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The trachea, an essential element of the lower respiratory tract, constitutes a fibrocartilaginous tube spanning approximately 10\u201312\u2009cm in length. It is characterized by 18\u2009\u00b1\u20092 tracheal cartilages distributed anterolaterally with the dynamic trachealis muscle located posteriorly. While tracheotomy is a common approach for patients with short\u2010length defects, situations requiring replacement arise when the extent of lesion exceeds 1\/2 of the length in adults (or 1\/3 in children). Tissue engineering (TE) holds promise in developing biocompatible airway grafts for addressing challenges in tracheal regeneration. Despite the potential, the extensive clinical application of tissue\u2010engineered tracheal substitutes encounters obstacles, including insufficient revascularization, inadequate re\u2010epithelialization, suboptimal mechanical properties, and insufficient durability. These limitations have led to limited success in implementing tissue\u2010engineered tracheal implants in clinical settings. This review provides a comprehensive exploration of historical attempts and lessons learned in the field of tracheal TE, contextualizing the clinical prerequisites and vital criteria for effective tracheal grafts. The manufacturing approaches employed in TE, along with the clinical application of both tissue\u2010engineered and non\u2010tissue\u2010engineered approaches for tracheal reconstruction, are discussed in detail. By offering a holistic view on TE substitutes and their implications for the clinical management of long\u2010segment tracheal lesions, this review aims to contribute to the understanding and advancement of strategies in this critical area of respiratory medicine.<\/jats:p>","DOI":"10.1002\/btm2.10671","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T08:18:45Z","timestamp":1713773925000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Tissue\u2010engineered tracheal implants: Advancements, challenges, and clinical considerations"],"prefix":"10.1002","volume":"9","author":[{"given":"Shixiong","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center The First Hospital of Jilin University  Changchun China"},{"name":"Department of Thoracic Surgery The First Hospital of Jilin University  Changchun 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