tissue engineered airway transplanted with no rejection

Inpharma 1666 - 29 Nov 2008

Tissue engineered airwaytransplanted with no rejection

A multinational team of scientists and clinicians havecollaborated to create and successfully transplant atissue-engineered airway, which did not requiresubsequent immunosuppression; a summary of theirwork was presented in The Lancet.

Preclinical work by team members had shown thatafter in vitro generation, tracheal matrices could begrafted into animals without an immunologicalresponse. So, when a 30-year old woman with post-tuberculous chronic tracheitis and secondary severebronchomalacia of the left main bronchus failed torespond to conventional treatment, the team and thepatient agreed to attempt such a transplantation ratherthan undergo left carinal total pneumonectomy, aprocedure associated with high rates of morbidity andmortality.

To create the bioengineered human trachea, the teambegan by decellularising a tracheal segment from adeceased female donor to form the airway matrix. Theythen prepared cultures of the recipient’s epithelial cellsand chondrocytes, and using a bioreactor, seeded thesecells onto the matrix. The bioengineered airway wasthen transplanted for the diseased airway, and the leftlung ventilated well immediately.

The postoperative period was uneventful, and thepatient was discharged after 10 postoperative days; shewas reported to be well since, able to walk up two flightsof stairs and care for her children. Serological testing at14 days, 1 month and 2 months showed a completeabsence of HLA antibodies, and bronchoscopy, at1 month, revealed that the graft to be indistinguishablefrom native tissue, and local mucosal bleeding indicatesuccessful revascularisation. Lung function tests at2 months were within the normal range for age and sex.Macchiarini P, et al. Clinical transplantation of a tissue-engineered airway. Lancet372: 2023-2030, No. 9655, 13 Dec 2008 801020762

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Inpharma 29 Nov 2008 No. 16661173-8324/10/1666-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved