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World's first tissue-engineered whole organ transplant is a success

23 November 2008
Appeared in BioNews 485

A Colombian woman has become the world's first recipient of a windpipe grown in part from her own cells. Published in the Lancet journal last week, the team of surgeons from Spain, the UK and Italy, orchestrated the world's first tissue-engineered whole organ transplant. Professor Paolo Macchiarini, of the Hospital Clinic of Barcelona, carried out the operation in June this year. The success has led some to herald the technique as the beginning of 'a new age in surgical care'.

Mother-of-two Claudio Castillo, 30, was left barely able to breathe after a tuberculosis infection left a bronchus irreversibly damaged. Surgeons rarely recommend a trachea transplant, as it condemns a patient to a life dependent on immunosuppressive drugs, leaving them open to other infections. The most common resort for people in similar positions is to remove a lung, which improves health but invariably shortens lifespan. However, given the option of undertaking an experimental 'tissue engineering' surgery, so far only tried on pigs, Ms Castillo consented.

To start, the Spanish team removed seven centimetres of trachea from a deceased organ donor. Maria Teresa Conconi and colleagues at the University of Padua then stripped the windpipe of all trace of the donor's cells, using a potent mixture of detergent and enzymes. After six weeks, just a collagen 'scaffold' remained. In the meantime, bone marrow stem cells from Ms Castillo's hip had been sent to Bristol, where they were induced into becoming cartilage cells. Upon their return to Barcelona - a return voyage nearly ruined by one airline company's bureaucracy - the collagen scaffold was suffused with the cells in a special bioreactor developed at the Polytechnic of Milan. Another Bristol group seeded epithelial cells, taken from Ms Castillo's airways, inside the donor trachea. After four days of repopulating the scaffold with cells, the new trachea was sculpted to shape and inserted in place of the damaged bronchus.

Professor Martin Birchall, professor of surgery at Bristol, who helped differentiate the stem cells, was delighted with the success. '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 with serious diseases', he said.

The major benefit of the necessarily laborious procedure is clear - after five months, there is still no sign of transplant rejection, since Ms Castillo's immune system has no difficulty in recognising her own cells. The hope is that the operation might become a reality for other transplant operations.

Easyjet 'threatened to derail stem cell transplant'
The Daily Telegraph |  20 November 2008
Transplant first a giant leap for surgery
The Guardian |  19 November 2008
Windpipe transplant breakthrough
BBC News Online |  19 November 2008
Woman receives windpipe built from her stem cells
New Scientist |  19 November 2008
15 February 2016 - by Kirsty Oswald 
The world-renowned Karolinska Institute is at the centre of a scandal surrounding the conduct of stem-cell surgeon Paulo Macchiarini...
4 February 2013 - by Dr Charlotte Warren-Gash 
The bacteria that cause tuberculosis (TB) evade immune cells and drug treatments by hiding in bone marrow stem cells, according to research...
30 July 2012 - by Daryl Ramai 
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...
21 November 2011 - by Dr Zara Mahmoud 
The world's first stem cell therapy to repair torn cartilage in the knee has been brought one step closer. Professor Anthony Hollander, co-founder of University of Bristol spin-out Azellon Cell Therapeutics, has just received funding of £65,000 to carry out clinical trials on the use of a patient's own stem cells for knee repair...
11 July 2011 - by Dr Rebecca Robey 
Surgeons have successfully transplanted a synthetic organ into a human for the first time. In a groundbreaking operation, a cancer patient's windpipe was replaced with an artificial replica that had been grown using his own stem cells....
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