg, 69 (1975), pp. 499-506
[2.]
R. Guijarro, A. Sánchez-Palencia, A. Cueto, F. Marti, M.G. De Vega, F. Paris.
Experimental study of a new porous tracheal prosthesis.
Ann Thorac Surg, 50 (1990), pp. 281-287
[3.]
F.G. Pearson, R.D. Henderson, A.E. Gross, R.J. Ginsberg, R.M. Stone.
The reconstruction of circunferential tracheal defect with porous prothesis: an experimental and clinical study using heavy Marlex mesh.
J Thorac Cardiovasc Surg, 55 (1968), pp. 605-616
[4.]
H.C. Grillo, P. Zannini, F. Michelass.
Complications of tracheal reconstruction Incidence, treatment and prevention.
J Thorac Cardiovasc Surg, 91 (1986), pp. 322-328
[5.]
T.O. Kato, A.S. Onuki, M. Watanabe, T. Hashizume, M. Kamaura, K. Kituchi, et al.
Tracheal reconstruction by esophageal interposition: an experimental study.
Ann Thorac Surg, 49 (1990), pp. 951-954
[6.]
E. Letang, J. Sánchez-Lloret, J.M. Gimferrer, M.D. Ramírez, A. Vincens.
Experimental reconstruction of the canine trachea with a free revascularized small bowell graft.
Ann Thorac Surg, 49 (1990), pp. 955-958
[7.]
R.W. Quisling.
Experimental tracheal reconstruction with external ear canal autografts.
Arch Otolaryngol, 104 (1978), pp. 311-312
[8.]
V.A. Ritsila, S. Santavirta, S. Alhopuro, M. Poussa, H. Jaroma, J.M. Rubak, et al.
Periosteal and perichondral grafting in reconstructive surgery.
Clin Orthop, 302 (1994), pp. 259-265
[9.]
F. Eckersberger, E. Moritz, E. Wolner.
Circumferential tracheal replacement with costal cartilage.
J Thorac Cardiovasc Surg, 94 (1987), pp. 175-180
[10.]
L. López-Rivero, S. Quevedo, J. Freixenet, F.R. De Castro, M. Liminana, A. Salvatierra, et al.
Experimental tracheal revascularization with omentum.
Eur J Cardiothorac Surg, 7 (1993), pp. 540-542
[11.]
P. Macchiarini, B. Lenot, V. De Montpreville, E. Dulmet, G.M. Mazmanian, M. Fattal, et al.
Heterotopic pig model for direct revascularization and venous drainage of tracheal allografts.
J Thorac Cardiovasc Surg, 108 (1994), pp. 1.066-1.075
[12.]
P.R. Delaere, Z.Y. Liu, R. Hermans, R. Sciot, L. Feenstra.
Experimental tracheal allograft revascularization and transplantation.
J Thorac Cardiovasc Surg, 110 (1995), pp. 728-737
[13.]
M. Strome, S. Strome, J. Darrell, J. Wu, G. Brodsky.
The effects of cyclosporin A on trasplanted rat allografts.
Laryngoscope, 103 (1993), pp. 394-398
[14.]
J.M. Borro, M. Chirivella, C. Vila, G. Galán, M. Prieto, F. Paris.
Successful revascularization of large isolated tracheal segments.
Eur J Cardiothorac Surg, 6 (1992), pp. 621-623
[15.]
V.M. Olech, S.H. Keshavjee, D.W. Chamberlain, A.S. Slutsky, G.A. Patterson.
Role of basic fibroblast growth factor in revascularization of rabbit tracheal autografts.
Ann Thorac Surg, 52 (1991), pp. 258-264
[16.]
H.C. Grillo, D.H. Donahue, D.J. Mathisen, J.C. Wain, C.D. Wright.
Post-intubation tracheal stenosis. Treatment and results.
J Thorac Cardiovasc Surg, 109 (1995), pp. 486-493
[17.]
F.G. Pearson, M.J. Andrew.
Detection and management of tracheal stenosis following cuffed tube tracheostomy.
Ann Thorac Surg, 12 (1971), pp. 359-365
[18.]
J.D. Cooper, F.G. Pearson, G.A. Patterson, T.R.J. Todd.
Use of silicone stents in the management of airway problems.
Ann Thorac Surg, 47 (1989), pp. 371-378
[19.]
A.D.C. MacKnight, A. Leaf.
Regulation of cellular volume.
Physiol. Rev, 57 (1977), pp. 510-573
[20.]
J.F. Khalil-Marzouk.
Allograft replacement of the trachea Experimental synchronous revascularization of composite thyrotracheal transplant.
J Thorac Cardiovasc Surg, 105 (1993), pp. 242-246
[21.]
B.D. Kahan.
Individualization of cyclosporine therapy using pharmacokinectic and pharmacodynamic parameters.
Transplantation, 40 (1985), pp. 457-476
[22.]
P.R. Delaere, Z.Y. Liu, L. Feenstra.
Tracheal autograft revascularization and transplantation.
Arch Otolaryngol Head Neck Surg, 120 (1994), pp. 1.130-1.136
[23.]
R. Nakanishi, T. Shirakusa, T. Mitsudomi.
Maximum length of tracheal autografts in dogs.
J Thorac Cardiovasc Surg, 106 (1993), pp. 1.081-1.087
Copyright © 1997. Sociedad Española de Neumología y Cirugía Torácica
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