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Bioengineered tracheas successfully transplanted in two men
New Trachea Grown, Transplanted In Two Men
Paolo Macchiarini, Philipp Jungebluth et al report in Lancet their successful bioprosthetic trachea creation and transplantation in a 36-year old man in Sweden after a distal tracheal resection for recurrent primary tracheal cancer. The same group transplanted a bioengineered trachea into a 30-year old Baltimore man, who is doing well, according to the New York Times.
The first man had a bulky mucoepidermoid carcinoma previously treated with debulking surgery and regional radiation, that recurred in the last 5 cm of the trachea, causing stridor and dyspnea. Investigators created a bioprosthesis of nanocomposite polymer, using 3-D modeling based on the CT scan. They seeded the scaffolding ex vivo with mononuclear cells obtained from bone marrow aspirate, which produced a continuous neomucosal epithelial lining along the entire inner surface.
The tumor and distal trachea were resected, the prosthesis was successfully transplanted and GM-CSF injections were given as boosters post-operatively. After recovering from a pneumonia post-op, the patient did well and was alive at 5 month follow-up with improved lung function.
The Baltimore man had a similar success story just reported in the New York Times, after Macchiarini's group transplanted a bioengineered trachea into him after resection of a tracheal tumor.
Jungebluth P et al. Tracheobronchial transplantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study. Lancet 2011;378:1997-2004.
Henry Fountain, "Synthetic Windpipe Is Used to Replace Cancerous One," New York Times, January 12, 2012.