Doctors Report First Windpipe Transplant Without Anti-Rejection Drugs

By Anna Boyd
14:30, November 19th 2008
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Doctors Report First Windpipe Transplant Without Anti-Rejection Drugs

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.



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