"We believe the matrix of the transplant will remodel with time. Since he's already shot up more than four inches since the operation, doctors think there's a good chance it will. Doctors are watching him closely to see if the new trachea will keep up with his growth spurts. Worldwide, just 12 tissue-engineered tracheas have been transplanted into patients. We used the child, himself, as a bioreactor," says researcher Paolo De Coppi, MD, PhD, one of the surgeons who treated Ciaran. "We did not have the time to engineer and to culture the cells in a bioreactor because this child needed to have something done quickly. Normally, donor organs are washed, reseeded with stem cells, and then grown in a lab until they are ready to be used in a patient. The 'Holy Grail' of Tissue Engineering: Organs That GrowĬiaran's case, which is reported in The Lancet, is the first time doctors have rebuilt an organ inside the body. The tissue samples acted like blueprints, giving the stem cells instructions for what they should become. For good measure, they took tissue samples from Ciaran's own trachea and placed those inside the tube of the windpipe with the stem cells. They also injected the tissue scaffold with proteins that encourage cell growth. The cells were sent to a specialized lab to be purified and returned to the hospital the same day.Īfter surgeons sewed the stripped-down donor windpipe in Ciaran's chest, they coated it with his purified stem cells. Stem cells are uniquely flexible cells that can be coaxed to grow into nearly any kind of tissue. That step was important because it cleared away any markers that might have caused Ciaran's immune system to reject the transplant.īack at Great Ormond Street Hospital, a children's hospital in London, doctors removed stem cells from Ciaran's bone marrow. It's a bit like remodeling a house by first tearing it down to the studs. Working with a detergent found in shampoo, they were able to strip the cells away from the protein scaffold they grew on. Scientists in Italy cleaned the organ of all its cells using a method discovered at Harvard Medical School. The trachea was about the same size and shape needed to replace the deformed one that Ciaran was born with. Working quickly, his doctors located a trachea, or windpipe, removed from a 30-year-old Italian woman whose organs were donated after she died. Though the technique had only been tried in adults, they thought the same method might work for Ciaran. Two years earlier, scientists had devised a new way to create organs using a patient's own stem cells. That gave his doctors a small window of time to look for other options. The second time, the bleeding stopped on its own. He was rushed to the hospital with massive bleeding. But eventually the tubes eroded into his aorta, the large vessel that carries blood out of the heart. An Urgent Medical Need Drives a DiscoveryĬiaran was born with a windpipe so small and deformed that it caused his lungs to collapse.ĭoctors managed to hold his airway open using metal tubes. What doctors are learning from his case could help thousands of children born each year with life-threatening birth defects. Best of all, he has no need for an expensive and complicated regimen of anti-rejection drugs. He's grown more than 4 inches and gone back to school. Two years after the surgery, doctors say Ciaran (pronounced KEER-an) is living the life of a normal teen. Ott worked out some of the science that made the procedure possible but was not directly involved in Ciaran's treatment. Ott, MD, an instructor of medicine at Harvard Medical School in Boston. "It's a really heroic story," says Harald C. Stem cells to grow him a new windpipe, and they did it inside his body - a feat that's never been accomplished before. With his life in danger, doctors used the 13-year-old's own J- Ciaran Finn-Lynch is an accidental medical pioneer. In a Tissue-Engineering First, Doctors Think the Boy's New Windpipe Could Grow
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