Artificial trachea: Past, present, and future

Abstract

The trachea and bronchus play important roles in the human body, providing a pathway for air to reach the lungs. Various diseases can arise in the airway, including cancer, stenosis, and tracheobronchomalacia. Surgery represents the main form of treatment for these diseases. However, resecting over 50% of the tracheal length is currently unfeasible because of the need for remnant trachea. To overcome this limitation and improve curability rates, alternatives are needed. Many investigators in both research fields and clinical practice have reported on artificial trachea. Autologous tissue, synthetic materials, and allograft have all been used as artificial trachea. However, practical artificial trachea for use in the clinical field remains lacking. Issues with artificial trachea that need to be overcome include infection, rigidity, the need for immunosuppressants, and in vivo growth for pediatric cases. Scaffold-free artificial trachea made using the patient's own cells could resolve some of these issues. Artificial trachea created using the "Regenova" bio-3D printing system has been successfully transplanted into rats to replace native trachea, achieving survival for more than 1 year without immunosuppressants. Many issues of trachea made by foreign materials have thus been solved in rats. However, many issues remain to be addressed before clinical application.