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CC BY-NC-ND 4.0 · Indian J Plast Surg 2020; 53(03): 357-362
DOI: 10.1055/s-0040-1721860
Original Article

Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model

Dimpy Sharma
1   Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Subramania Iyer 
1   Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
2   Department of Head and Neck Surgical Oncology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Sobha Subramaniam
3   Department of Pulmonary Medicine, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Janarthanan Ramu
1   Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Mohit Sharma
1   Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Ajit Nambiar
4   Department of Clinical Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
AKK Unni
5   Department of Central Animal Research Facility, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
,
Sivanarayanan S.
5   Department of Central Animal Research Facility, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
› Author Affiliations Funding sources Partly funded by APSI–Goa Research Award Grant.
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Abstract

Background Tracheal transplantation seems to be the logical step in the process of reconstruction of the trachea following a long-segment resection, which is usually done to treat malignant disease or benign stenosis of the airway caused by a traumatic, congenital, inflammatory, or iatrogenic lesion. Immunosuppression following transplant is essential but not ideal after oncoresection.

Methods The tracheal allografts, harvested from Sprague Dawley rats, were implanted in the Wistar strain rat. The harvested tracheal grafts were divided into groups and subgroups, based on the layers of trachea, method of decellularization, and immunosuppression. The antigenicity of different layers of trachea and the effect of various decellularization methods were studied within three time frames, that is, day 3, 9, and 15.

Result On structural analysis, the day 3 and day 15 samples showed no meaningful comparison could be made, due to extensive neutrophil infiltration in all three layers. The day 9 tracheal grafts showed loss of epithelium, with no signs of regeneration in most of the allografts. The subepithelial lymphoid infiltration was found to be severe in nonimmunosuppressed allografts. The group in which both inner and outer layers were removed showed moderate-to-severe infiltrate of lymphoid cells in all the allografts, but there was no cartilage loss, irrespective of the method of decellularization. The irradiated specimens retained the cartilage but showed extensive ischemic damage.

Conclusion Rat trachea is a good model for tracheal transplant research but not adequately sturdy to sustain mechanical debridement. Irradiation and chemical decellularization eliminates the immune response but causes intense ischemic damage. Out of the three time frames, day 9 seemed to be the best to study the immune response. To substantiate the results obtained in this study, the immunohistochemical study of the allografts is needed to be performed among a larger group of animals.

Keywords

decellularized tracheal allograft - immune-mediated rejection - rodent model - tracheal allograft antigenicity - tracheal transplantation


Publication History

Article published online:
21 December 2020

© 2020. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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