Breakthrough over rejection of donated organs

Doctors and scientists from three countries have set a world first in successfully transplanting an artificial organ using stem cells and a donated trachea.

The new organ transplanted into a 30-year-old woman, Claudia Castillo, with end-stage bronchomalacia after contracting TB, has shown no signs of rejection four months later, reports the Lancet online today.

After multiple treatments and procedures since being hospitalised in March 2008, Ms Castillo was facing a left lung transplant until a novel technique was suggested.

The teams from Spain the UK and Italy removed all the biological cells from the donated trachea and replaced with cells cultured from Ms Castillo’s own stem cells in the laboratory. The graft was then used to replace her left main bronchus.

Surgery to replace large airways is notoriously difficult with complications such as graft necrosis, lethal bleeding, and severe and life-threatening infections often arising.

But Ms Castillo’s procedure has been successful with no complications and discharge on day 10 following the operation.

The graft looks normal and has its own blood supply, no anti-donor antibodies have been found and Ms Castillo is not taking immunosuppressives.

Professor Paolo Macchiarini, who carried out the operation at the Hospital Clinic, Barcelona said: “We are terribly excited by these results. Just four days after transplantation the graft was almost indistinguishable from adjacent normal bronchi. After one month, a biopsy elicited local bleeding, indicating that the blood vessels had already grown back successfully.

“We think that this first experience represents a milestone in medicine and hope that it will unlock the door for a safe and recipient-tailored transplantation of the airway in adults and children. We hope that these future patients will no longer suffer the trauma of speech loss, severe shortness of breath and other limited clinical and social activities.”