Reply to Tricard et al.

Dear Editor,

We are thankful to Professor Alain Wurtz and his team for their insightful critique on our article, ‘Feasibility of Tracheal Reconstruction using Silicone-Stented Aortic Allografts’. Their comments regarding long-term outcomes and structural changes in aortic allografts contribute significantly to our understanding and highlight areas needing further exploration [1, 2].

Professor Wurtz’s team pointed out the necessity of comparing our results with long-term data, specifically regarding graft contraction and the need for subsequent interventions observed in clinical settings [1]. While our study emphasized promising initial outcomes in graft remodelling and cartilage regeneration within a rat model, the complexities of long-term graft stability, as supported by their clinical observations and analogous preclinical studies, clearly warrant deeper investigation.

Our team has conducted a thorough analysis of the single-cell sequencing data from Professor Tendy Chiang’s published research, which involved decellularized tracheal grafts [3]. While this analysis revealed the critical role of the glutathione pathway—specifically glutamate–cysteine ligase, glutathione peroxidases, glutathione reductase and glutathione S-transferases—in cartilage regeneration, we acknowledge that there might be some differences when compared to aortic allografts. Additionally, we are utilizing advanced physical science techniques such as scanning electron microscopy, transmission electron microscopy and atomic force microscopy to detail the microstructural evolution and assess the structural integrity within the grafts.

At our hospital, we currently do not conduct clinical studies involving aortic allografts for airway transplantation, and thus we lack clinical specimens. Therefore, we propose a collaborative study where your team could provide single-cell sequencing data of postoperative specimens at various time points [1, 4]. Our team, with its strong expertise in bioinformatics, could perform in-depth analyses of these data. This partnership would enable us to comprehensively explore the structural regeneration processes of the grafts and potentially identify key regulatory pathways and molecules.

We are grateful for this engaging discussion and look forward to potential collaborative opportunities that promise to advance our field significantly.

ACKNOWLEDGEMENTS

This manuscript has been approved by all authors and has not been submitted to any other journal.

Conflict of interest: none declared.

REFERENCES