“He was condemned to die,” said Paolo Macchiarini, a professor of regenerative surgery who carried out the procedure at Sweden’s Karolinska University Hospital. “We now plan to discharge him [Friday].”

For the first time in surgical history, on June 9th 2011, an entirely synthetic and permanent trachea was successfully transplanted using a patient’s own cells. An Eretrian man from Iceland, Andemariam Teklesenbet Beyene, left Karolinska University Hospital in Huddinge, Stockholm Friday breathing through a trachea engineered with cells that came from his own body, not one transplanted from a cadaver’s throat.

As a 36 year old father of two and student of geology at the University of Iceland in Reykjavik, Beyene never imagined that he would suffer from an advanced case of tracheal cancer, experiencing the excruciating difficulty of malignant tumors expanding to about six centimeters in length, almost completely blocking his windpipe and choking off his oxygen supply.

It had reached a point where Dr. Paolo Macchiarini of Karolinska University Hospital decided that there was no time to wait for a donor trachea and assembled a team to build one with Beyene’s own cells. With the successful transplantation of cadaver-based windpipes in 10 patients, he had good reason to feel emboldened. But tracheas from cadavers that are so relied on by patients like Beyene are in very short supply and those who are fortunate enough to receive one face risk of rejection and a life-time of immunosuppressant drugs that also inconveniently include a number of side effects. With a synthetic trachea built from his own cells, Beyene can breathe easy–without the use of the immune-suppressing drugs.

“It makes all the difference,” said Dr. Macchiarini. “If the patient has a malignant tumor in the windpipe, you can’t wait months for a donor to come along.”

So how did they do it? Scientiest Alexander Seifalian of University College London built the trachea with a glass tube as a base with the precise dimensions of Beyene’s trachea, obtained from three-dimensional images. A medical plastic called polyethylene glycol was then used to build a scaffold around it. Because of the plastic’s porous nature, stem cells can grow into it, induced by the hormones applied by the scientists to persuade them to differentiate into the bony cells- the cells normally found in the lining and exterior of the trachea. Then it’s “popped” into the oven-like bioreactor where after the two days it takes for the cells to grow and proliferate, it’s ready for implantation. From beginning to end, the entire process took less than a week’s time.

The operation marks another step forward for the field of regenerative medicine and “further validates the fact that these technologies may have a role in treating larger numbers of patients in the future,” said Dr. Anthony Atala, director of the Institute for Regenerative Medicine at Wake Forest University School of Medicine in Winston-Salem, N.C.

48 hours after the procedure, the appropriate cells were shown by imaging and other studies to populate the artificial windpipe which had begun to function like a natural one. Beyene’s immune system did not reject it because the cells came from his own body. In fact, he no longer has cancer and is expected to have a normal life expectancy, the doctors said. His speedy recovery is quite a testament to the mission of making fresh body parts for transplantation or treatment from one’s own cells and more immediately, it offers a viable option for thousands who suffer from tracheal cancer or other life-threatening conditions that affect the trachea.

Dr. Macchiarini says he plans to use the same windpipe-transplant technique on three more patients, two from the U.S. and a nine-month-old child from North Korea who was born without a trachea.

Regenerative therapies are saving more and more lives but there is yet so much ground to cover before much more complex organs like the heart with its many different cell types can be built from a patient’s own cells. We plead you to help us get there faster! Join the New Organ Network for free. Create a profile, build a network of your friends and family. Show that you care!

References:

Cevallos, Marissa. “Transplanted Trachea, Born in Lab, Is One of Several Engineered-organ Success Stories.” Los Angeles Times Booster Shots. Los Angeles Times, 8 July 2011. Web. 8 July 2011.
http://www.latimes.com/health/boostershots/la-heb-trachea-transplant-stem-cell-20110708,0,2121263.story.