Feasibility of Tracheobronchial Reconstruction Using Allogenic Aortic Patch in Children
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Taipei, Taiwan
- Taiwan National Taiwan University Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
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:
- Dependence on mechanical ventilation for more than 1 month due to airway narrowing or defect, with inability to wean.
- Airway stenosis exceeding 50% (confirmed by bronchoscopy or CT imaging), accompanied by persistent stridor, inspiratory dyspnea, or suprasternal/substernal retractions, causing impairment of daily activities or feeding difficulties.
- Unilateral or bilateral lung atelectasis persisting for more than 1 month due to tracheal or bronchial stenosis, with no sign of recovery.
- Recurrent post-obstructive pneumonia (≥3 episodes) in one or both lungs caused by tracheal or bronchial stenosis, requiring hospitalization for treatment.
Exclusion Criteria:
- Inability to obtain legal informed consent from the lawful guardian.
- Locally invasive tracheal tumors that cannot be completely resected surgically.
- Malignant solid tumors with distant metastases that cannot be completely resected surgically or controlled with medication.
- Presence of severe immunodeficiency (e.g., congenital immunodeficiency, HIV infection, ongoing chemotherapy, or recovery period after bone marrow transplantation).
- Presence of major congenital diseases or chromosomal abnormalities (e.g., Trisomy 13, Trisomy 18) with extremely poor prognosis as assessed clinically.
- End-stage organ failure (e.g., persistent multiple organ failure, irreversible cardiopulmonary failure, or brain death).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Cryopreserved aorta
After resection of tracheal or bronchial lesion, reconstruct the airway with cryopreserved aortic allograft.
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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.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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90-day Mortality
Time Frame: Postoperative 90 days
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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.
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Postoperative 90 days
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Anastomotic Leakage
Time Frame: Within 90 days postoperatively
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Incidence of anastomotic leakage at the tracheal anastomosis site.
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Within 90 days postoperatively
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Pneumonia
Time Frame: Within 90 days postoperatively
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Incidence of postoperative pneumonia.
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Within 90 days postoperatively
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Difficult Extubation
Time Frame: Within 90 days postoperatively
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Occurrence of difficulties in extubation after surgery.
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Within 90 days postoperatively
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Granulation Tissue Obstruction
Time Frame: Within 90 days postoperatively
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Incidence of airway obstruction due to granulation tissue formation.
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Within 90 days postoperatively
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Stenosis Caused by Scar Fibrosis and Related Complications
Time Frame: Within 90 days postoperatively
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Occurrence of airway stenosis due to scar fibrosis or other related complications.
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Within 90 days postoperatively
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Long-term Clinical Follow-up
Time Frame: At least 1 year postoperatively; infants and young children followed until at least puberty
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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.
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At least 1 year postoperatively; infants and young children followed until at least puberty
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- 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.
- 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.
- 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.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Musculoskeletal Diseases
- Connective Tissue Diseases
- Respiratory Tract Infections
- Infections
- Respiratory Tract Diseases
- Musculoskeletal Abnormalities
- Congenital Abnormalities
- Gram-Positive Bacterial Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Actinomycetales Infections
- Mycobacterium Infections
- Cartilage Diseases
- Tracheobronchomalacia
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Skin and Connective Tissue Diseases
- Tuberculosis
- Tracheomalacia
- Tracheal Diseases
- Tracheal Stenosis
- Tracheitis
Other Study ID Numbers
Other Study ID Numbers
- 202404094DINC
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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