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Tissue engineered trachea, 5 years on...

Thu, 24th Oct 2013

Chris Smith

What happened to the lady given a laboratory-grown trachea 5 years ago?

This week, writing in the Lancet, the team who re-grew Trachea tissue engineeringa replacement windpipe for a woman with severe respiratory complications caused by tuberculosis, have reported on her long-term outcome.

The patient, Claudio Castillo, who was 30 at the time of her surgery, was the world's first recipient of a "new" trachea grown using tissue engineering.

What Karolinska Institute scientist Paolo Macchiarini did in 2008 was to use detergent to "decellularise" - remove all of the cells from - a trachea obtained from a donor patient who had died of a stroke.

The removal of the donor cells left behind just a scaffold of connective tissue, to which the team added stem cells collected from Castillo's bone marrow and airway-lining cells collected from her nose.

Incubated in a bioreactor, the cells completely repopulated the connective tissue, resulting in a genetically compatible replacement trachea, which was implanted a few days later.

The woman made a rapid recovery and left hospital shortly afterwards, but has been followed-up regularly ever since, using CT, bronchoscopy and biopsy tests every 3-6 months.

Now, the researchers have published the long-term results of this first-of-a-kind therapy. They confirm that the woman's graft tissue remains healthy and, critically, there has been no evidence of tumour formation, which is a major concern where stem cell therapies are concerned.

The woman has also shown no evidence of an immune response to the donor tissue and enjoys a normal work and social life. She has, however, experienced a repeated narrowing in part of her airway, but not within the region replaced by the graft.

"These clinical results," the team conclude, "provide evidence that a tissue-engineering strategy including decellularisation of a human trachea... is safe and promising."

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Very interesting.
I wonder if the next step would be building the main support structure "scaffold" with 3-D printing, or some casting process without the requirement of a human donor.  Or, for that matter, would a xenograft be possible? CliffordK, Thu, 24th Oct 2013

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