You may recall that an Italian group has been engineering and transplanting comparatively simple organ structures - such as tracheas - in recent years. The researchers have used a range of techniques to build these organs from the patient's own cells, such as decellularization and nanoscale polymer scaffolds. The former requires a donor organ to be stripped of cells in order to provide a scaffold formed of its extracellular matrix, while the latter results in a completely synthetic organ. In both cases, the raw materials that form that scaffold are populated with the patient's own cells, leading to a transplant without the risk of immune rejection.
This is all very promising groundwork for later and more extensive tissue engineering of replacement parts to order. The first synthetic trachea transplant occurred earlier this year, and an update is doing the rounds:
The Eritrean patient, 36-year-old Andemariam Teklesenbet Beyene, was the first person in the world to receive this type of transplant in June, 2011 at the Karolinska University Hospital, Stockholm, Sweden. ... Currently Beyene is living in Reykjavík, Iceland, where he is a geology student studying for his PhD. Beyene's wife and two children live in Eritrea. ... The patient has been doing great for the last 4 months and has been able to live a normal life. After arriving in Iceland at the start of July, he was 1 month in hospital and another month in the rehabilitation center. Already at the rehabilitation center he could start to work on his Master of Science Thesis in Geophysics, a scientific project that he has been working on for the last years at the University of Iceland here in Reyklavik. For the last two months he has been able to focus on his studies and the plan is the he will defend his thesis at the end of this year.
A 30-year-old man from Maryland, USA, who also had primary cancer of the airway, is the second patient to receive a bioartificial scaffold transplantation from Prof. Macchiarini. The scaffold used in this case was created from nanofibres and therefore, according to Prof. Macchiarini, represents a further advance from the transplant Beyene received. Prof. Macchiarini's team is now hoping to use the same technique in order to treat a 13-month old South Korean infant.
We will continue to improve the regenerative medicine approaches for transplanting the windpipe and extend it to the lungs, heart, and oesophagus. And investigate whether cell therapy could be applied to irreversible diseases of the major airways and lungs.
So good news all round so far - this is one of the more successful lines of work in tissue engineering, and with success so clearly demonstrated you can be certain that other clinics worldwide will adopt these techniques over the next few years.