27 Jun '12
Oleg Kouzbit, Online News Managing Editor
Nanotechnology has made possible the world’s first artificial trachea and partial larynx transplantation based on patient’s own biomaterial. A 33-year-old woman was operated on earlier this month in Krasnodar and is now reportedly recovering. In this unique approach, her marrow cells were used to grow her new trachea. The international endeavor that brought together leading surgeons from Sweden and Russia as well as biotech scientists from the United States is part of a broader Russian government led program to promote regenerative medicine in Russia.
The pioneering operation was performed on June 19 in Krasnodar’s Ochapovsky Regional Clinic, Southern Russia. In an unprecedented international effort led by Professor Paolo Macchiarini of Stockholm’s Karolinska Institutet and Academician Vladimir Porkhanov of Kuban Medical University, Krasnodar, a female patient got a new nanocomposite-based trachea with her own marrow cells seeded all over the artificial frame.
How it went
Yulia, a 33-year-old resident of St. Petersburg, had been severely injured in a car accident, which led to her developing cicatrical stenosis at her trachea that impeded breathing and speech. A series of surgeries that followed only reportedly exacerbated the situation.
The innovative bioimplant frame co-designed by the U.S.’ Nanofiber Solutions, Ohio, was an exact copy of the woman’s trachea and, partially, larynx. It was made to not only replace Yulia’s damaged organ but also make sure there was no graft-versus-host reaction in her body.
To make the ‘trachea’ tube the developers used a resilient and pliant porous nanocomposite material. The patient’s own cells extracted from her marrow were planted upon it. The frame was then placed in a special bioreactor developed by a US project partner, Harvard Bioscience, and customized fully to fit Yulia’s biological identity. The cells reportedly took about 48 hours to ‘take root,’ producing the woman’s new trachea.
The Swedish and Russian doctors who led the surgical team in the 5.5-hour operation have told the media that the patient’s immune system did not recognize the recipient as ‘foreign;’ on the contrary, the technology enabled the graft to start ‘acclimatizing’ to the new condition all by itself.
The partners in innovation and surgery
Kuban Medical University was set up in 1920 and has evolved since then to rank among Russia’s ten best educational and research institutions. There are seven departments, 68 chairs and two clinics (obstetrics and dental care). The university also runs a branch office in the neighboring Adygeia region.
Vladimir Porkhanov, head of the university’s oncology and thoracic surgery chair, is also a Corresponding Member of the Russian Academy of Medical Sciences.
Karolinska Institutet is a medical university located in Solna, the Stockholm urban area. Founded in 1810, it is Sweden’s third oldest such institution and one of Europe’s largest. Paolo Macchiarini, the key developer of the trachea transplantation method successfully test-run in Krasnodar, works at the university as professor of regenerative medicine.
The Ochapovsky Regional Clinic where Yulia was operated on is one of the largest in Southern Russia and has a vast experience in donor organ transplantation. According to Prof. Macchiarini, the clinic is “one of the best” he has seen in Europe. Its surgeons have performed a reported 80 heart transplantation operations over the past two years.
To be continued
The Yulia case has been assisted through a special Russian government program aimed at promoting regenerative medicine in this country.
Last year Prof. Macchiarini and his Russian partners won a major grant from the federal government for vast research and clinical trials of new techniques in the recuperation of human airways and lungs. The support has enabled the most recent Krasnodar effort and is expected to help establish Russia’s first International Center for Regenerative Medicine.