Artificial trachea: technology is being improved
The world's first transplantation of an artificial trachea and part of the larynx
using the patient's own cells was carried out in Russia
The transplantation was performed by Paolo Macchiarini, Professor of Regenerative Surgery at the Karolinska Institute (Stockholm, Sweden) and Vladimir Porkhanov, Head of the Department of Oncology and Thoracic Surgery at Kuban Medical University, Corresponding Member of the Russian Academy of Medical Sciences. A trachea was transplanted to the patient, created on the basis of a frame of nanocomposite material seeded with its own cells isolated from bone marrow. Professor Paolo Macchiarini led an international team of scientists, which also included specialists from Nanofiber Solutions (Ohio, USA), frame manufacturers, and Harvard Bioscience (Boston, USA), developers of a "personal" bioreactor created specifically for the patient. Preparation for this most difficult transplantation took more than six months.
The created bioprosthesis – an exact copy of the trachea and part of the patient's larynx – allows you to replace the affected organ and avoid rejection reactions. Externally, it looks like a tube made of elastic and at the same time plastic porous material, on which the patient's own cells isolated from the bone marrow are seeded. Then this structure is placed in a bioreactor, where the cells are attached to the frame. Within 48 hours, the base of the trachea is formed. In the future, the patient's body not only does not reject it, but on the contrary, the transplanted organ itself begins to "adapt" to new conditions. All the work on seeding the frame was carried out in the laboratory of KKB No. 1. It was attended by specialists of the clinic who completed an internship at the Karolinska Institute.
Candidates for transplantation were selected in February of this year after discussion at an international video consultation, which was attended by thoracic surgeons of the KKB No. 1 (Krasnodar), the State Medical Institution of the Russian Scientific Center of Surgery. Academician B.V. Petrovsky RAMS (Moscow), Karolinska Institute (Sweden), the Carreggi Clinic of the University of Florence (Italy) and the Clinic of the University of Texas (USA). They have extensive damage to the trachea, formed as a result of the consequences of trauma.
The first patient, 33–year-old Yulia T. from St. Petersburg, is no exception. A year and a half ago, she was the victim of a car accident with serious consequences. She developed cicatricial stenosis of the trachea, which caused serious difficulties with breathing and speech. She underwent several surgical interventions on the trachea, which did not give a significant result, moreover, worsened her condition. This transplant was the only chance for Yulia to recover and have a full life.
The operation, which lasted five and a half hours, was successful, and already in the operating room Yulia was able to say a few words. She addressed Professor Macchiarini in Spanish, who knows a little, and thanked him that "now, finally, he will be able to play and talk with his little son."
Specialists from the USA, Norway, and Germany came to Krasnodar to observe the transplantation technique, which was broadcast on the big screen, to participate in discussions. One of them, Mark Holterman, a professor of surgery from the Center of Pediatrics in Peoria (Illinois, USA), will be doing a transplant this summer with Professor Macchiarini to a two-year-old boy from South Korea who was born without a trachea. Dr. Holterman highly appreciated the work of his colleague and Krasnodar surgeons. He stated that he witnessed a unique event. "Such an operation requires very complex and precise preparation, as well as jewelry equipment, which was demonstrated in Krasnodar," he added.
David Green, president of Harvard Biosciences, believes that this event is an important step in the development of regenerative medicine.
"We are happy to see the result – the patient was able to help with the help of regenerative technologies. We congratulate Professor Macchiarini on another achievement in this field and are glad to have a new collaboration with Professor Porkhanov and the Krasnodar Regional Clinical Hospital, where about 80 donor heart transplants have been performed over the past two years," he said.
Paolo Macchiarini himself notes: "The fact that the world's first transplantation of an artificial trachea and part of the larynx using regenerative medicine technologies was carried out in the Krasnodar Regional Hospital is not an accident. This clinic is one of the best I have seen in Europe. There is a huge experience of donor organ transplants and very qualified thoracic surgeons work here."
Paolo Macchiarini, the author of the method of creating and transplanting the trachea using regenerative medicine technologies, has so far performed more than ten similar operations. First – using a decontaminated donor frame (one of them was carried out in December 2010 at the Petrovsky Russian Scientific Center of Surgery of the Russian Academy of Medical Sciences) and three (including transplantation in Krasnodar) – based on an artificial frame.
In 2011, Professor Paolo Macchiarini, together with the Kuban State Medical University and the KKB No. 1 named after Professor S.V. Ochapovsky, won a Mega-grant from the Government of the Russian Federation for the implementation of a research, clinical and educational project in the field of respiratory tract and lung regeneration, the result of which should be the creation of the country's first international Center for regenerative medicine.
Portal "Eternal youth" http://vechnayamolodost.ru25.06.2012