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Entries in Trachea (2)

Thursday
Jul262012

Stunning Recovery for First Child to Get Stem Cell Trachea

Great Ormond Street Hospital Children's Charity(NEW YORK) -- The first child in history to receive a trachea fashioned by his own stem cells has shown remarkable progress since the initial transplant two years ago, marking a new record for the novel procedure.

Ciaran Finn-Lynch, the now 13-year-old boy from the U.K. who was the world's first child to receive the stem cell trachea transplant, is breathing normally and no longer needs anti-rejection medication, researchers reported in a paper published Wednesday in the journal Lancet.

The organ itself is strong, has not shown signs of rejection, and has even grown 11 centimeters since it had been transplanted, according to the researchers.

Finn-Lynch was born with a rare condition known as Long Segment Tracheal Stenosis, marked by a small windpipe that does not grow and can restrict breathing.  He underwent the stem cell transplant in March 2010 after a standard trachea transplant did not work.

Researchers at the Great Ormond Street Hospital for Children, the Karolinska Institute in Stockholm and the University College London, stripped cells from a donor trachea and then used Finn-Lynch's own bone marrow stem cells to rebuild the airways in the body.  They also infused growth proteins to generate the tissue lining.

Using a patient's own stem cells not only could help to rebuild the fragile tissue, but also potentially could bypass the risk of having the organ rejected.  A trachea is considered a difficult tissue to grow and transplant since it has a limited blood supply, according to Dr. Bill Putnam, professor and chair of the department of thoracic surgery at Vanderbilt University Medical Center, who was not involved in the research.

"I don't think there's anything standard about a tracheal transplant," said Putnam.  "The fact that this single patient has survived for two years is worthy of notice."

Once the trachea was transplanted, the researchers continued to infuse growth proteins into the organ to continue stem cell generation.  This technique allowed for researchers to transplant the organ faster instead of having to wait for the organ to grow outside of the body.

"Because the protocol used in this study was devised in an emergency, we applied empirically a new combination of technologies on the basis of previous clinical successes in non-airway settings," the researchers wrote, citing bioengineering techniques previously used to regenerate bone, nerves and skin.

Dr. Paolo Macchiarini, director of the Advanced Center for Translational Regenerative Medicine at the Karolinska Institute in Stockholm -- who was the head surgeon in this case -- and his team have been performing the transplants since 2008, when they transplanted a trachea using adult stem cells on a woman in Barcelona who suffered from tuberculosis.

In January 2012, the first U.S. patient underwent a stem cell trachea transplant.

While the procedure seems to have worked in a few patients, many experts said the method is still in the earliest stages of development.

"You never know what to do or how to interpret a success when it's one success," said Dr. Larry Goldstein, director of the stem cell program at University of California San Diego. "The question you grapple with is whether this treatment is going to be good with a larger number of people with this disease."

Copyright 2012 ABC News Radio

Friday
Jan132012

First U.S. Patient Gets Stem Cell Trachea Transplant

Jupiterimages/Thinkstock(ABINGDON, Md.) -- Christopher Lyles, 30, of Abingdon, Md. exhausted the limited treatment options available in the U.S. for his tracheal cancer. But Lyles read about an experimental tracheal transplant procedure surgeons performed in Europe using adult stem cells. He reached out to Dr. Paolo Macchiarini, director of the Advanced Center for Translational Regenerative Medicine at the Karolinska Institute in Stockholm, who was the head surgeon in previous transplant cases.

After a 12-hour procedure in Sweden, Lyles was breathing through a lab-grown windpipe that doctors fashioned from his own stem cells.

Doctors regenerated tissue from Lyles' bone marrow stem cells to create a trachea biologically identical to Lyles' original organ. Lyle underwent the transplant in November and arrived back home Wednesday.

Within three months, Lyles was able to eat and speak on his own, he said.

According to Dr. Mark Iannettoni, head of the department of cardiothoracic surgery at University of Iowa, a trachea is a fragile organ because it is mostly cartilage, which has a poor blood supply.

"Once damaged, it is difficult to get it to heal correctly," said Iannettoni.

In June 2011, Lyles was diagnosed with a rare form of trachea cancer. Unlike some patients with the same condition, Lyle tumor extended below his thyroid gland and did not affect his voice box.

Trachea cancer is resistant to chemotherapy and radiation and attempts to replace the trachea with mechanical devices have not been effective.

Lyles first underwent seven rounds of chemotherapy and 33 rounds of radiation treatment between July and September.

Using a patient's own stem cells not only could help to rebuild the fragile tissue, but also potentially could bypass the risk of having the organ rejected, according to Dr. Eric Lambright, surgical director of lung transplant at Vanderbilt University Medical Center, who was not involved with the procedure.

"These patients [are] otherwise sentenced to rather significant horrible quality of life related to their tumors and heroic measures may indeed be very appropriate," said Lambright.

After surgery, Lyles contracted pneumonia in both lungs, which slowed his recovery.

The experimental procedure, not covered by medical insurance, cost between $300,000 to $600,000, Lyles said. The family asked for at least  $300,000 in a donation through the non-profit organization Help Hope Live, which works to fund uninsured transplant-related expenses.

Macchiarini and his surgical team have been performing the transplants since 2008, when they transplanted a trachea using adult stem cells on a woman who suffered from tuberculosis. The procedure was first implemented on patients with tracheal cancer in August 2010.

While the procedure seemed to have worked in a few patients, many experts said the method is still in the earliest stages of development.

Macchiarini said this procedure could pave the way for other challenging transplants including the heart valve, chest wall, lungs and the esophagus.

"We need to be very cautious and don't make hope for patients with cancer, because this is experimental," said Macchiarini. "But so far the patients have had incredible results for an untreatable cancer."

Copyright 2012 ABC News Radio







ABC News Radio