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Boy Recieves Trachea in Historic Transplant Operation

April 3, 2010

A 10-year old boy underwent historic transplant surgery in a London hospital in early March, becoming only the second person to receive transplant tissue grown from his own stem cells and the first to receive an entire trachea.

The boy, whose name has not been released, was born with a rare, life threatening condition called long segment tracheal stenosis. At birth, his trachea (windpipe) was 1/6 th the size it should be, and it did not grow properly. Doctors at Great Ormond Street Hospital for Children in London used a cadaver trachea stripped down so that only the collagen structure was left, then seeded the scaffold with the boy’s own bone marrow stem cells (the same cells used in a bone marrow transplant). Doctors hope that these cells will grow, divide and develop into the specialized cells of the trachea over time. Since the majority of the trachea is made up of the boy’s own cells, his body should recognize them as his own. This means the trachea will not be attacked as foreign by the boy’s immune system, and that the boy may not have to deal with the lifelong, powerful anti-rejection drugs usually prescribed to transplant patients. Doctors say the boy is recovering well from surgery and that he reports breathing better than he has in years.

The very first stem cell generated tissue transplant was performed two years ago by Dr. Paolo Macchiarini of Careggi University Hospital in Florence, Italy. He transplanted a partial trachea into a 30-year-old woman in Spain. The woman’s own trachea had been severely damaged by tuberculosis.

While the long-term effects and risks of stem cell generated tissue transplants are still under investigation, if this technology is successful it represents a huge step forward in transplant technology. Using the patients own stem cells coupled with donor (or even synthetic) scaffolding could reduce the wait time for compatible organs and the risk of transplant rejection. While complex organs such as heart and kidney are years away, other tissues, such as esophagus and larynx (voice box) could be next on the list of tissues to attempt.

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