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Airway Transplant Aided by Stem Cells a Medical First
Date:11/18/2008

r life span," said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City. "There are more questions in my mind than answers to this, and it's difficult to be able to say, this is definitely the dawn of the future, and this is going to work. We have to see if it's going to work and works in more patients before we can say this is a mainstream approach."

Four years ago, Castillo developed a cough that wouldn't go away; it was eventually diagnosed as tuberculosis. That cough led to a collapsed lung.

By March of this year, Castillo's condition had deteriorated to the point where she was unable to care for her children. Removing a lung was one treatment option, which would have allowed her to live, but seriously impaired her quality of life.

Instead, Castillo received a "new," bioengineered airway.

The scientists essentially created epithelial and cartilage cells from stem cells from Castillo's own bone marrow. Those cells were put on a 7-centimeter piece of trachea from a 51-year-old woman who had died of a brain hemorrhage. Four months later, the scientists had a "hybrid" organ that they used in June to replace Castillo's left main bronchus, which connects the main trachea (windpipe) to the left lung.

The donated organ underwent 25 "washing cycles" to remove donor antigens, which could cause the new tissue to be rejected by the recipient.

Castillo suffered no complications from the surgery and left the hospital 10 days after the procedure.

Tissue bioengineering has already been used to provide organ replacements in other parts of the body, but not in the airway, the study authors said.

"Hopefully the [stem] cells of this woman that were mixed will somehow coat or become integrated [with the donated trachea] so the graft won't be rejected with the assurance that most human tissues are," Horovitz said. "This is the first transplant of this kind. You're using ste
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