The first tissue-engineered trachea met expectations

In 2008, an international group of surgeons led by Professor Paolo Macchiarini performed a unique operation at that time. A 30-year-old Colombian woman, part of whose trachea lost its functionality as a result of a complication of tuberculosis, had an organ transplanted, obtained in laboratory conditions using tissue engineering methods. To do this, the donor trachea was cleaned of its own cells (chondrocytes and epithelial cells), and the remaining collagen framework was populated with the patient's own stem cells, as well as epithelial cells isolated from the preserved fragment of her trachea.

The operation went without complications, and on the tenth day the patient was discharged from the clinic. The examination carried out after 4 months showed that the graft retained its normal appearance and properties, the patient's blood did not contain antibodies against the donor's antigens and she did not need to take immunosuppressive drugs.

In addition to the regular (approximately every 3 months) check of the implanted trachea, the researchers used computed tomography and bronchoscopy to assess its physical condition. 12 months after the operation, noticeable scars appeared in the transplantation area, which gradually led to a narrowing of this fragment of the respiratory tract and the appearance of a chronic progressive cough in the woman. This problem was solved by implanting a stent that ensures the preservation of the tracheal lumen. After that, despite the preservation of a certain amount of scar tissue (as evidenced by the results of regular bronchoscopies), unpleasant symptoms did not resume.

Now, five years after the successful operation, Professor Macchiarini and his colleagues have published the results of the latest examination of a patient who continues to enjoy a good quality of life. She works and leads an active social life. Moreover, the results of regular checks of lung functions, immunological parameters and other key indicators of the state of the body indicate that the woman's lungs are functioning well and she does not suffer from immunological complications.

According to Macchiarini, the results confirmed what the doctors themselves and potential patients had pinned their hopes on at the time of the operation: the safety and effectiveness of transplants obtained using tissue engineering methods in the long term. However, scarring in the area of surgical intervention indicates the need to improve the biomechanical stability of the graft. Currently, this aspect is being worked out as part of a preclinical study. In general, the results obtained in the framework of the first active clinical study indicate that tissue-engineered trachea transplantation may become a routine clinical procedure soon enough.

Article by Alessandro Gonfiotti et al. The first tissue-engineered airway transplantation: 5-year follow-up results is published in The Lancet magazine.

Evgeniya Ryabtseva
Portal "Eternal youth" http://vechnayamolodost.ru according to the materials of MedicalNewsToday:
Five years on, first ever tissue-engineered airway transplant remains successful.

24.10.2013