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Synthetic trachea save the lives of dying patients Is it possible to manufacture organs that work just as well as donations? Yes - and it has already been done. So far, the surgeon Paolo Macchiarini has given five patients new trachea made from nanotechnology and the patient’s own stem cells.

T

he first two operations performed using these techniques were reported worldwide in 2011. In both cases, the patients were young men under 40, with late-stage tracheal cancer. In order to survive, both patients needed their cancerous trachea removed immediately - a task which was not possible, as no replacement donor organs were available. “They had, in effect, been given a death sentence. As a last resort, they elected to try this method. Seeing them get a new chance to live their lives was fantastic, a great experience”, says Paolo Macchiarini, Visiting Professor of Regenerative Surgery at Karolinska Institutet, and responsible for the surgery. However, less than four months later in March 2012, one of the patients died; a man from the USA who was operated

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on at the Karolinska University Hospital in Huddinge. The death occurred suddenly at a hospital in the USA. “Of course it was shocking to discover that the man died. I’m not at liberty to discuss the more in-depth details behind his death, due to patient confidentiality, but it was not linked to our interventions. Nevertheless, we have evaluated everything and looked to what we can improve. Naturally this must be done, as we are dealing with previously untested technology. Each operation provides us with further important knowledge. We must always be humble and try to do better”, says Paolo Macchiarini. As A result of this evaluation, Paolo Macchiarini and his team have chosen a new material for the manufacture of the synthetic trachea. Nanotechnology is

still being used, but hopefully the structure of the new material will encourage the stem cells to bond even better than previously. With this new, fine-tuned technology, a further three patients have received new trachea. All of these patients were operated on during the summer of 2012; two in Russia and one at the Karolinska University Hospital in Huddinge. These patients are doing well, as is the very first patient to receive the transplant, a man from Ethiopia. The three new patients, however, received the surgery under different circumstances than previously, as they did not have cancer. Instead they are patients whose trachea had been damaged by other incidents, such as accidents. Synthetic materials and tissues have previously been used in many other areas; for example, it is relatively common to use synthetic blood vessels. The

Photograph: Staffan Larsson

Text: Annika lund Photograph: Istock Photo

Medical Science 2013  

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