Airway transplant success
Wednesday October 23rd, 2013
A woman who received an artificial windpipe five years ago is doing well and has no complications, doctors reported today.
The
first transplantation of a tissue-engineered windpipe (trachea) in a human
was carried out in 2008. Cells were taken from a healthy donated trachea
and then grown in the lab together with cells from the 30-year-old female
recipient, Claudia Lorena Castillo Sánchez, from Colombia. This
created a graft to replace a damaged left bronchus.
It allowed her to breathe immediately, and at four months it had improved her quality of life, and worked effectively with no need for treatment to prevent rejection.
Now, the team report their five-year follow-up results. In The Lancet, the team explain that the patient was followed up about every three months with a CT scan and assessment. Biopsy samples were taken every six months.
After one year, some narrowing occurred due to scar tissue and a stent was needed to maintain airway width.
"However, the tissue-engineered trachea itself remained open over its entire length, well vascularised, completely re-cellularised with respiratory epithelium, and had normal ciliary function and mucus clearance," say the team.
Her lung function and cough reflex were normal. No abnormal growths formed and no antibodies were made against the donated cells. Apart from frequent tests, "the patient had a normal social and working life," they report.
Team leader, Professor Paolo Macchiarini of the Karolinska Institutet in Stockholm, Sweden, said: "These results confirm what we - and many patients - hoped at the time of the original operation: that tissue engineered transplants are safe and effective in the long-term."
But he added that the scarring which occurred "shows that long-term biomechanical stability can be improved".
Gonfiotti, A. et al. The first tissue-engineered airway transplantation: 5-year follow-up results. The Lancet 23 October 2013 doi:10.1016/S0140-6736(13)62033-4 [abstract]
Tags: Europe | Respiratory | Transplant
Printer friendly page