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Post details: Trachea Transplant Makes History

20/11/08

Permalink 11:54:32 am, by Tom, 413 words, 3356 views   English (UK)
Categories: Information

Trachea Transplant Makes History

Many years of research have today culminated in what could arguably be deemed an historic medical event. Claudia Castillo, a Columbian woman aged 30 who now lives in Spain, has been pronounced 'in excellent health' five months after a significant tissue-engineering operation following irreparable damage from tuberculosis.

As a result of a long line of experiments using pigs, cows, dogs, rats and sheep during the 1990s, Spanish doctors were able to work with researchers in Bristol to decellularise a donor trachea from a 51-year-old woman and successfully implant it into Ms Castillo. Decellularisation is needed in order to ensure that the receiver's body does not reject the transplanted organ: however, this must not take place to such a degree that the integrity of the donor organ's structure is compromised negatively. Significantly, the donor trachea was repopulated with Ms Castillo's own stem cells, rather than xenogeneically- or allogeneically-produced cells being used, and unlike other transplant patients, Ms Castillo will not have to take immunosuppressants as part of her post-operative care (a positive, given how far immunosuppressants can leave patients vulnerable to infection), as her body recognises her own cells. The other option for Ms Castillo would have been to have a lung removed, which could potentially have shortened her life.

The findings of the research, published in The Lancet (1), describe how the decellularised donated trachea was rotated in a bioreactor with Ms Castillo's stem cells before transplantation. The donor trachea, after time in the bioreactor, looked identical to a normal trachea, and some time after the operation had taken place, the divisions between Ms Castillo's own trachea and the donated trachea could barely be seen.

Even in 2007 (2), researchers using animals were writing cautiously about their results and claiming that more research needed to be carried out. However, to be able to start clinical trials on humans within the next 5 years is perhaps in another league, paving the way for the future of transplantation in humans. Animal research in Europe over the past ten years showed extremely positive results in both pigs and dogs, and Ms Castillo is the first human in which the same techniques have been applied. The success of her treatment allows enormous progression both in terms of transplant development and in terms of the use of extra-cellular matrices.

Regards

Bianca Summons

(1) Macchiarini, P. et al., "Clinical Transplantation of a tissue-engineered airway", The Lancet, Online Publication 19th November 2008
(2) Badylak, S.F. et al., "The extra-cellular matrix as a biologic scaffold material", Biomaterials 28: 2007, 3587-3593

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