30 July 2012
ByAppeared in BioNews 667
The Irish boy who had pioneering surgery two years ago to implant a new windpipe partially derived from his own stem cells is healthy and back at school. A follow-up study published in The Lancet medical journal reports that Ciaran Finn-Lynch, now 13, is breathing normally and no longer needs anti-rejection medication.
Finn-Lynch was born with a rare condition called long-segment tracheal stenosis which causes severe breathing difficulties. To prevent his lungs collapsing, he had metal tubes inserted into his airways but this resulted in damage to a main artery. In 2010 surgeons proposed using a novel technique where a donor windpipe coated with Finn-Lynch's own stem cells would be implanted.
At the time, Martin Birchall, professor of laryngology from University College London, who co-led the team carrying out the transplant called the technique 'a completely new approach'.
'We did a similar operation to a young woman in Spain in 2008. She is now working full-time, looking after her children and doing very well. This is very different and we can't predict exactly what is going to happen', he said.
One novelty of the procedure was the method of culturing the stem cells inside the body rather than in the laboratory. Surgeons stripped the donor's windpipe to its collagen scaffolding and then sprayed on stem cells from the boy's bone marrow. Once this structure was implanted, the stem cells began dividing and matured to create the new organ.
Commenting on the results of the two-year follow-up, Martin Elliott, professor of cardiothoracic surgery at University College London and Professor Birchall's partner leading the team, said: 'The ideal outcomes for tracheal transplants in children are normal airway and lung function, good general growth, a decent quality of life, and no further surgical interventions'.
'So far we have achieved this, but we are at the edge of medicine and, similarly to first attempts of organ transplantation in the 1950s, many challenges remain'.
The team hopes the operation and successful outcome will spark more research and innovative stem cell applications. Professor Birchall commented: 'We need more research on stem cells grown deliberately inside the body, rather than grown first in a laboratory over a long time. This research should help to convert one-off successes into more widely available clinical treatments'.
Indeed, while the procedure appears to have been successful in Finn-Lynch's case, it is still considered as experimental. Professor Larry Goldstein, director of the stem cell program at University of California in San Diego told ABC News: 'You never know what to do or how to interpret a success when it's one success; the question you grapple with is whether this treatment is going to be good with a larger number of people with this disease'.