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A new trachea from stem cells and a scaffold

Posted by Mark Haigh on Mon, Jul 14, 2014 @ 01:26 PM

Italian surgeon uses plastic as a scaffold, rather than a donated trachea. The first recipient would be Andermariam Beyene, a 36-year-old engineer from Eritrea.

 

Macchiarini’s team began by collecting stem cells from Beyene’s bone marrow. Those cells were mixed with special growth factors and then poured onto a scaffold made from plastic — in fact, the very same plastic that is used to make soda bottles — which had been made to mimic the shape of a real windpipe.

In just a matter of days, the scaffold began to transform into an actual functioning windpipe.

Macchiarini described the magical sounding process like this: “It’s like if you roast a chicken. It’s the same thing. You fill this box with fluid that includes cells. And then this chicken scaffold just is submerged in this fluid and the cells penetrate inside.”

Eight patients have now received his completely artificial, bio-engineered tracheas, but because the surgery is still highly experimental and unproven, critics worry that he is putting his patients at risk and taking the science out of the lab prematurely.

Skeptics have questioned whether he is using his desperate — and highly vulnerable — patients as human guinea pigs.

“I do believe he’s in the gray zone,” Dr. Joseph Vacanti, surgeon- in-chief at the Massachusetts General Hospital for Children, told Vieira in September of 2013.

Not all of Macchiarini's patients have survived, but supporters argue that this is how surgery advances.


"I do believe he’s in the gray zone."


“Take a look at any major turn in surgery,” said Dr. Rick Pearl, pediatric surgeon-in-chief at Children's Hospital of Illinois in Peoria. “It never started out working, did it?

“Tom Starzl, when he started doing liver transplants, the first seven, eight, nine patients all died. Everybody said he was nuts, OK? Christian Barnard, when he started doing heart transplants, everyone threw rocks at him. This is how we’re going to treat diseases in the future and this is the start of it.”

One of Macchiarini's most promising success stories is Claudia Castillo, a Spanish mother who is doing so well six years after her transplant that an increasing number of Macchiarini's colleagues are beginning to see him in a new light.

“I believe, for the field, we are now at the end of the beginning,” Vacanti said. “And so, he may feel alone, but he is not alone. He’s part of the group that’s making fantasy real.”

Original article By Linda Caroll

Linda Carroll is a regular contributor to NBC News. She writes about health and science and her work has appeared in The Science Times, Newsday and The Los Angeles Times as well as national magazines including Smart Money and Health. She is coauthor of "The Concussion Crisis: Anatomy of a Silent Epidemic" and the recently released "Duel for the Crown: Affirmed, Alydar, and Racing's Greatest Rivalry." She lives in rural New Jersey.

Tags: Research, Healthcare, Regenerative Medicine, Adult Stem Cells

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