Woman given windpipe created in laboratory

[Dargos]

Linkto story.

LONDON, England (CNN) -- Doctors have given a woman a new windpipe with tissue engineered from her own stem cells in what experts have hailed as a "milestone in medicine."


Claudia Castillo, 30, suffered from tuberculosis for years.

The breakthrough allowed Claudia Castillo, a 30-year-old Colombian mother of two living in Barcelona, to receive a new section of trachea -- an airway essential for breathing -- without risk her body would reject the transplant.

Castillo was given the stem cell surgery, the controversial branch of medicine that some say could lead to human cloning, after the tuberculosis she had suffered for years left her with a severe lung collapse.

The condition left Castillo unable to carry out simple domestic duties or care for her children, researchers said. The only conventional option was a major operation to remove her left lung, a risky procedure with a high mortality rate.

Sound off: What do you think about this medical breakthrough?

A team from the universities of Barcelona, Spain; Bristol, England; and Padua and Milan, Italy, decided instead to replace Castillo's lower trachea and bronchial tube to her left lung with a lab-grown airway.

The operation, reported Wednesday in the British medical journal The Lancet, has been hailed as a major leap for medicine that could offer new hope for patients suffering from serious illness.

"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," said Martin Birchall, professor of surgery at the University of Bristol, who was part of the team that did the operation.

"We believe this success has proved that we are on the verge of a new age in surgical care."

To create the new windpipe, the team took a seven-centimeter (2.75-inch) segment of trachea from a 51-year-old who had died. Over a six-week period, the team then removed all the cells from the donor trachea, because those cells could lead to rejection of the organ after transplant.

The team then replaced the donor's cells with cells derived from Castillo's own stem cells, along with cells taken from a healthy part of her trachea. Birchall had already taken Castillo's stem cells from her bone marrow and grown them into a large population in his Bristol lab.


Four days after putting Castillo's stem cells into the donor trachea, the team was able to perform the transplant operation at the Hospital Clinic in Barcelona. Castillo had no complications from the operation and was discharged from the hospital 10 days later.

"We are terribly excited by these results," said Paolo Macchiarini of the University of Barcelona, who performed the operation in June.

Macchiarini said just four days after the operation, the transplanted windpipe was "almost indistinguishable" from the patient's normal bronchi. After one month, he said, the blood vessels had successfully grown back.

"We think that this first experience represents a milestone in medicine and hope that it will unlock the door for a safe and recipient-tailored transplantation of the airway in adults and children," the authors said in their report. "We hope that these future patients will no longer suffer the trauma of speech loss, severe shortness of breath and other limited clinical and social activities."

The doctors said Castillo is now able to care for her children and enjoy a normal quality of life. She can walk up two flights of stairs and occasionally even go out dancing at night.

In a comment accompanying the Lancet report, Toshihiko Sato and Tatsuo Nakamura of Kyoto University in Japan said the operation should be highly regarded, but follow-ups from longer evaluation periods are needed to better evaluate the results

No comment at this time, other than its great news!

[PeZook]

Holy shit...that woman went from "unable to do anything slightly exherting" to walking up stairs and dancing...holy shit...

The procedure still sounds complicated, delicate and slow, but hot damn. Where will this take us in twenty years? How about forty?

[tim31]

Someone's going to jump on this as stupid, but... If they removed all the cells from the donor trachea before replacing them with the woman's stem cells... What was left the the trachea in between? I just want some clarity there. That aside, this is great news!

[Kanastrous]

Someone's going to jump on this as stupid, but... If they removed all the cells from the donor trachea before replacing them with the woman's stem cells... What was left the the trachea in between? I just want some clarity there. That aside, this is great news!

I think you would end up with a sort of trachea-shaped structure made from collagen, without any endothelial cells attached.

I think.

[White Haven]

Windpipe transplant breakthrough
By Michelle Roberts
Health reporter, BBC News

Surgeons in Spain have carried out the world's first tissue-engineered whole organ transplant - using a windpipe made with the patient's own stem cells.

The groundbreaking technology also means for the first time tissue transplants can be carried out without the need for anti-rejection drugs.

Five months on the patient, 30-year-old mother-of-two Claudia Castillo, is in perfect health, The Lancet reports.

She needed the transplant to save a lung after contracting tuberculosis.

The disease had damaged her airways.

Scientists from Bristol helped grow the cells for the transplant and the European team believes such tailor-made organs could become the norm.

To make the new airway, the doctors took a donor windpipe, or trachea, from a patient who had recently died.

Then they used strong chemicals and enzymes to wash away all of the cells from the donor trachea, leaving only a tissue scaffold made of the fibrous protein collagen.

This gave them a structure to repopulate with cells from Ms Castillo herself, which could then be used in an operation to repair her damaged left bronchus - a branch of the windpipe.

By using Ms Castillo's own cells the doctors were able to trick her body into thinking the donated trachea was part of it, thus avoiding rejection.

Two types of cell were taken from Ms Castillo: cells lining her windpipe, and adult stem cells - very immature cells from the bone marrow - which could be encouraged to grow into the cells that normally surround the windpipe.

I was very much afraid. Before this, we had been doing this work only in pigs

Surgeon Professor Paolo Macchiarini of the Hospital Clínic of Barcelona, Spain

After four days of growth in the lab in a special rotating bioreactor, the newly-coated donor windpipe was ready to be transplanted into Ms Castillo.

Her surgeon, Professor Paolo Macchiarini of the Hospital Clínic of Barcelona, Spain, carried out the operation in June

He said: "I was very much afraid. Before this, we had been doing this work only on pigs.

"But as soon as the donor trachea came out of the bioreactor it was a very positive surprise."

He said it looked and behaved identically to a normal human donor trachea.

The operation was a great success and just four days after transplantation the hybrid windpipe was almost indistinguishable from adjacent normal airways.

After a month, a biopsy of the site proved that the transplant had developed its own blood supply.

And with no signs of rejection four months on, Professor Macchiarini says the future chance of rejection is practically zero.

"We are terribly excited by these results," he said.

"She is enjoying a normal life, which for us clinicians is the most beautiful gift."

Today Ms Castillo is living an active, normal life, and once again able to look after her children Johan, 15, and Isabella, four. She can walk up two flights of stairs without getting breathless.
I was a sick woman, now I will be able to live a normal life
Claudia Castillo

Professor Martin Birchall, professor of surgery at the University of Bristol who helped grow the cells for the transplant, said: "This will represent a huge step change in surgery.

"Surgeons can now start to see and understand the potential for adult stem cells and tissue engineering to radically improve their ability to treat patients with serious diseases."

He said that in 20 years time, virtually any transplant organ could be made in this way.

US scientists have already successfully implanted bladder patches grown in the laboratory from patients' own cells into people with bladder disease.

The European research team, which also includes experts from the University of Padua and the Polytechnic of Milan in Italy, is applying for funding to do windpipe and voice box transplants in cancer patients.

Clinical trials could begin five years from now, they said.

Between 50,000 and 60,000 people are diagnosed with cancer of the larynx each year in Europe, and scientists say about half them may be suitable candidates for tissue engineering transplants.

WINDPIPE TRANSPLANT
1 Trachea is removed from dead donor patient
2 It is flushed with chemicals to remove all existing cells
3 Donor trachea "scaffold" coated with stem cells from the patient's hip bone marrow. Cells from the airway lining added
4 Once cells have grown (after about four days) donor trachea is inserted into patient's bronchus

The BBC has some more detail on the subject that should answer your question, Tim.

[Kodiak]

Someone's going to jump on this as stupid, but... If they removed all the cells from the donor trachea before replacing them with the woman's stem cells... What was left the the trachea in between? I just want some clarity there. That aside, this is great news!

I think you would end up with a sort of trachea-shaped structure made from collagen, without any endothelial cells attached.

I think.

Exactly. You basically have a "cellular matrix" which provides a structure for the hosts own cells to take over. This is phenomenal.

[PeZook]

All we need now is a way to manufacture collagen structures in correct shapes to populate with stem cells, and voila: 100% compatible artificial tracheas!

[Solauren]

What would be ironcy: If an idiot that was anti-stem cell had extensive tracheal damage (and therefore couldn't talk), and needed this proceedure to restore it.

Anyway: Score another one for science!

[tim31]

I think you would end up with a sort of trachea-shaped structure made from collagen, without any endothelial cells attached.

I think.

Exactly. You basically have a "cellular matrix" which provides a structure for the hosts own cells to take over. This is phenomenal.

Fantastic! Was there a mention of how much this all cost?

[Kanastrous]

What would be ironcy: If an idiot that was anti-stem cell had extensive tracheal damage (and therefore couldn't talk), and needed this proceedure to restore it.

I wonder what would happen if the physicians involved declared that as a matter of personal morality they could not in good conscience perform the procedure on such a person.

[Junghalli]

This seems marvellously close to being able to produce replacement organs, and render conventional organ transplants obsolete. Yeah, I know, it's still a ways away from that, but damn this is exciting.

[K. A. Pital]

Great news. Yeah, I wonder where this will take us 20 years from now - if religious nutters won't get in the way.

[Broomstick]

All we need now is a way to manufacture collagen structures in correct shapes to populate with stem cells, and voila: 100% compatible artificial tracheas!

Why manufacture them when we can produce them from naturally grown collagen structures? It's like organ donation, but without the worry of rejection. Since you aren't worried about organ function, just structure, it should be far easier to gather up such parts than whole, functional organs. Tap into the organ donor pool. Many who die in a way that makes them ineligible to donate whole organs may still be able to provide such "collagen structures" to save lives.

As for the stem-cell controversy - the stem cells used are harvested from the recipient's own bone marrow, there should be no moral objection to this from the anti-abortion/pro-life crowd although some parties who object to blood products in any form will probably not want this.

[Patrick Degan]

But but butbutbut... Spain has socialised medicine! How can this be possible? Socialised medicine stifles incentive for research. You never have the latest technologies and the waiting time for treatment even for a hangnail is horrendous! This woman should have died from bureaucracy, because we all know a country with socialised medicine can't possibly pull off what a country with private healthcare and insurance and great big, happy, rich healthcare companies, like America, can do! Who do those Spanish Marxists think they're fooling?!?!

This can't be for real! Socialised medicine never works! RUSH SEZ SO!*

*well, that is, when he's high as a kite on hillybilly heroin...

[Molyneux]

It's peculiarly appropriate that I was watching Gurren Lagann when I read this.
I believe that the only words that suffice are "freaking" and "awesome"...though as far as organs go, a windpipe is still pretty simple, that's a great step towards real do-it-yourself transplants.

[Chris OFarrell]

But but butbutbut... Spain has socialised medicine! How can this be possible? Socialised medicine stifles incentive for research. You never have the latest technologies and the waiting time for treatment even for a hangnail is horrendous! This woman should have died from bureaucracy, because we all know a country with socialised medicine can't possibly pull off what a country with private healthcare and insurance and great big, happy, rich healthcare companies, like America, can do! Who do those Spanish Marxists think they're fooling?!?!

This can't be for real! Socialised medicine never works! RUSH SEZ SO!*

*well, that is, when he's high as a kite on hillybilly heroin...

The scary thing is there are a LOT of people who think that way.

For an example, I picked up a new Tom Clancy Book a few days ago.
I know I know, why the fuck did I do something so stupid?

A friend told me this 'Red Rabbit' was actually good, a throwback to the good ole Tom Clancy where he just wrote spy stories and so on, not the right wing Mary Sue Jack Ryan BS his last 4 Ryanverse books were.

Jesus CHRIST. I brought this book to read about Jack Ryan working with the CIA to uncover some kind of plot and the intricacies of counter-espionage work I was lead to believe would be here...not Carolyn Ryan EVERY FUCKING CHAPTER ranting about the evils of the British socialized medical system. An evil land where Doctors get full one hour lunch breaks where they all drink bear before going into major operations, with primitive tools and lesser trained people. Where it takes a year on the 'fast list' to get someone a life saving operation, and where if the operation cuts into their lunch hour, they immediately leave the patient on the table, go out and have lunch, then come back!
Compared to the glorious US system which would have the same operation done in a week with far superior tools, with doctors who would stay there all day if needed and all for the low low price of a few hundred dollars!! Hail the glorious US medical system!

The fact that some people honestly think this is the truth genuinely terrifies me.

[PeZook]

Where it takes a year on the 'fast list' to get someone a life saving operation, and where if the operation cuts into their lunch hour, they immediately leave the patient on the table, go out and have lunch, then come back!

He actually wrote that? Come on!

[Aranfan]

Yet another Miracle of Science.