A Colombian woman has received the world’s first tailor-made trachea transplant, grown by seeding a donor organ with her own stem cells to prevent her body rejecting it, an international research team reported recently on The Lancet.
The success of the operation, performed in June using tissue generated from the woman’s own bone marrow, raises the prospect that transplanting other organs may be possible without drugs to dampen the immune system, they said.
Doctors work hard to match tissue type when transplanting organs so that the body does not completely reject the new organ, but patients usually have to take immunosuppressants for the rest of their lives.
“The probability this lady will have a rejection is almost zero percent,” Dr. Paolo Macchiarini, head of thoracic surgery at the Hospital Clinic, Barcelona who performed the transplant, told a news conference — news agency Reuters says.
“The patient is enjoying a normal life with no signs of rejection after four months.”
Claudia Castillo sought help after a case of tuberculosis destroyed part of her trachea — the windpipe connected to the lungs — and left her with breathing difficulties, prone to infections and unable to care for her two children.
The 30-year-old’s only option other than the experimental surgery was for doctors to remove part of her lung — a choice that would have seriously degraded her quality of life, the researchers said.
“It is not just an issue of life, it is an issue of quality of life,” said Martin Birchall, a surgeon at the University of Bristol, who helped treat Castillo.
After finding a donor, the researchers first depleted the transplanted trachea of the donor’s cells and then obtained bone marrow stem cells from Castillo they grew into cartilage cells.
Next, the team seeded these cells on the outside of the donor trachea using a device developed at Milan Polytechnic in Italy that incubated the cells. The researchers used the same device to make epithelial cells to construct the lining of the trachea.
This created a hybrid organ in a lab that Castillo’s body would identify as its own and make immunosupressant drugs unnecessary, the researchers said.
Finally, the team grafted a 5 cm (1.97 inch) piece of the trachea onto Castillo’s damaged left main bronchus, which connects the main windpipe to the left lung.
Castillo, who lives in Spain, had no complications from the surgery and left the hospital after 10 days. She is returning to normal activities and even called her doctors from a night club to say she had been out dancing all night, the researchers said.
“We believe this success has proved we are on the verge of a new age in surgical care,” said Birchall, who predicted the technique could be applied to other hollow organs similar in structure, such as the bowel, bladder and reproductive tract.
Source: The Daily Star, November 22, 2008