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1st Trachea Transplant From Stem Cells

Nov. 19, 2008 -- Doctors in Europe have performed the first trachea transplant that hinges on the patient's own stem cells.

The operation, done in June at Hospital Clinic in Barcelona, Spain, was successful and is detailed in today's online edition of The Lancet.

The patient was a 30-year-old woman whose left airway collapsed as a result of tuberculosis. She'd already had a stent implanted to reopen that airway, but that didn't work out and the stent had been removed.

Doctors got a trachea from an organ donor and stripped the donated trachea of cells that would have been rejected when transplanted into another person.

The doctors took adult stem cells and some other cells from the healthy right airway of the woman needing the trachea transplant, grafted those cells onto the stripped-down donated trachea, and marinated the trachea in chemicals in a lab to coax the trachea into rebuilding itself.

When the trachea was ready, the doctors implanted it into the patient. The procedure worked, and since the trachea had been prepped by the patient's own stem cells before transplantation, her body accepted it without immune-suppressing drugs.

Four months after the surgery, the woman was still doing well. By then, she could "walk up two flights of stairs, walk 500 meters without stopping, and care for her children," write Paolo Macchiarini, MD, and colleagues.

"We are terribly excited by these results," Macchiarini says in a news release.

The results should be "highly regarded," but longer follow-up is needed, states an editorial published with the trachea transplant report. The editorialists included Toshihiko Sato, MD, of the Institute for Frontier Medical Sciences at Japan's Kyoto University. Macchiarini's team agrees that more than six months of follow-up would be helpful before the procedure is tested in a clinical trial.