Tracheal Allograft after Withdrawal of Immunosuppressive Therapy

This letter describes findings from an evaluation of a tracheal allotransplant at 2 years, documented with imaging studies and a video. Despite immunologic rejection of the donor mucosal lining, the tracheal cartilage appears to remain intact without immunosuppression. To the Editor: Obstruction of the airway causes substantial morbidity, and with the increased use of artificial airways, the incidence of tracheal stenosis is increasing. A tracheal defect that is shorter than 5 cm usually can be closed by means of an end-to-end anastomosis. 1 , 2 Allotransplanted tracheal segments provide a potential means of reconstruction in patients with longer airway defects. In 2010, we reported on the successful transplantation of a tracheal allograft after it had undergone revascularization in the recipient's forearm. 3 That tracheal allograft remained viable after the discontinuation of immunosuppressive therapy, probably because the chondrocytes were embedded in a . . .