Positive results five years after windpipe transplant
FOOTNOTE. After publication the conditions have changed. We have decided to keep this news article at our website as it is vital that our historic actions are transparent to the public. The researcher and medical doctor Paolo Macchiarini has been and is subject to internal and external investigations as well as scrutiny from the media. Read KI's latest comment regarding Paolo Macchiarini.
A five-year follow-up of the first successful transplant of a "tissue engineered" windpipe shows positive results, according to an article in the scientific periodical The Lancet. The patient, who was treated by Professor Paolo Macchiarini in 2008, has a good quality of life and has not experienced any immunological complications or rejection of the implanted airway.
The operation allowed a 30-year-old Colombian woman to receive a new section of tissue engineered trachea (windpipe), after part of her own trachea collapsed due to complications from tuberculosis. An international team of researchers, led by Professor Paolo Macchiarini at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet (then at the Hospital Clínic of Barcelona in Spain) implanted a tissue engineered trachea, produced by removing the cells from a human donor trachea, which was then reseeded with the patient's own stem cells as well as epithelial cells taken from a healthy part of her trachea.
The recipient had no complications from the operation and was discharged from hospital on the 10th postoperative day. As reported in The Lancet in 2008, after 4 months the graft had a normal appearance and properties, and the patient had no anti-donor antibodies and did not need to take immunosuppressive drugs. Now, Paolo Macchiarini and colleagues present five year follow-up data from the operation, reporting that the recipient continues to enjoy a good quality of life, including a normal social and working life.
Moreover, regular testing of lung function, immunological response to the transplant, and other key indicators reveal that the recipient has retained good lung function and has not experienced any immunological complications. In addition to regular testing of the implanted trachea's function, the researchers also examined the internal structure of the transplant area using CT scans and bronchoscopy. Six months after surgery, scarring in the area of the graft became apparent, which gradually led to narrowing of part of the airway, resulting in a persistent and worsening cough. This was addressed by implantation of a stent (a sort of scaffold) which holds the airway open, and although some scarring remains the patient no longer experiences any symptoms.
"These results confirm what we and many patients hoped at the time of the original operation, that tissue engineered transplants are safe and effective in the long term. However, the scarring which occurred in this patient shows that long-term biomechanical stability can be improved, something which is currently under active pre-clinical investigation", comments Paolo Macchiarini.
The study was supported by several funding bodies, among them the European Commission, the Swedish Research Council, and the Stockholm County Council (ALF grants).
Publication
The first tissue-engineered airway transplantation: 5-year follow-up results.
Lancet 2014 Jan;383(9913):238-44