Development and clinical translation of tubular constructs for tracheal tissue engineering: a review

• Published in: European respiratory review Vol. 30; no. 162; p. 210154
• Main Authors: Soriano, Luis, Khalid, Tehreem, Whelan, Derek, O'Huallachain, Niall, Redmond, Karen C., O'Brien, Fergal J., O'Leary, Cian, Cryan, Sally-Ann
• Format: Journal Article
• Language: English
• Published: European Respiratory Society 31.12.2021
• Subjects: Reviews
• ISSN: 0905-9180; 1600-0617
• DOI: 10.1183/16000617.0154-2021

Effective restoration of extensive tracheal damage arising from cancer, stenosis, infection or congenital abnormalities remains an unmet clinical need in respiratory medicine. The trachea is a 10–11 cm long fibrocartilaginous tube of the lower respiratory tract, with 16–20 tracheal cartilages anterolaterally and a dynamic trachealis muscle posteriorly. Tracheal resection is commonly offered to patients suffering from short-length tracheal defects, but replacement is required when the trauma exceeds 50% of total length of the trachea in adults and 30% in children. Recently, tissue engineering (TE) has shown promise to fabricate biocompatible tissue-engineered tracheal implants for tracheal replacement and regeneration. However, its widespread use is hampered by inadequate re-epithelialisation, poor mechanical properties, insufficient revascularisation and unsatisfactory durability, leading to little success in the clinical use of tissue-engineered tracheal implants to date. Here, we describe in detail the historical attempts and the lessons learned for tracheal TE approaches by contextualising the clinical needs and essential requirements for a functional tracheal graft. TE manufacturing approaches explored to date and the clinical translation of both TE and non-TE strategies for tracheal regeneration are summarised to fully understand the big picture of tracheal TE and its impact on clinical treatment of extensive tracheal defects.