Extensive circumferential tracheal defects remain a major challenging problem in the field of tracheal reconstruction. In this study, a tissue-engineered tracheal graft based on three-dimensional (3D) printing was developed for extensive circumferential tracheal reconstruction. A native trachea-mimetic bellows scaffold, a framework for a tissue-engineered tracheal graft, was indirectly 3D printed and reinforced with ring-shaped bands made from medical grade silicone rubber. A tissue-engineered tracheal graft was then created by stratifying tracheal mucosa decellularized extracellular matrix (tmdECM) hydrogel on the luminal surface of the scaffold and transferring human inferior turbinate mesenchymal stromal cell (hTMSC) sheets onto the tmdECM hydrogel layer. The tissue-engineered tracheal graft with critical length was anastomosed end-to-end to the native trachea and complete re-epithelialization was achieved on the entire luminal surface within 2 months in a rabbit model with no post-operative complications. With this successful result, the present study reports the preliminary potential of the tissue-engineered tracheal graft as a rational tissue engineering strategy for extensive circumferential tracheal reconstruction.

在气管重建领域中，广泛的周向气管缺损仍然是主要的挑战性问题。在这项研究中，基于三维（3D）打印的组织工程气管移植物被开发用于广泛的圆周气管重建。通过医学级硅橡胶制成的环形带间接地3D打印并增强了天然气管模拟波纹管支架（用于组织工程气管移植的框架）。然后，通过将支架腔表面上的气管粘膜脱细胞的细胞外基质（tmdECM）水凝胶分层，并将人下鼻甲间充质基质细胞（hTMSC）层转移到tmdECM水凝胶层上，来创建组织工程化的气管移植物。在兔模型中，在没有术后并发症的情况下，将具有关键长度的组织工程性气管移植物端到端与天然气管端接吻合，并在2个月内在整个腔表面实现了完全的上皮形成。有了这个成功的结果，本研究报告了组织工程气管移植物作为广泛的气管周围重建的合理组织工程策略的初步潜力。