The Role of Tissue Engineering in Transplantation
Macchiarini P, Jungebluth P, Go T, et al.
Lancet. 2008;372: 2023-2030
The authors reported details concerning replacement of a stenotic bronchus with a substitute bronchus constructed from a donor trachea. The recipient had a history of tuberculosis, which produced a bronchial stricture and greatly impaired respiratory function. The donor trachea was treated to remove viable cells and antigens, leaving only a skeleton of cartilage. This tissue was subsequently colonized with the patient's own epithelial cells and chondrocytes. Within a few days of transplant, the new bronchus was functioning well and has continued to remain functional over a 4-month period without any need for immunosuppressive drugs.
Apart from transplant, a pneumonectomy would have been this patient's only treatment option. This dramatic case report emphasizes the role of tissue engineering as a way of replacing defective organs. The favorable results are expected to persist because the bioengineered organ has already developed its own blood supply. Because the living cells originated from the recipient, immunosuppressive therapy has not been necessary.
Abstract
Clinical Transplantation of a Tissue-Engineered Airway
Macchiarini P, Jungebluth P, Go T, et al.
Lancet. 2008;372: 2023-2030
Summary
The authors reported details concerning replacement of a stenotic bronchus with a substitute bronchus constructed from a donor trachea. The recipient had a history of tuberculosis, which produced a bronchial stricture and greatly impaired respiratory function. The donor trachea was treated to remove viable cells and antigens, leaving only a skeleton of cartilage. This tissue was subsequently colonized with the patient's own epithelial cells and chondrocytes. Within a few days of transplant, the new bronchus was functioning well and has continued to remain functional over a 4-month period without any need for immunosuppressive drugs.
Viewpoint
Apart from transplant, a pneumonectomy would have been this patient's only treatment option. This dramatic case report emphasizes the role of tissue engineering as a way of replacing defective organs. The favorable results are expected to persist because the bioengineered organ has already developed its own blood supply. Because the living cells originated from the recipient, immunosuppressive therapy has not been necessary.
Abstract
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