Last month in Sweden, a man suffering from late-stage tracheal cancer received a new windpipe made in the lab from a synthetic scaffold with flesh grown from his own stem cells. This is the first successful transplant in the world of a tissue-engineered trachea that does not use a scaffold made from a donor organ.
The 36-year-old man is due to be discharged today: he is not taking immunosuppressant drugs because the transplanted tissue was made with his own cells, said the hospital.
The operation took place on 9 June 2011 at the Karolinska University Hospital in Huddinge, Stockholm. Professor Paolo Macchiarini, who works at the Hospital and the Karolinska Institutet, led the international transplant team.
Macchiarini, a world expert in regenerative medicine, has successfully transplanted tissue-engineered tracheas before, for instance at the Hospital Clinic of Barcelona. But those tissue-engineered windpipes used “scaffolds” from trachea taken from organ donors. In those procedures the donated windpipe has the donor cells stripped away, leaving just the extracellular matrix, and then the recipient’s stem cells are used to seed new tissue onto the scaffold.
This new operation is a world first because it used an artificial scaffold made from a nanocomposite polymer material (a sort of spongy and flexible plastic made of extremely small building blocks).
Also on the team were Professor Alexander Seifalian of University College London in the UK, who designed and built the Y-shaped scaffold, and members from Harvard Bioscience in Boston in the US, who custom-produced the bioreactor that, in only two days, grew the flesh onto the scaffold from the patient’s own stem cells.
The man’s cancer had progressed to the point where he needed a transplant but no suitable donor organ was available. The tumor in his trachea was about 6 cm long and beginning to spread to a main bronchus, a tube that leads to a lung. He had received maximum treatment with radiotherapy, but to no avail.
The tissue-engineered option was the only one left to save his life. He was receiving cancer treatment at Landspitali University Hospital in Iceland, under the supervision of Professor Tomas Gudbjartsson who referred him to the Swedish hospital. Gudbjartsson was also on the transplant team.
The successful transplant brings hope to thousands of other patients who have late-stage tracheal cancer or other conditions that block the passage of air into the lungs. Children in particular would benefit from having this option, since child donor tracheas are much harder to obtain.
In a CNN-reported comment to the media about the significance of the operation, Macchiarini described it as a “beautiful international collaboration”:
“If scientists and clinicians work together, we can help humanity,” he said.
Source : Karolinska University Hospital, CNN.
Written by: Catharine Paddock, PhD