Nov. 19, 2008 -- Doctors in Europe have performed the first tracheatransplant that hinges on the patient's own stem cells.
The operation, done in June at Hospital Clinic in Barcelona, Spain, wassuccessful 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 resultof tuberculosis. She'd already hada stent implanted to reopen that airway, but that didn't work out and the stenthad been removed.
Doctors got a trachea from an organ donor and stripped the donated tracheaof cells that would have been rejected when transplanted into anotherperson.
The doctors took adult stem cells and some other cells from the healthyright airway of the woman needing the trachea transplant, grafted those cellsonto the stripped-down donated trachea, and marinated the trachea in chemicalsin a lab to coax the trachea into rebuilding itself.
When the trachea was ready, the doctors implanted it into the patient. Theprocedure worked, and since the trachea had been prepped by the patient's ownstem cells before transplantation, her body accepted it withoutimmune-suppressing drugs.
Four months after the surgery, the woman was still doing well. By then, shecould "walk up two flights of stairs, walk 500 meters without stopping, andcare for her children," write Paolo Macchiarini, MD, and colleagues.
"We are terribly excited by these results," Macchiarini says in anews release.
The results should be "highly regarded," but longer follow-up isneeded, states an editorial published with the trachea transplant report. Theeditorialists included Toshihiko Sato, MD, of the Institute for FrontierMedical Sciences at Japan's Kyoto University. Macchiarini's team agrees thatmore than six months of follow-up would be helpful before the procedure istested in a clinical trial.