Tailor-Made Trachea Transplant Brings Hope Of Drug-Free Transplants

In a historic transplant surgery, a donated trachea cultured with the recipient’s stem cells was successfully implanted, with no reported rejection, while also doing away with the need for powerful drugs, reported an international research team Wednesday.

The trail-blazing operation performed on a Columbian woman in June brings hope that the procedure can be used soon to duplicate drug-free transplants of other organs too.
Dr. Paolo Macchiarini, head of thoracic surgery at the Hospital Clinic, Barcelona who performed the transplant, told news reporters that 30-year-old Claudia Castillo is in fine health four months following the operation.
Prof Macchiarini said: "We are terribly excited by these results. Just four days after transplantation, the graft was almost indistinguishable from adjacent, normal bronchi." Details of the transplant are described in an online edition of The Lancet journal.
"We believe this success has proved we are on the verge of a new age in surgical care," said Martin Birchall, a surgeon at the University of Bristol, who helped in the operation. He also pointed to the possibility of applying the same technique to other hollow organs, such as the bowel, bladder and reproductive tract.
In five years, scientists hope to begin clinical trials in which cancer of the larynx can be treated with laboratory-made implants. Castillo had been suffering from breathing trouble after a part of her trachea, the windpipe connected to the lungs, was damaged in an attack of tuberculosis.
Instead of removing part of her lung, which would have seriously compromised her quality of life, she opted for the experimental surgery, which had hitherto been tried on pigs only. Researchers from the UK, Italy, and Spain worked together in the complex process.
A section of windpipe was taken from a deceased female donor and its cells were depleted. Stem cells from Castillo's bone marrow were grown in the laboratory, which were “seeded” in the donor trachea along with some cells from her nose and healthy air passages.
The trachea graft was next planted in the correct places, and allowed to grow naturally. Finally the trachea, covered in cartilage and lined with the patient’s own cells, was put into place.
Castillo responded remarkably well to the operation. She left the hospital after 10 days and is enjoying an eventful life now.
The drug-free trachea transplant is a major step ahead in the field of regenerative medicine. It skirts the major tissue-rejection issues that put recipients of transplanted organs on powerful drugs for the rest of their lives.