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New Trachea Grown, Transplanted In Two Men
Paolo Macchiarini, Philipp Jungebluth et al report in Lancet their successful bioprosthetic trachea creation and transplantation in a 36-year old man in Sweden after a distal tracheal resection for recurrent primary tracheal cancer. The same group transplanted a bioengineered trachea into a 30-year old Baltimore man, who is doing well, according to the New York Times.
The first man had a bulky mucoepidermoid carcinoma previously treated with debulking surgery and regional radiation, that recurred in the last 5 cm of the trachea, causing stridor and dyspnea. Investigators created a bioprosthesis of nanocomposite polymer, using 3-D modeling based on the CT scan. They seeded the scaffolding ex vivo with mononuclear cells obtained from bone marrow aspirate, which produced a continuous neomucosal epithelial lining along the entire inner surface.
The tumor and distal trachea were resected, the prosthesis was successfully transplanted and GM-CSF injections were given as boosters post-operatively. After recovering from a pneumonia post-op, the patient did well and was alive at 5 month follow-up with improved lung function.
The Baltimore man had a similar success story just reported in the New York Times, after Macchiarini's group transplanted a bioengineered trachea into him after resection of a tracheal tumor.
Jungebluth P et al. Tracheobronchial transplantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study. Lancet 2011;378:1997-2004.
Henry Fountain, "Synthetic Windpipe Is Used to Replace Cancerous One," New York Times, January 12, 2012.