Hannah Warren, 2, recovers in a post-op room at the Children's Hospital of Illinois in Peoria
Jim Carlson / OSF Saint Francis Medical Center / handout / AP
Darryl Warren and Lee Young-mi visit their 2-year-old daughter, Hannah Warren, in a post-op room at the Children's Hospital of Illinois in Peoria after having received a new windpipe in a landmark transplant operation on April 9, 2013.
Stem Cells Grow a Whole New Windpipe for Transplant
A pioneering Italian surgeon, Professor Paolo Macchiarini, carried out the world’s first synthetic organ transplant earlier this month using a windpipe built from the patient’s own stem cells. Unlike previous stem cell surgeries using donor tissues (such as tracheas), this operation used a glass polymer scaffold coated in the patient’s stem cells to completely regrow a functional windpipe that poses no risk of rejection and no need for life-long medication to suppress the immune system. The stem cell surgery was carried out in Sweden using a scaffold made in London, which was coated in the patient’s bone marrow stem cells, and stem cells from the lining of his nose. The resulting windpipe, a perfect match for the patient’s own, was grown within days, which is an additional benefit allowing physicians to overcome the problem of a lack of appropriate donor tissue for such procedures.
The patient who underwent the surgery (a 36-year-old cancer patient) is said to be doing well and Macchiarini is already lining up future patients to receive similar transplants at the Karolinska University Hospital. The next patient may be a nine-month-old child in Korea who was born with a windpipe malformation. Macchiarini was at the helm of another earlier operation where Claudia Costillo, a 30-year-old Spaniard, received a tissue-engineered trachea transplant and the surgeon has now performed almost a dozen such transplants to treat connective tissue and cartilage disorders. These operations all required an initial donor trachea however, on which to grow the new tissue using the patients’ own cells, thus creating the potential for tissue rejection.
Building New Organs with Stem Cells
The London-based team building the tissue scaffold made use of 3D scans of the patient’s anatomy before creating a perfect copy of his trachea and two main bronchii. This use of nanotechnology allows incredibly intricate structures to be built from a nanocomposite material. Some elements of the material are less than 100nanometers in size and the nanocomposite polymer appears destined for use in cardiac procedures involving stents and grafts. The tailor-made scaffold was then flown to Sweden, soaked in a solution containing Andermariam Teklesenbet Beyene’s stem cells and placed in a bioreactor. This bioreactor, designed by Harvard Biocience, acts as an incubator for the growth of healthy tissue, resulting in a finished trachea almost indistinguishable from the real thing. In just two days the porous windpipe scaffold had been colonized by the patient’s own tissue. The nature of the material reduces the risks of rejection, breakage, and repeat surgery. Instead, the tissue is more elastic, stronger, and behaves as ordinary tissue would during any natural healing process.
Mr Beyene underwent a twelve-hour operation to remove his diseased windpipe and fit the healthy replica trachea. Without the operation Mr Beyene would have died as the tumor was inoperable and was blocking his breathing. Despite his fears about the novel operation he is now doing well and looking forward to returning to his PhD studies in Iceland and seeing his family in Eritrea.
The Future of Tissue Engineering
Professor Alexander Seifalian, from UCL’s Division of Surgery & Interventional Science, developed and patented the nanocomposite materials used in the procedure and the doctors and scientists involved in the operation continue to work with UCL Business to further develop their medical use. Professor Seifalian has said that the difference with this new procedure is that “it’s the first time that a wholly tissue engineered synthetic windpipe has been made and successfully transplanted, making it an important milestone for regenerative medicine.” Another patient awaiting similar treatment is the former ballerina Rachel Phillips. The Florida-born dancer, who performed with Rudolf Nureyev and held a place in London’s Royal Ballet, suffers from the autoimmune disease Ehlers-Danlos Syndrome which affects joint tissue.
Having had a chance meeting with Macchiarini at a conference in the US, Phillips is now hoping that the FDA grants a ‘compassionate use’ exemption to allow the doctor to perform a similar windpipe transplant on US soil, as current legislation means that the operation would otherwise have to be done outside the country. Phillips’ EDS has caused the condition known as tracheobroncholomalacia, a disorder involving the collapse of the trachea and bronchial airways upon each exhalation. Without numerous surgeries to re-open her airway, the 34-year-old would be unable to breathe, and doctors have warned that her airway is close to complete collapse. Phillips’ doctors are also investigating the possibility of identifying the underlying cause of Ehlers-Danlos Syndrome by looking at the bone marrow sample provided by the dancer. Theoretically, those cells could then be genetically engineered to correct the fault(s) causing the connective tissue disorder before the tissue is transplanted. The hope is that this kind of gene therapy would cure the disease after transplantation. In the meantime, Phillips’ awaits notice of permission to undergo the stem cell windpipe transplant surgery on home soil, which could set a precedent for others likely to benefit from the treatment.
Young Girl Receives Lifesaving Windpipe Transplant Made From Her Stem Cells
By Alexandra SifferlinApril 30, 2013
(TIME.com) -- Hannah Warren was born without a trachea but now has one made from plastic fibers and a stew of her own stem cells.
The 2-year-old Korean Canadian has spent every day of her life in intensive care, kept alive by a tube that substituted for the windpipe that was supposed to connect her mouth to her lungs. But nearly a month after her transplant, the toddler is mostly breathing on her own and is responding to doctors and nurses.
The surgery, pioneered by Dr. Paolo Macchiarini, director of the Advanced Center for Translational Regenerative Medicine at the Karolinska Institute in Stockholm, was only the sixth performed in the world, and Hannah was the youngest patient and first to receive the transplant in the United States.
The procedure was approved by the FDA as an experimental operation for patients with very little hope of survival; being born without a trachea is fatal in 99% of cases.
Macchiarini performed the nine-hour operation on April 9 at the Children's Hospital of Illinois after carefully creating the windpipe using stem cells from Hannah's bone marrow that were saturated over a matrix of plastic fibers shaped into a tube.
Exactly what happens to the windpipe after it is transplanted isn't clear, but researchers believe that placing stem cells, which are capable of developing into different types of body cells, can pick up signals from their environment and integrate with existing tissues.
Macchiarini told the New York Times that the body's regenerative capabilities may help such bioengineered organs to integrate with existing tissues. Children may make the ideal patients for these procedures since they have natural and active abilities to heal and grow.
"Hannah's transplant has completely changed my thinking about regenerative medicine," he told the Times, adding that he wants to conduct a clinical trial in the United States.
For children born with a windpipe defect or without one, and for others with defective or diseased organs, manipulating stem cells to generate healthy tissues or organs could be their only chance at survival.
Macchiarini performed all five of the previous transplants of the bioengineered windpipes; four of the patients have done well, while one, Christopher Lyles, who received his trachea in Stockholm, died. Last year, in describing Lyles' operation, TIME's Alice Park wrote:
"Macchiarini has been perfecting the process of using stem cells to seed bioengineered scaffolds for organs like the trachea since 2008; in his first such procedure, he used a donor trachea to replace that of a Spanish woman, stripping the organ of its cells and coating it with the woman's own stem cells. But using a completely synthetic, bioengineered matrix such as the one transplanted in Lyles, he says, makes the transplant safer for the patient, potentially sparing him the complications that can arise if he can't accept the new organ.
"Researchers have used similar stem-cell-seeding techniques to create other organs. Dr. Anthony Atala at Wake Forest University generated bladders and a urethra using scaffolds and patients' stem cells."
Because of the small number of patients he has treated, his critics say it's hard to determine how valid Macchiarini's bioengineering technique is in treating patients like Hannah. But he plans to conduct a clinical trial to properly assess the risks and benefits of the procedure, and document how bodies react to the transplanted devices. Hopefully those trials will show that it's possible to regenerate not just organs but hope as well.
This story originally published on TIME.com
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STEM CELL.... WHAT ARE THE POSIBILITIES?
One of the positives about life in today's time, is the modern technological research and future possibilities, specifically, associated with the future possibilities of Stem Cell Research.
Thus Far, I've covered stem cell research:
Studies: Stem cells reverse heart damage
Heart Attack Repair Capability:
First Hints That Stem Cells Can Help Patients Get Better
Blindness and Eye Repair capability :
And, the first of it's kind, stem cell research grew a "Trachea Externally", and removed a bad one, installed the newly grew Trachea.
I find the fact that "Stem Cell" research is in it's early stages of development, yet, even without the extensive years of testing on thousands of bodies, improvements to existing instances of medical research are astonishing, and continue to surprise scientist, in that, things are seemingly being done "off the cuff" and the results have surpassed all possible expectations.... to this date.
The Possibilities, for the next 20 years, are astounding, with respect to the possibilities of the number of possibilities of the use of stem cell, once a good understanding of stem cell research has been completed, allowing the full understanding of stem cell full capabilities.
Severe Heart Attacks can be repaired by Stem Cell, Organ Transplant with the possibility of not needing life long drugs to ensure that the body does not reject the non compatible organ,
Eye Tissue repair for people who have been deemed legally blind, and the actual ability to grow an entire body part externally, remove the bad part, and install a new part... are all simply amazing things.
What seems to be the pattern, regarding stem cell research, every six months, somewhere around the world, some type of new stem cell medical operation is being reported as being successful, when the circumstance were expected to be un-known, or the expectations are very low.
If I were a billionaire, seeking out some type of future investment, that would be the leading edge of future technology, it would not be "energy", space exploration, deep sea exploration, or robotic technology, it would be in "Stem Cell Research".
What affect on the world's population, will stem cell research take in 20 years, when more data has been studied, more successful injections have been studied, more successful external growing of body parts are successfully implanted?
What specific Organs, Tissue, or possibly, even Bone..., can be grown externally, and used to replace individuals bad Organs, Tissue or Bone?
There is so much to learn and so much to look forward to, for those who would appreciate the possibilities of what affect stem cell can be for human race's future.
In My Opinion
Slowly but surely, Stem Cell is plowing it's way through the eyes of doubt.
The Internet have already changed the world in such a significant way that, no time in human history, have so much change in human socialization have ever taken place in a period of less than 25 solid years.
Yet, we are scratching the surface of a possible future that can change social behavior associated with human education, political offices world wide, and the social positioning of all humans around the world.
However, the possibilities of Stem Cell can affect medicine, at least, equal to the affect that the internet have had on the world over the past 25 years.
In 20 years, with more research and understanding of the capabilities of Stem Cell capabilities, areas of medicine that focus on the Heart, Lungs, and Kidneys, will evolve to possibly..., ensuring that humans that normally would have died of a heart attach will be reduced to less that 10% fatality, kidney transplants and human's re-growing their own kidney's may be now possibilities, and Lung's may be able to be replace, repaired or re-grown to replace damaged lungs.
And that is just only the beginning.
People with Eye issues may have possible solutions in the next 20 years, but, in the next 50 years, those participating in athletics will look at sports injuries with the same mind set of a person who must deal with the minor irritations of allowing a muscle group to repair for 5 to 7 days.
Based on the current level of research applied to stem cell research around the world, as compared to the astounding results of unexpected successes of experiments like this one with Hannah Warren, the future possibilities of stem cell research, are more than positive enough to warrant a full all out investment by all nations around the world, not to mention the possibilities for companies that seek to gain an edge in the area of medicine.
These are truly exciting times, and if you can survive for the 20 more years, you will see a future that could not be predicted 20 years ago.
In My Opinion
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