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Stem cells used for pioneering windpipe transplant

22 March 2010
Appeared in BioNews 550

A UK child has become the world's first to receive a full windpipe transplant using an organ built from his own stem cells. Doctors stripped a donor windpipe - trachea - to its collagen scaffolding and coated it with stem cells from the 10-year-old boy's bone marrow. The boy is reportedly doing well and breathing normally.

This is the first such transplant received by a child and the longest airway replaced so far. The first windpipe transplant using stem cells was performed in 2008 on a 30-year-old South American woman, Claudia Castillo, but only part of her airway was replaced.

Professor Martin Birchall, the head of translational regenerative medicine at University College London and part of the team behind the transplant, said: 'It is the first time a child has received stem cell organ treatment, and it's the longest airway that has ever been replaced'. He said: 'We need to conduct more clinical trials to demonstrate that this concept works. We'd like to move to other organs as well, particularly the larynx and oesophagus'.

The boy's new trachea was transplanted just hours after stem cells mixed with growth medium were injected onto its inner and outer surface. The stem cells are expected to change into tracheal cells inside his body. Previous transplants grew the new windpipe outside the laboratory before it was implanted - this takes several months. But this latest transplant was accelerated because the boy's condition deteriorated, according to The Telegraph.

The boy has a rare condition called long segment tracheal stenosis - his windpipe was one millimetre across at birth, too narrow to breathe unaided. A metal device had been used to hold his trachea open, but it had began to damage blood vessels from his heart and could have caused a life-threatening bleed.

The doctors hope using a patient's own stem cells will reduce the chances of transplant rejection. 'The question is do we really need to transplant the entire organ and put the patient on immunosuppression or can we stimulate stem cells to make it function again?' said Professor Paolo Macchiarini of Careggi University hospital in Florence who was involved in this and Claudia's operation.

Boy's windpipe replaced in pioneering stem cell operation
Guardian |  19 March 2010
Child has windpipe transplant with stem cells
WebMD |  20 March 2010
Windpipe operation is major step forward for transplant surgery
The Telegraph |  20 March 2010
Windpipe transplant success in UK child
BBC News |  19 March 2010
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