An article in the Nov. 19 online issue of the journal The
Lancet tells that story of a Colombian woman who got her life back thanks to a
surgery that gave her a new windpipe with tissue grown from her own stem cells,
thus eliminating the need for anti-rejection drugs.
Claudia Castillo, 30, a mother of two living in Barcelona had been
suffering from tuberculosis for years. The disease destroyed part of her
trachea, the windpipe connected to the lungs. In March, her left lung collapsed
and Castillo needed regular hospital visits to clear her airways thus being
unable to take care of her children the way she wanted. Doctors initially
wanted to remove the entire left lung but on a second thought, Dr. Paolo
Macchiarini, head of thoracic surgery at Barcelona’s
Hospital Clinic, proposed a windpipe transplant instead. He was the one
performing the surgery on Castillo.
With the help of a new technique developed at the University
of Padua, Italy, scientists removed all the cells from the trachea of a 51-year
old donor by essentially scrubbing it clean with a high-tech detergent
solution.
Meanwhile, doctors at the University
of Bristol, in England took a sample of Castillo’s
bone marrow from the patient’s hip. They used the bone marrow's stem cells to
create millions of cartilage and tissue cells to cover and line the windpipe.
Then doctors at the University
of Milan used a device to
put the new cartilage and tissue onto the windpipe, which was transplanted into
Castillo in June.
The surgery was a real success, the authors reported.
“Within four days after transplantation, the graft was almost
indistinguishable from adjacent normal bronchi,” Dr. Macchiarini said. After a
month, a biopsy of the site proved that the transplant had developed its own
blood supply. Also there was no sign of rejection after four months.
“The possibility of avoiding the removal of my entire lung and, instead,
replacing only my diseased bronchus with this tissue engineering process
represented a unique chance for me to return to a normal life that I am now
enjoying with my children and family,” Castillo said in a news release.
Now the doctors believe 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.”
However, Castillo needs to be closely monitored, as it can take up to three
years to know if the windpipe’s cartilage structure s solid and won’t fall
apart. She takes no drugs to suppress her immune system, a standard approach to
prevent rejection when foreign donor organs are used in a transplant. She is
able to walk 500 meters without stopping, climb stairs and take care of her
children, Johan, 15, and Isabella, four.