The first tissue-engineered trachea (windpipe), using the patient's own stem cells, has been successfully transplanted into a woman with a failing airway. The bioengineered trachea provided the patient with a normally functioning airway which saved her life.
The patient was a 30-year-old mother of two, suffering from collapsed airways following a severe case of TB. She was hospitalised in March 2008 with shortness of breath rendering her unable to carry out simple domestic tasks or care for her children. The only other option remaining was a major operation to remove her left lung which carries a litany of risks and possible complications that most likely lead to death.
A medical team from the universities of Barcelona, Bristol, Padua and Milan have pioneered the developments in stem cell research. Based on successful laboratory work previously performed by the group, and given the urgency of the situation, it was proposed that the lower trachea and the tube to the patient's left lung (bronchus) should be replaced with a bioengineered airway based on the scaffold of a human trachea.
A seven-centimetre tracheal segment was donated by a 51-year-old transplant donor who had died of cerebral hemorrhage. Spain has a policy of assumed consent for organ donation. Using a new technique developed in Padua University, the trachea was decellularised over a six-week period so that no donor cells remained.
Stem cells were obtained from the recipient's own bone marrow, grown into a large population in Professor Martin Birchall's lab at the University of Bristol, and matured into cartilage cells (chondrocytes) using an adapted method originally devised for treating osteoarthritis by Professor Anthony Hollander at the University of Bristol.
The donor trachea was then seeded with chondrocytes on the outside, using a novel bioreactor which incubates cells, developed at the Politecnico di Milano, Italy, allowing them to migrate into the tissue under conditions ideal for each individual cell type. In order to replicate the lining of the trachea, epithelial cells were seeded onto the inside of the trachea using the same bioreactor. Four days after seeding, the graft was used to replace the patient's left main bronchus. The operation was performed Professor Paola Macchiarini in June 2008 at the Hospital Clinic in Barcelona.
Click here for the source
