http://www.dailymail.co.uk/health/article-1299877/British-cancer-girl-saved-windpipe-stem-cells.html?printingPage=true

Doctors have carried out pioneering lifesaving surgery to give a new windpipe to a British teenager suffering from cancer.

The 19-year-old was able to speak within a few days of the operation carried out in Italy using her own stem cells.

Another 31-year-old patient from Czechoslovakia also underwent surgery for the same rare form of trachea cancer.

Doctors regenerated tissue from the patients’ nose and bone marrow stem cells to create windpipes in the laboratory which were biologically identical to the patients’ original organs.

Because they contained no donor material, the patients will not have to take anti-rejection drugs.

Dr Walter Giovannini, from AOU Careggi Hospital, in Florence, Italy, said the British woman was speaking just three or four days following the operation last month.

He said: 'This is a unique solution for a problem that had none, except the death of the patient. '

Surgeons have been making advances in the transplant of windpipes, but previous cases have mostly focused on patients whose windpipes have been physically damaged due to trauma.

'While trachea cancer is rare, it is very difficult to treat because it is resistant to chemotherapy and radiation and transplants of mechanical devices to replace the windpipe have not been effective.'

The surgical team was headed by Professor Paolo Macchiarini who participated in a windpipe transplant in Spain nearly two years ago.

In that case doctors gave a Colombian mother of two suffering from tuberculosis a new windpipe with tissue grown from her own stem cells.

 

Doctors regenerated tissue from the patients' nose and bone marrow stem cells to create tracheas identical to the patients' original

A similar procedure was followed in Italy, where a donor windpipe was stripped of all cells leaving just a tube containing no organic material.

Just before being transplanted Prof Macchiarini injected the donor trachea with the patient's own stem cells.

In the Spanish case, the stem cells were grown on to the windpipe in advance before the transplant.

Dr Giovannini said using the new approach means it takes two to three months for the stem cells to completely cover the trachea, creating a new organ.

He said: 'In the meantime, the windpipe is functional without the cells - acting as a sort of mechanical device before the stem cells transform it into an organ.'

Alessandro Nanni Costa, director of Italy’s National Transplant Centre, said the new technique was extraordinary.

He said: 'What is new about this procedure is combining a surgical technique with biotechnology, through the use of stem cells.'

The hospital is keeping secret the identities of the patients, who have both been discharged, although it said the Czech woman is the mother of a six-month-old tot.

Professor Anthony Hollander, head of the school of cellular and molecular medicine at Bristol University, was one of the British team which helped create a windpipe for the Colombian woman.

The technique involved multiplying the patient's stem cells in the laboratory, and persuading them to develop into cartilage cells on a 'scaffold' of a stripped donor windpipe before it was transplanted.

Prof Hollander believes this technique offers greater control over the transplant organ.

He said: 'It's a more mature product. Although the latest approach is cheaper and not bound by regulatory challenges, there is some uncertainty over how the transplanted stem cells will behave which can only be used in lower numbers.'

However, Josephine Quintavalle, of Comment on Reproductive Ethics, said adult stem cell research is now leading to tangible results, with around 65 diseases being looked at, and would end up providing better solutions than embryonic stem cell research.

She said: 'Using the patient's own stem cells to provide a potential cure for their disease must be the way forward.

'It does not produce a lot of money for the commercial firms hoping to capitalise on the use of embryonic stem cells but is far more likely to be a lasting advance.'

Aug. 4, 2010 (Daily Mail)