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Home/Biologics/Windpipe Recipient Doing Well
Biologics

Windpipe Recipient Doing Well

November 6, 2013 1 min read Premium comments

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Windpipe Recipient Doing Well
Claudia Castillo / Courtesy: NPR and Robert Krulwich Wonders
Secondary

This is a follow-up on the stem cells and windpipes story. Surgeon Paolo Macchiarini, from Stockholm’s Karolinska University Hospital, reports that Claudia Castillo, the patient to whom he gave a new windpipe five years ago, continues to enjoy “a normal social and working life”.

The procedure performed on Claudia Castillo involved removing the cells from a section of donor windpipe and grafting cartilage cells grown from her own stem cells onto it, as well as other cells taken from a healthy part of her windpipe.

Macchiarini pioneered this surgery. In 2011, he gave a 36-year-old Eritrean the world’s first transplant of an artificial windpipe seeded with his own stem cells. Donor windpipes are often rejected by the recipient’s immune system, while patients also suffer from necrosis—the uncontrolled die-off of cells. But having the stem cells come from the patient reduces the risk of attack by the immune system.

Castillo was a 30 year old suffering from tuberculosis when she received her transplant. She was discharged from the hospital ten days following the operation and researchers have been following her case ever since to determine the long-term success of the surgery

“The recipient continues to enjoy a good quality of life, and has not experienced any immunological complications or rejection of the implanted airway, ” said a report published in The Lancet medical journal.

Macchiarini noted, “Moreover, regular testing of lung function, immunological response to the transplant, and other key indicators reveal that the recipient has retained good lung function and has not experienced any immunological complications. These results confirm what we, and many patients, hoped at the time of the original operation: that tissue engineered transplants are safe and effective in the long term.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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