Establishing Benchmarks for Airway Replacement: Long-Term Outcomes of Tracheal Autografts in a Large Animal Model

Ann Otol Rhinol Laryngol. 2024 Nov;133(11):967-974. doi: 10.1177/00034894241282582. Epub 2024 Sep 27.

Abstract

Objective: Airway replacement is a challenging surgical intervention and remains an unmet clinical need. Due to the risk of airway stenosis, anastomotic separation, poor vascularization, and necrosis, it is necessary to establish the gold-standard outcomes of tracheal replacement. In this study, we use a large animal autograft model to assess long-term outcomes following tracheal replacement.

Methods: Four New Zealand White rabbits underwent tracheal autograft surgery and were observed for 6 months. Clinical and radiographic surveillance were recorded, and grafts were analyzed histologically and radiographically at endpoint.

Results: All animals survived to the endpoint with minimal respiratory symptoms and normal growth rates. No complications were observed. Computed tomography scans of the post-surgical airway demonstrated graft patency at all time points. Histological sections showed no sign of stenosis or necrosis with preservation of the native structure of the trachea.

Conclusion: We established benchmarks for airway replacement. Our findings suggest that a rabbit model of tracheal autograft with direct reimplantation is feasible and does not result in graft stenosis or airway collapse.

Keywords: large animal model; post-operative care; preclinical study; segmental tracheal replacement; trachea autograft surgery.

MeSH terms

  • Animals
  • Autografts*
  • Benchmarking
  • Disease Models, Animal
  • Models, Animal
  • Rabbits
  • Tomography, X-Ray Computed
  • Trachea* / transplantation
  • Tracheal Stenosis / surgery
  • Transplantation, Autologous