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Feasibility and safety of repairing tracheal and bronchial defects in infants and children using cryopreserved donor aortic patches.
This trial plans to use cryopreserved donor aortic tissue patches to repair and treat pediatric patients with end-stage, life-threatening or severely disabling tracheal diseases who have not responded to conventional conservative therapies or lack sufficient native tracheal tissue for tracheal defect reconstruction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cryopreserved aorta | Experimental | After resection of tracheal or bronchial lesion, reconstruct the airway with cryopreserved aortic allograft. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cryopreserved aorta | Procedure | After resection of the tracheal or bronchial lesion with standard surgical techniques, the airway gap is reconstructed with a segment of human cryopreserved (-80 celsius degree) aortic allograft, which was not matched by the ABO and leukocyte antigen systems. The anastomosis is performed with standard technique for airway anastomosis. |
| Measure | Description | Time Frame |
|---|---|---|
| 90-day Mortality | Survival status of patients within 90 days after surgery. This primary endpoint evaluates patient mortality, as patients undergoing this type of surgery often have a high short-term risk of death. | Postoperative 90 days |
| Measure | Description | Time Frame |
|---|---|---|
| Anastomotic Leakage | Incidence of anastomotic leakage at the tracheal anastomosis site. | Within 90 days postoperatively |
| Pneumonia | Incidence of postoperative pneumonia. |
| Measure | Description | Time Frame |
|---|---|---|
| Long-term Clinical Follow-up | Patients will undergo long-term follow-up including medical history review, physical examination, and imaging studies as clinically indicated (including but not limited to X-ray, CT scan, and bronchoscopy) to monitor long-term airway status and overall health. | At least 1 year postoperatively; infants and young children followed until at least puberty |
Inclusion Criteria:
Meeting any of the following conditions, and being unsuitable for standard end-to-end tracheal anastomosis or lacking sufficient native tracheal tissue for defect reconstruction:
Congenital tracheal malformations: including congenital tracheomalacia, congenital tracheobronchial anomalies, complete tracheal rings, etc., with severe clinical respiratory symptoms and recommended for treatment after evaluation.
Acquired tracheal stenosis: including tracheal narrowing caused by disease, endotracheal intubation, or postoperative scar formation, with severe clinical respiratory symptoms and recommended for treatment after evaluation.
Tracheal injury or tissue loss due to trauma or burns requiring surgical repair.
Tracheal tumors: reconstruction of tracheal tissue after resection of benign or malignant tumors.
The term "severe clinical respiratory symptoms" includes:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Taiwan National Taiwan University Hospital | Taipei | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37002174 | Background | Tsou KC, Hung WT, Ju YT, Liao HC, Hsu HH, Chen JS. Application of aortic allograft in trachea transplantation. J Formos Med Assoc. 2023 Sep;122(9):940-946. doi: 10.1016/j.jfma.2023.03.006. Epub 2023 Mar 29. | |
| 39478918 | Background | Lu CW, Liao HC, Tsou KC, Hung WT, Huang PM, Hsu HH, Chen JS. Cryopreserved aortic graft patch repair of traumatic tracheal rupture defect: A case report. JTCVS Tech. 2024 Aug 17;27:182-184. doi: 10.1016/j.xjtc.2024.07.023. eCollection 2024 Oct. No abstract available. |
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|
| Within 90 days postoperatively |
| Difficult Extubation | Occurrence of difficulties in extubation after surgery. | Within 90 days postoperatively |
| Granulation Tissue Obstruction | Incidence of airway obstruction due to granulation tissue formation. | Within 90 days postoperatively |
| Stenosis Caused by Scar Fibrosis and Related Complications | Occurrence of airway stenosis due to scar fibrosis or other related complications. | Within 90 days postoperatively |
| 38494361 | Background | Hung WT, Liao HC, Hsu HH, Chen JS. Stented cryopreserved aortic allograft for reconstruction of long-segment post-tuberculosis tracheal stenosis. J Formos Med Assoc. 2024 Jul;123(7):818-820. doi: 10.1016/j.jfma.2024.03.006. Epub 2024 Mar 16. |
| ID | Term |
|---|---|
| D014133 | Tracheal Diseases |
| D014135 | Tracheal Stenosis |
| D014376 | Tuberculosis |
| D014136 | Tracheitis |
| D055090 | Tracheomalacia |
| ID | Term |
|---|---|
| D012140 | Respiratory Tract Diseases |
| D009164 | Mycobacterium Infections |
| D000193 | Actinomycetales Infections |
| D016908 | Gram-Positive Bacterial Infections |
| D001424 | Bacterial Infections |
| D001423 | Bacterial Infections and Mycoses |
| D007239 | Infections |
| D012141 | Respiratory Tract Infections |
| D055089 | Tracheobronchomalacia |
| D002357 | Cartilage Diseases |
| D009140 | Musculoskeletal Diseases |
| D009139 | Musculoskeletal Abnormalities |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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