Tissue-engineered trachea transplantation: now in Russia
For the first time in Russia, a "self-growing" trachea was transplanted
RIA NewsFor the first time in Russia, a trachea was transplanted to a patient, "assembled" from a donor "frame" and her own cells, from which all tissues will subsequently grow, and the transplanted organ will become completely "its own".
This was reported to journalists on Thursday by specialists of the Russian Scientific Center of Surgery named after B.V. Petrovsky of the Russian Academy of Medical Sciences (RNCC), where the operation was performed.
"This method makes it possible to dispense with the lifelong use of immunity-suppressing drugs, which are necessary for the transplantation of a conventional donor organ. In this case, mucous membranes and all other structures of the trachea are formed from the patient's own cells, and eventually, we hope, this organ will become indistinguishable from the original one," said Professor Vladimir Parshin, under whose guidance the operation was performed.
The main problem with organ transplantation is the rejection reaction – the patient's immune system perceives the donor organ as foreign and attacks it. In order to survive after surgery, patients need to take drugs that suppress immune reactions for many years. The solution to this problem may be the use of the patient's own tissues during transplantation.
The author of the technique of creating "almost their own" tracheas, which was used in this case, is Professor Paolo Macchiarini, head of the Department of Regenerative Surgery and Biotransplantation of the Carreggi Clinic of the University of Florence. To date, eight such transplants have been performed in Western Europe over the course of three years.
The Macchiarini group took a tracheal "skeleton" from donors, carefully cleaned of donor cells that could cause a rejection reaction. Then, on this frame, an organ intended for transplantation was grown from the patient's cells in a special bioreactor.
However, Macchiarini subsequently abandoned the bioreactor.
"We decided to use the human body as such a reactor. We implanted a tracheal skeleton with cells planted on it, which then grew into normal tissues. This makes it possible to avoid infections, incorrect formation of structures, possible development of neoplasms," the Italian scientist said at a meeting with journalists at the RNC.
He stressed that the donor frame almost never causes a rejection reaction, because it does not contain donor cells.
The transplant operation was performed on a 26-year-old girl, a student from Kazakhstan, who had a serious accident in 2006. For nine months she was in a coma, on an artificial respiration machine, because of which her trachea was severely degraded. She began to experience severe breathing difficulties, she regularly had to undergo endoscopic surgery to expand the tracheal lumen. Sometimes the interval between operations was only a few days.
In the RNC, where the patient got, having previously visited clinics in China and Israel, it was decided to carry out transplantation using the Macchiarini method. Russian specialists completed an internship with him in the fall and gained the experience necessary for such operations.
The processed frame of the trachea was brought to Russia by Professor Macchiarini. Before the operation, 320 milliliters of specially selected mononuclear cells of the patient's bone marrow were injected into the frame, as well as fragments of the mucous membrane, around which its own mucosa should then form. In addition, a special self-absorbing stent was placed in the trachea.
During the six-hour operation, the girl had her own trachea removed, replacing it with a new one.
16 days after the operation, the patient feels much better than before the surgical procedure. In a short interview with journalists, she told that she could already walk down the corridor and talk, despite the fact that earlier, due to lack of air, she could only take a few steps.
The costs of the operation were paid by the Science for Life Extension Foundation.
According to Parshin, in a few days the patient will be able to be discharged, although she will have to come to the center regularly for examination. The professor said that currently there are four possible candidates for transplantation using this technology.
He added that after the new year, the specialists of the RNC will try to get their own "frame" of the trachea, prepared using Macchiarini technology, and then it will be possible to talk about the timing of a new operation.
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24.12.2010