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A transplant first: Stem-cell-grown trachea gives woman new vigor

A 30-year-old Colombian woman with damaged airways is healthy months after receiving what European doctors are reporting is a first-ever, stem-cell-based windpipe transplant. They say the technique has allowed the woman to thrive without the use of the drugs that other transplant patients must take to prevent their immune systems from rejecting the new organs.

The unique transplant was performed in June on Claudia Castillo, who was severely short of breath after part of her trachea had collapsed from tuberculosis, hampering the flow of oxygen to her left lung. Doctors in Barcelona took a trachea from a 51-year-old female donor who’d died of a stroke and, over a six-week “washing,” stripped it of its cells. British doctors then grew stem cells from Castillo’s own bone marrow in the lab and had them grow on the donor trachea with them before implanting it, creating a kind of hybrid windpipe with the donor organ as a scaffold, the doctors write in this week’s edition of The Lancet.

Four months after the surgery, Castillo shows no signs of antibodies – proteins in the blood that detect foreign invaders – against the donor, and she hasn’t required medicine to prevent her body from rejecting the transplant. Her doctors told the BBC that there's close to zero chance she'll reject the organ since it's been so long. The transplanted trachea also developed its own blood vessels — typically a challenge in bioengineered tissues, and there were no side effects from the surgery. Doctors don’t report how much it cost.

"We think that this first experience represents a milestone in medicine,” the doctors said in a statement.

Eventually, nearly any transplant organ could be constructed using the technique, Martin Birchall of the University of Bristol, who helped culture Castillo’s stem cells, told the BBC. It may also be used to treat patients with cancers of the voicebox or windpipe, he said, or for transplants of the bowel, bladder or reproductive tract, according to Discover.

Castillo, who at her worst couldn’t even perform household chores, can now take care of her two children, who are 15 and 4, and walk up two flights of stairs, the doctors write.

Media are using news of the study to note that President-elect Barack Obama may reverse President Bush’s ban on federal funding of embryonic stem-cell research. But the trachea transplant used Castillo’s own cells to treat her, a practice that has never been controversial.

The transplant was performed at the Hospital Clínic of Barcelona (Universitat de Barcelona) in Spain. Doctors from the University of Bristol in England, Politecnico di Milano and the University of Padua in Italy also contributed.

Image of Claudia Castillo/The Lancet

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