According to a recent article in Lancet magazine, the first “engineered” transplant in the world was a success. For the first time, a trachea was “tailored” to the patient before being implanted. 30 year old Colombian Claudia Castillo who suffered damage to her trachea due to tuberculosis was the patient in an operation that was particularly interesting for Italy, since the operation was performed in June by an international medical team led by Paolo Macchiarini, the head of Thoracic Surgery at the Clinic de Barcelona, in collaboration with specialists from the Milan General Hospital, and the Universities of Bristol and .
During the transplant, her own stem cells were implanted into the donor trachea in order to avoid using traditional anti-rejection therapy based on immunosuppressant drugs. In order to allow the patient’s immune system to accept the trachea without having to use anti-rejection therapies, doctors resorted to a tissue engineering technique. The result was a sort of hybrid organ between the donor and the patient. Basically, the donor’s organ was used, but it was cleaned of its own cells which were then substituted with stem cells from the patient. This allowed doctors to perform the transplant without using immunosuppressants. The therapy used was only tested on pigs and is still in its experimental phases.
The operation can now open the doors to the “construction” of hollow organs like the intestines, blood vessels, parts of the reproductive tracts, and could in the future involve solid organs like the heart, liver, and kidneys. “We are finally starting to see the clinical application of regenerative medicine. The trachea transplant performed successfully in Spain opens up new scenarios and leads to the belief that the innovative techniques could be used on organs like the trachea, bladder, or esophagus,” according to the director of the National Transplant Center Alessandro Nanni Costa.
Nanni Costa continued, speaking to Adnkronos Salute, “The truly new aspect of this operation is that it uses engineered tissue, which allows doctors to avoid the use of immunosuppressant drugs and allows complete compatibility with the patient receiving the transplant at least in the initial phase. The objective now is to extend this type of operation to other transplants like the bladder or the esophagus which are similar to the trachea”.