Bioengineered Trachea Transplants: Growing New Air

Reconstructing the trachea of the human body traditionally is a complex, detailed biomechanical process that involves many different approaches, such as grafting and prostheses. More recently, tracheal transplants have been regenerated through surgery that allows for the growth of new airways. The tracheostomy transplant procedure involves using stem cells from a patient's bone marrow to create an artificial organ. A bioengineered transplant allows for a longer succession after surgery, rather than an allograft, which can cause immune rejection by the patient's cells.

There are three factors to bioengineered tracheostomy surgery. Scaffolding, the first factor, involves a frame and shape for an organ to grow. Scaffolds are created through donor trachea or synthetically. Scaffolds are especially important for providing strength for the trachea. The second factor is the cell count. The cells need to be able to degenerate and adapt to the surrounding environment. This allows the cells to grow and connect to the surrounding tissue. Last is vascularization and integration. Vascularization is a complex idea because it involves providing just enough blood supply and nutrients for the trachea to live and grow. 

Throughout the surgery, the patient is given general anesthesia, and the area of the trachea that is damaged is surgically removed. The surgeon then places the newly grown trachea and connects the new trachea to the rest of the airways. The surgeon then has to restore the blood supply to the patient and wrap the trachea with a tissue flap, like omentum, to grow the blood vessels into the graft. The surgeon then also places an internal stent to protect the new tissue because it may be weakened. 

After the surgery, the patient is moved to the ICU (Intensive Care Unit) to be closely watched. The process of tissue creation of the trachea can take days or weeks to grow and surround the tissue of the body. Over time, the patients' stem cells grow and become cartilage as well as structural support. Since the first surgery, tracheal transplants have been controversial, but this is due to the limited research that has been done. As the technology advances, tracheal transplants have been and can continue to be a benefit. Bioengineered Trachea Transplants have been found to prevent issues such as respiratory issues, coughing, neck pain, neck pressure, and more that regular allografts would cause. 

Written by Urvi Vora at Incisionary

APA References

Adamo, D., Galaverni, G., Genna, V. G., Lococo, F., & Pellegrini, G. (2022). The Growing Medical Need for Tracheal Replacement: Reconstructive Strategies Should Overcome Their Limits. Frontiers in Bioengineering and Biotechnology, 10. https://doi.org/10.3389/fbioe.2022.846632

Figure 3: The entire concept of the regenerative approach to tracheal... (2024). ResearchGate. https://www.researchgate.net/figure/The-entire-concept-of-the-regenerative-approach-to-tracheal-transplantation-using-natural_fig5_51842715

Liang, Y., Wei, S., & Zhang, A. (2025). Bioengineered tracheal graft with enhanced vascularization and mechanical stability for functional airway reconstruction. Regenerative Therapy, 29, 364–380. https://doi.org/10.1016/j.reth.2025.03.016

Mammana, M., Bonis, A., Verzeletti, V., Dell’Amore, A., & Rea, F. (2024). Tracheal Tissue Engineering: Principles and State of the Art. Bioengineering, 11(2), 198. https://doi.org/10.3390/bioengineering11020198