Tracheal Regeneration Following Tracheal Replacement With an Allogenic Aorta Emmanuel Martinod, MD, PhD, Agathe Seguin, MD, Muriel Holder-Espinasse, MD,

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Tracheal Regeneration Following Tracheal Replacement With an Allogenic Aorta Emmanuel Martinod, MD, PhD, Agathe Seguin, MD, Muriel Holder-Espinasse, MD, Marianne Kambouchner, MD, Martine Duterque- Coquillaud, PhD, Jacques F. Azorin, MD, Alain F. Carpentier, MD, PhD The Annals of Thoracic Surgery Volume 79, Issue 3, Pages 942-948 (March 2005) DOI: 10.1016/j.athoracsur.2004.08.035 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Macroscopic view of a neotrachea at 12 months showing the absence of stenosis. The two suture lines (arrows) delineate the regenerated trachea, the new cartilage rings, and the continuous epithelium. The Annals of Thoracic Surgery 2005 79, 942-948DOI: (10.1016/j.athoracsur.2004.08.035) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Histologic examination at 3 months showing a continuous epithelium with islands of newly formed cartilage (stars) (hematoxylin-eosin staining, original magnification ×50). The Annals of Thoracic Surgery 2005 79, 942-948DOI: (10.1016/j.athoracsur.2004.08.035) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Histologic examination at different stage of follow-up from 1 to 12 months shows the successive steps of epithelium regeneration from squamous (a, b) to mixed (c), and to mucociliary (d) (hematoxylin-eosin staining, original magnification ×200). The Annals of Thoracic Surgery 2005 79, 942-948DOI: (10.1016/j.athoracsur.2004.08.035) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Histologic examination at 3 months showing islands of newly formed immature cartilage (stars) within the aortic allograft (hematoxylin-eosin staining, original magnification ×200). The Annals of Thoracic Surgery 2005 79, 942-948DOI: (10.1016/j.athoracsur.2004.08.035) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Histologic examination at 12 months showing a vascularized mature newly formed cartilage (hematoxylin-eosin staining, original magnification ×200). The Annals of Thoracic Surgery 2005 79, 942-948DOI: (10.1016/j.athoracsur.2004.08.035) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Histologic examination at 3 months showing disorganized elastic fibers (arrows) from the aortic allograft (hematoxylin-eosin staining, original magnification ×100). The Annals of Thoracic Surgery 2005 79, 942-948DOI: (10.1016/j.athoracsur.2004.08.035) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 7 In situ RNA hybridization with radioactive RNA was positive (white spots) for type II collagen in newly formed cartilage at 7 months. The Annals of Thoracic Surgery 2005 79, 942-948DOI: (10.1016/j.athoracsur.2004.08.035) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 8 SRY and IGF1 genes amplification on 3% acrylamide gel. SRY gene is not expressed in the graft specimen. (IGF1 = insulin-like growth factor 1; PHA = phytohemagglutinin; SRY = SRY gene.) The Annals of Thoracic Surgery 2005 79, 942-948DOI: (10.1016/j.athoracsur.2004.08.035) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions