Groundbreaking operation gives surgeons hope
It marked a huge step forward from pioneering surgery in Spain two years ago on 30-year-old mother-of-two Claudia Castillo, the first person toreceive a transplant organ created from stem cells.
Ms Castillo was given a section of tracheal airway rebuilt from stem cells, although doctors grew the new tissue outside her body in a special ‘bioreactor’ and then transplanted it into her body. In Ciarán’s case, his own body was used as a ‘living bioreactor’.
Stem cell pioneer Professor Paolo Macchiarini carried out the living bioreactor stem cell procedure for the first time on a 53-year-old Italian woman, replacing part of her windpipe. He was contacted by British doctors looking for a last-ditch solution after Ciarán’s condition deteriorated last November.
In February, Prof Macchiarini’s team selected a dead donor, a 30-year-old Italian woman, from a shortlist of three. They removed her trachea and stripped its cells using digestive enzymes, leaving just inert collagen and the basal membrane, a scaffold for the cell growth.
On the day of the operation in March, Prof Macchiarini “seeded” the trachea with the stem cells and applied growth factor chemicals to help it form.
In Ms Castillo’s case it took six months to prepare her new windpipe outside her body, but using the new technique Ciarán’s was ready to be implanted in just four hours. The team, led by Professor Martin Elliott of Great Ormond Street Hospital, London, also involved Professor Martin Birchall, professor of laryngology from University College London, and Dr Mark Lowdell from the Royal Free Hospital.
Prof Birchall said: “For decades surgeons have been trying to get a satisfactory solution to the problem of adults and children whose windpipes are destroyed by disease or problems at birth.”
He said there were plenty of conventional methods to help, including the use of metal splints, or stents, but surgeons and scientists had been trying to find a more natural solution.
“This is a completely new approach,” he said. “This is the first time this has ever been done in a child.
“We did a similar operation to a young woman in Spain in 2008. She is now working full-time, looking after her children and doing very well.
“This is very different and we can’t predict exactly what is going to happen, but we can say things have gone better than we expected.” He saidCiarán now also has a new type of stent to help support his airway. It is made of a suture-type material rather than metal and will dissolve.
He will have to return for regular check-ups, but doctors remain hopeful of his recovery. “It’s certainly not been an easy road and we’re not at the end of it yet, but it has gone better than we hoped it would,” Prof Birchall said.
“It’s given him a better airway than he has ever had before. He is left with a healthy organ made with his own stem cells, which, in a way, is a kind of miracle.”
