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General Hospital Chiayi Branch","award":["TCVGH-VHCY1128602"],"award-info":[{"award-number":["TCVGH-VHCY1128602"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Polycaprolactone (PCL) implants in large animals show great promise for tracheal transplantation. However, the longest survival time achieved to date is only about three weeks. To meet clinical application standards, it is essential to extend the survival time and ensure the complete integration and functionality of the implant. Our study investigates the use of three-dimensional (3D)-printed, biodegradable, PCL-based tracheal grafts for large-scale porcine tracheal transplantation, assessing the feasibility and early structural integrity crucial for long-term survival experiments. A biodegradable PCL tracheal graft was fabricated using a BIOX bioprinter and transplanted into large-scale porcine models. The grafts, measuring 20 \u00d7 20 \u00d7 1.5 mm, were implanted following a 2 cm circumferential resection of the porcine trachea. The experiment design was traditionally implanted in eight porcines to replace four-ring tracheal segments, only two of which survived more than three months. Data were collected on the graft construction and clinical outcomes. The 3D-printed biosynthetic grafts replicated the native organ with high fidelity. The implantations were successful, without immediate complications. At two weeks, bronchoscopy revealed significant granulation tissue around the anastomosis, which was managed with laser ablation. The presence of neocartilage, neoglands, and partial epithelialization near the anastomosis was verified in the final pathology findings. Our study demonstrates in situ regenerative tissue growth with intact cartilage following transplantation, marked by neotissue formation on the graft\u2019s exterior. The 90-day survival milestone was achieved due to innovative surgical strategies, reinforced with strap muscle attached to the distal trachea. Further improvements in graft design and granulation tissue management are essential to optimize outcomes.<\/jats:p>","DOI":"10.3390\/bioengineering11080832","type":"journal-article","created":{"date-parts":[[2024,8,14]],"date-time":"2024-08-14T10:28:41Z","timestamp":1723631321000},"page":"832","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Long-Term Survival and Regeneration Following Transplantation of 3D-Printed Biodegradable PCL Tracheal Grafts in Large-Scale Porcine Models"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0944-9907","authenticated-orcid":false,"given":"Sen-Ei","family":"Shai","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Taichung Veterans General Hospital, Taichung 407219, Taiwan"},{"name":"Department of Applied Chemistry, National Chi Nan University, Nantou 545301, Taiwan"},{"name":"Institute of Clinical Medicine, National Yang-Ming Chiao-Tung University, Taipei 112304, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Ling","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Taichung Veterans General Hospital, Taichung 407219, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Wen","family":"Hung","sequence":"additional","affiliation":[{"name":"Animal Radiation Therapy Research Center, Central Taiwan University of Science and Technology, Taichung 406053, Taiwan"},{"name":"Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung 404327, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Wei","family":"Hsieh","sequence":"additional","affiliation":[{"name":"School of Medicine, National Cheng Kung University, Tainan 701401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Chih","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Three Dimensional Printing Research and Development Group, Taichung Veterans General Hospital, Taichung 407219, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Hsiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Three Dimensional Printing Research and Development Group, Taichung Veterans General Hospital, Taichung 407219, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Te-Hsin","family":"Chao","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery, Department of Surgery, Chiayi and Wangiao Branch, Taichung Veterans General Hospital, Chiayi 600573, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung-Tsung","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Medical Research and Education, Taichung Veterans General Hospital, Taichung 407219, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7224-8425","authenticated-orcid":false,"given":"Chia-Ching","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Medicine, National Cheng Kung University, Tainan 701401, Taiwan"},{"name":"Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1813-4616","authenticated-orcid":false,"given":"Shih-Chieh","family":"Hung","sequence":"additional","affiliation":[{"name":"Integrative Stem Cell Center, China Medical University Hospital, Taichung 404327, Taiwan"},{"name":"Institute of New Drug Development, China Medical University, Taichung 404328, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.4161\/org.5.3.9494","article-title":"Cryopreservation of the tracheal grafts: Review and perspective","volume":"5","author":"Nakanishi","year":"2009","journal-title":"Organogenesis"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1097\/TP.0b013e31822a4082","article-title":"Bone marrow-derived mesenchymal stem cells enhance cryopreserved trachea allograft epithelium regeneration and vascular endothelial growth factor expression","volume":"92","author":"Han","year":"2011","journal-title":"Transplantation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/2047-783X-18-25","article-title":"Airway transplantation: A challenge for regenerative medicine","volume":"18","author":"Martinod","year":"2013","journal-title":"Eur. 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