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Transcriptomic profiling of conventional TETs revealed enriched hypoxia and inflammatory pathways, underscoring the need for robust vascular and epithelial strategies. Herein, a dual\u2010pedicle biomimetic TET is developed to provide a stable cartilaginous framework for airway support, immediate blood supply for tissue perfusion, and functional epithelial lining for barrier protection. Autologous rabbit auricular skin is sutured into tubes for epithelial lining, while chondrocytes in photo\u2010crosslinkable decellularized Wharton's jelly matrix hydrogels formed C\u2010shaped constructs assembled into cartilage tubes. Both are pre\u2010vascularized separately in cervical muscle for 4 weeks, then assembled with preserved unilateral pedicles, yielding integrated TETs with dual\u2010pedicle vascular networks and enhanced biomechanical properties. Orthotopic tracheal transplantation of this construct into rabbits demonstrated sustained patency, minimal stenosis, and improved 28\u00a0day survival (60% vs 40% for single\u2010pedicle controls). Immunofluorescence confirmed reduced bacterial infiltration, apoptosis, and inflammation (TLR4, MPO), with restored epithelial barriers (Claudin\u20101, \u03b2\u2010defensin 1) and airway differentiation (cytokeratin 8 upregulation). Transcriptomics validated regenerative pathways, including oxidative phosphorylation and tight junctions. This dual\u2010pedicle approach preempts pathological cascades, offering a promising paradigm for clinical tracheal regeneration.<\/jats:p>","DOI":"10.1002\/advs.202514724","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T02:56:24Z","timestamp":1760410584000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dual\u2010Pedicle Tissue\u2010Engineered Trachea Promotes Biomimetic Cartilaginous Framework, Vascularization, and Epithelial Lining for Long\u2010Segment Tracheal Reconstruction"],"prefix":"10.1002","volume":"12","author":[{"given":"Ziming","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Shanghai Pulmonary Hospital Tongji University School of Medicine Shanghai 200433 China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuming","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Lung Cancer 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