BRITISH DOCTORS HELP PERFORM
WORLD'S FIRST TRANSPLANT OF A WHOLE ORGAN GROWN IN LAB
By Kate Devlin
The Telegraph
November 19, 2008
Original LinkSurgeons replaced the damaged windpipe of Claudia Castillo, a 30-year-old mother of two, with one created from stem cells grown in a laboratory at Bristol University.
Because the new windpipe was made from cells taken from Ms Castillo's own body, using a process called "tissue engineering", she has not needed powerful drugs to prevent her body rejecting the organ.
Avoiding the use of these drugs means she will not be at an increased risk of cancer and other diseases unlike other transplant patients -- another significant advance.
Five months after the operation was carried out she is now living normally and is able to look after her children again.
Stem cells are "master cells" which can be manipulated in a laboratory to become any other cell in the body.
Scientists hailed the procedure as a breakthrough and predicted surgeons could be regularly replacing hearts with laboratory-grown organs within 20 years.
The technique would "revolutionise" surgery, they claimed, and has the potential to save thousands of lives.
The team behind the operation hope to replicate the procedure to grow voiceboxes within five years and say that from there the door would be open to use the technology to create any organ including a bladder, kidney or even a heart.
Professor Martin Birchall, who grew the stem cells in his laboratory at the University of Bristol, said: "In 20 years' time this will be the most common operation that surgeons are doing. This will completely revolutionise how we think about surgery and medicine."
Although doctors were able to carry out a similar operation on a bladder two years ago, Prof Birchall said that that had merely been a "patch", transferring part rather than the whole of the organ, a much less complex task.
"This is another major step forward again," he said.
Every year more than 1,000 patients in Britain die on transplant waiting lists, prompting scientists to consider other ways to produce organs. Ms Castillo's operation required a section of windpipe from an organ donor as a "scaffold" for the stem cells -- meaning the technique will not immediately solve the shortage of donor organs. However, it is hoped that eventually artificial scaffolds can be made which would avoid the need for donor organs completely.
Without the operation, surgeons would have had to remove one of Ms Castillo's lungs, which would have reduced her life expectancy dramatically, said Professor Paolo Macchiarini, who performed the surgery at the Hospital Clinic, Barcelona, in June.
"But now she can expect to have a normal life expectancy for a woman her age," he said
Ms Castillo, who is originally from Colombia but who lives in Spain, is now able to look after her children, walk up two flights of stairs and even occasionally go dancing.
She said: "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 my normal life.
"I was scared at the beginning because I was the first patient but had confidence and trusted the doctors. I am now enjoying life and am very happy that my illness has been cured."
After suffering from tuberculosis, she was admitted to hospital in March of this year with acute shortness of breath which meant that she was unable to carry out simple domestic duties or care for her children.
With the only other option available an operation to remove her left lung, doctors decided to see if they could grow a new windpipe in the laboratory.
To create the new airway scientists originally started with a donor windpipe which they stripped of all its cells, using a new technique developed by Padua University, leaving just a form of "scaffold" which they then encouraged Ms Castillo's cells to grow around.
After growing a 5cm-long trachea in the lab, the scientists then carried out the operation to transplant it into the patient.
Doctors have previously been unsuccessful in attempting to transplant a windpipe from one human to another, because the large amount of immune-system suppressing drugs needed to ensure that the body would not immediately reject the organ. Severe infections, bleeding and tissue death have led to other trachea transplants failing.
No such medication was needed in this case, because the airway had been grown using the patient's own stem cells, taken from her hip and nose.
Two months after the transplant, tests showed that her lung function had returned to normal, according to the findings published in the Lancet medical journal.
Around 300 patients a year suffer from similar problems as Ms Castillo, caused by cancer, infection or tuberculosis.
Around 3,000 a year could benefit from a voicebox transplant while tens of thousands of lives worldwide could be saved if doctors were able to transplant hearts and other organs grown in the laboratory.
Prof Macchiarini, from the University of Barcelona, said: "We are terribly excited by these results. After one month, a biopsy elicited local bleeding, indicating that the blood vessels had already grown back successfully".
Anthony Hollander, also from the University of Bristol, said: "This successful treatment manifestly demonstrates the potential of adult stem cells to save lives".
Ben Sykes, from the UK National Stem Cell Network, said: "This is an excellent demonstration of the potential of adult stem cells as one of several possible avenues in regenerative medicine and shows that the funding which has been invested into, and continues to be invested into, bone marrow stem cell research over decades is worthwhile."
John Evans, president of the British Organ Donor Society, said: "This is certainly science advancing at a rate of knots. It is something that has great merit and great possibility.
"Creating organs from stem cells would also remove some of the emotional as well as medical problems, by preventing the need to intrude upon a recently bereaved family and their private grief."