A team of British researchers and Spanish surgeons have carried out the world’s first tissue-engineered whole organ transplant.
30-year-old mother-of-two Claudia Castillo needed a new left bronchus after her airways had been damaged by tuberculosis. Transplanting airways has always been very problematic and such transplants are usually unsuccessful. Therefore researchers at the University of Bristol in England embarked upon growing the woman a new airway.
Firstly, they obtained a donor trachea. They then used a series of chemicals and enzymes to wash away the cells from the donor trachea until all was left of it was a tissue scaffold made of collagen. They then repopulated the scaffold with epithelial cells and mesenchymal stem-cell-derived chondrocytes that had been cultured from cells taken from Ms Castillo. The new airway was then taken to Spain and transplanted into Ms Castillo by a team of Spanish surgeons.
A month after the transplant, a biopsy showed that the engineered airway had its own blood supply. At four-months, the transplant looked the same and had the same mechanical properties as normal airways, and the patients quality of life had returned to normal. Furthermore, there were no signs of transplant rejection even though the patient was not taking immunosuppressive anti-rejection drugs.
Study leader Martin Birchall, Professor of Surgery at the University of Bristol, said in a news release: “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. We believe this success has proved that we are on the verge of a new age in surgical care”.
Writing in The Lancet, the authors conclude: “The results show that we can produce a cellular, tissue-engineered airway with mechanical properties that allow normal functioning, and which is free from the risks of rejection. The findings suggest that autologous cells combined with appropriate biomaterials might provide successful treatment for patients with serious clinical disorders.”
Macchiarini P, Jungebluth P, Go T, et al. Clinical transplantation of a tissue-engineered airway. The Lancet. Early Online Publication, 19 November 2008. doi:10.1016/S0140-6736(08)61598-6
News release: Adult stem cell breakthrough. University of Bristol. November 19th 2008.
