The first child in history to receive a trachea fashioned by his own stem cells has shown remarkable progress since the initial transplant two years ago, marking a new record for the novel procedure.
Ciaran Finn-Lynch, now 13, from the UK who the world’s first child to receive the stem cell trachea transplant, is breathing normally and no longer needs his anti-rejection medication, researchers reported in a paper published Wednesday in the journal Lancet.
The organ itself is strong, has not shown signs of rejection, and has even grown 11 centimeters since it had been transplanted, according to the researchers.
Ciaran was born with a rare condition known as Long Segment Tracheal Stenosis, marked by a small windpipe that does not grow and can restrict breathing.He underwent thestem cell transplantin March 2010 after a standard trachea transplant did not work.This was reported in the March 23, 2010 issue of the British Medical Journal.
Researchers at the Great Ormond Street Hospital for Children, theKarolinska Institutein Stockholm and theUniversity College London, stripped cells from a donortracheaand then used Ciaran’s own bone marrowstem cellsto rebuild the airways in the body.They also infused growth proteins to generate the tissue lining.
Using a patient’s own stem cells could not only help to rebuild the fragile tissue, but also could potentially bypass the risk of having the organ rejected.A trachea is considered a difficult tissue to grow and transplant since it has a limited blood supply.
Once the trachea was transplanted, the researchers continued to infuse growth proteins into the organ to continue stem cell generation.This technique allowed for researchers to transplant the organ faster, instead of having to wait for the organ to be grown outside of the body.
“Because the protocol used in this study was devised in an emergency, we applied empirically a new combination of technologies on the basis of previous clinical successes in non-airway settings,” the researchers wrote, citing bioengineering techniques previously used to regenerate bone, nerves and skin.
“We need more research on stem cells grown deliberately inside the body, rather than grown first in a laboratory over a long time,” said Dr Martin Birchall, professor of Laryngology at the University College London, and co-author of the paper.”This research should help to convert one-off successes such as this into more widely available clinical treatments for thousands of children with severe tracheal problems worldwide.”
Dr. Paolo Macchiarini, director of the Advanced Center for Translational Regenerative Medicine at the Karolinska Institute in Stockholm – who was the head surgeon in this case – and his team have been performing the transplants since 2008, when they transplanted a trachea using adult stem cells on a woman in Barcelona who suffered from tuberculosis
In January 2012, the first U.S. patient underwent a stem cell trachea transplant.
While the procedure seems to have worked in a few patients, many experts said the method is still in the earliest stages of development. “You never know what to do or how to interpret a success when it’s one success,” said Dr. Larry Goldstein, director of the stem cell program at University of California San Diego. “The question you grapple with is whether this treatment is going to be good with a larger number of people with this disease.”
According to Putnam, should the treatment work for a wider group, the challenge may be in delivering such a specialized processed to a large number of people. “There’s a lot of infrastructure that has to be established to grow these cells and maintain the tracheal scaffolds,” said Putnam. “You can’t get these off the shelves; they have to be individually constructed which takes time and effort.”
Stem cells appear to hold great promise in treating a variety of diseases and conditions, and the success of the procedure for this young patient furthers that promise.Some conditions, such as joint, tendon and muscle injuries, are treatable now with stem cells.Other conditions, such as ALS, diabetes, heart disease and MS, appear to be treatable with stem cell therapy.Other research is exploring the use of stem cells to grow various tissues for use in transplants, but widespread treatment is still in the near-future.
Dr Dennis Lox has been sucessfully preforming stem cell therapy for several years. Dr. Lox is located in the Tampa bay area in Clearwater, Florida
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