Impact of topically-applied ipd-giucose on tracheal mucociliary clearance after warm and cold ischemia: short communication

Tracheal transplantation remains a challenge for General Thoracic Surgery.1 A large number of surgical techniques and implantable devices has been tested with poor results.1,2 In spite of that, some recent findings on tracheal revascularization and graft epithelial replacement have renewed the interest on tracheal transplantation, with special attention to graft bioengineering.2-5 However, in order to succeed in tracheal transplantation, the effects of tracheal ischemic injury secondary to harvesting need to be better understood. Functional preservation of solid organs is usually achieved by the use of intravascular preservation solutions.6 However, because of the particular segmental pattern of the tracheal vascularization, with no major tracheal vessels,7 intravascular administration of preservation solutions into tracheal grafts is technically complex,8 and far from being useful in a clinical scenario. The trachea is composed of thin cell layers and maintains an open lumen after harvesting. Based on those anatomical characteristics, we hypothesized if a topically‐applied preservation solution could penetrate into tracheal layers and maintain mucociliary function of tracheal grafts submitted to either warm or cold ischemia. Our objectives were: 1) to evaluate if topically‐applied LPD‐glucose, a solution largely used for lung preservation, could ameliorate the effects of warm (room temperature) ischemia on tracheal mucociliary clearance; and 2) to evaluate if topically‐applied LPD‐glucose could ameliorate the effects of cold ischemia on tracheal mucociliary clearance.