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2011-07-08 04:45:14
By Michelle Roberts Health reporter, BBC News, in Stockholm
Surgeons in Sweden have carried out the world's first synthetic organ
transplant.
Scientists in London created an artificial windpipe which was then coated in
stem cells from the patient.
Crucially, the technique does not need a donor, and there is no risk of the
organ being rejected. The surgeons stress a windpipe can also be made within
days.
The 36-year-old cancer patient is doing well a month after the operation.
Professor Paolo Macchiarini from Italy led the pioneering surgery, which took
place at the Karolinska University Hospital.
In an interview with the BBC, he said he now hopes to use the technique to
treat a nine-month-old child in Korea who was born with a malformed windpipe or
trachea.
Professor Macchiarini already has 10 other windpipe transplants under his belt
- most notably the world's first tissue-engineered tracheal transplant in 2008
on 30-year-old Spanish woman Claudia Costillo - but all required a donor.
Indistinguishable
The key to the latest technique is modelling a structure or scaffold that is an
exact replica of the patient's own windpipe, removing the need for a donor
organ.
To do this he enlisted the help of UK experts who were given 3D scans of the
36-year-old African patient, Andemariam Teklesenbet Beyene. The geology student
currently lives in Iceland where he is studying for a PhD.
Using these images, the scientists at University College London were able to
craft a perfect copy of Mr Beyene's trachea and two main bronchi out of glass.
This was then flown to Sweden and soaked in a solution of stem cells taken from
the patient's bone marrow.
After two days, the millions of holes in the porous windpipe had been seeded
with the patient's own tissue.
Dr Alex Seifalian and his team used this fragile structure to create a
replacement for the patient, whose own windpipe was ravaged by an inoperable
tumour.
Despite aggressive chemotherapy and radiotherapy, the cancer had grown to the
size of a golf ball and was blocking his breathing. Without a transplant he
would have died.
During a 12-hour operation Professor Macchiarini removed all of the tumour and
the diseased windpipe and replaced it with the tailor-made replica.
The bone marrow cells and lining cells taken from his nose, which were also
implanted during the operation, were able to divide and grow, turning the inert
windpipe scaffold into an organ indistinguishable from a normal healthy one.
And, importantly, Mr Beyene's body will accept it as its own, meaning he will
not need to take the strong anti-rejection drugs that other transplant patients
have to.
Professor Macchiarini said this was the real breakthrough.
"Thanks to nanotechnology, this new branch of regenerative medicine, we are now
able to produce a custom-made windpipe within two days or one week.
"This is a synthetic windpipe. The beauty of this is you can have it
immediately. There is no delay. This technique does not rely on a human
donation."
He said many other organs could be repaired or replaced in the same way.
A month on from his operation, Mr Beyene is still looking weak, but well.
Sitting up in his hospital bed, he said: "I was very scared, very scared about
the operation. But it was live or die."
He says he is looking forward to getting back to Iceland to finish his studies
and then returning to his home in Eritrea where he will be reunited with his
wife and young family, and meet his new three-month-old child.
He says he is eternally grateful to the medical team that has saved his life.