Patient's Stem Cells Used To Create New Trachea

In a revolutionary development, an international medical effort has succeeded in providing a critically ill, 30-year-old Colombian woman with a new tracheal graft. The new organ was constructed by Italian and British scientists, while the reconstructive surgery took place in Spain. A 7-cm long portion of trachea was harvested from a deceased patient, cleansed of all its tissue, and then modified with the woman's own stem cells.

The stem cells were harvested from the woman's own spinal cord, and grown in the laboratory at the University of Bristol (UB; UK). "Surgeons can now start to see and understand the very real potential for adult stem cells and tissue engineering to radically improve their ability to treat patients. We believe this success has proved that we are on the verge of a new age in surgical care,” said UB surgery professor, Dr. Martin Birchall, one of the members of the team that grew the cells.

The next step, for the hospital in Barcelona, Spain, was to send the harvested windpipe to University of Padua (Italy), where a team of researchers, led by Dr. Maria Teresa Conconi, used detergents and a variety of enzymes to remove all existing cells from the trachea. After approximately six weeks, all that was left was a scaffold, strong enough to sustain the implantation of other cells on top of it.

At the same time, Bristol scientists grew the cells in the laboratory, forcing them to develop as new cartilage cells, the type that can usually be found in the windpipe. When the graft was complete, they sent it to Italy again, but this time at the Polytechnic of Milan. There, a bioreactor fused the scaffold and the new cells together, after four days of incubation. It took from March to June 2008 to complete this troublesome task, but, finally, surgeon Dr. Paolo Macchiarini, at the Hospital Clinic (Barcelona, Spain) managed to perform the surgery, offering the patient, who could not use her left lung, a new chance. Now, more than five months later, the transplant is still healthy, and her body shows no signs of rejecting the new organ.

The study was published online November 19, 2008, in the journal The Lancet. "We think this represents a landmark and hope it will unlock the door for a safe and recipient-tailored transplantation of the airway in adults and children,” the authors reported in their study. "We hope that these future patients will no longer suffer the trauma of speech loss, severe shortness of breath, and limited social activities.”

Even more significantly, the procedure helps establish real evidence that new organs can be developed from a patient's stem cells. Moreover, this may lead to a groundbreaking new approach to developing replacement body parts.

Related Links:
University of Bristol
University of Padua
Hospital Clinic, Barcelona