Stem cell-based windpipe transplant: patient is healthy two years later

The Irish boy who had
pioneering surgery two years ago to implant a new windpipe partially derived
from his own stem cells is healthy and back at school. A follow-up study
published in The Lancet medical journal reports that Ciaran Finn-Lynch, now 13,
is breathing normally and no longer needs anti-rejection medication.

Finn-Lynch was born
with a rare condition called long-segment tracheal stenosis which causes severe
breathing difficulties. To prevent his
lungs collapsing, he had metal tubes inserted into his airways but this resulted
in damage to a main artery. In 2010 surgeons proposed using a novel technique
where a donor windpipe coated with Finn-Lynch's own stem cells would be
implanted.

At the time, Martin
Birchall, professor of laryngology from University College London, who co-led
the team carrying out the transplant called the technique 'a completely new
approach'.

'We did a similar operation to a young woman
in Spain in 2008. She is now working full-time, looking after her children and
doing very well. This is very different and we can't predict exactly what is
going to happen', he said.

One novelty of the procedure
was the method of culturing the stem cells inside the body rather than in
the laboratory. Surgeons stripped the donor's windpipe to its collagen scaffolding
and then sprayed on stem cells from the boy's bone marrow. Once this structure
was implanted, the stem cells began dividing and matured to create the new
organ.

Commenting on the
results of the two-year follow-up, Martin Elliott, professor of cardiothoracic
surgery at University College London and Professor Birchall's partner leading
the team, said: 'The ideal outcomes for tracheal transplants in children are
normal airway and lung function, good general growth, a decent quality of life,
and no further surgical interventions'.

'So far we have
achieved this, but we are at the edge of medicine and, similarly to first
attempts of organ transplantation in the 1950s, many challenges remain'.

The team hopes the operation and successful outcome will spark more research and
innovative stem cell applications. Professor Birchall commented: 'We need more research on stem
cells grown deliberately inside the body, rather than grown first in a
laboratory over a long time. This research should help to convert one-off
successes into more widely available clinical treatments'.

Indeed, while the procedure appears to have been
successful in Finn-Lynch's case, it is still considered as experimental. Professor Larry Goldstein, director of the stem
cell program at University of California in San Diego told ABC News: 'You never
know what to do or how to interpret a success when it's one success; the
question you grapple with is whether this treatment is going to be good with a
larger number of people with this disease'.