Hospital News, 10-1-2011 - Western Pennsylvania Healthcare News

Issue No. 10 wphospitalnews.com| 13Tomorrow’s Organ Transplants: A Farewell to Wait Lists andImmune Rejection?By David GreenMore than 100,000 Americans are currently on the activewaiting list for an organ transplant. Meanwhile, theaverage annual cost of immunosuppressive drugs—takenafter a transplant to keep the body from rejecting the neworgan—is more than $11,000, and in some instances canbe as much as $25,000, according to the American Societyof Transplant Surgeons.These stark figures are motivating a quest within thebiomedical research community for innovation. “One ofthe most promising avenues of approach is the developmentof techniques for growing an organ from a patient’sown stem cells,” says David Green, President of Holliston, MA-based Harvard Bioscience.“In so doing, we eliminate the long wait time that might be required forthe patient to receive a suitable organ, and do away with the need for immunosuppressivemedications following the procedure.”A significant success in this area was recently achieved with the company’s help.At Karolinska University Hospital in Huddinge, Stockholm, Sweden, a 36-year-oldman suffering from late-stage tracheal cancer was recently provided with a new tracheathat was grown in the laboratory, seeded by the patient’s own stem cells. Theoperation was performed by Professor Paolo Macchiarini of Karolinska UniversityHospital and Karolinska Institutet, along with colleagues including Prof. AlexanderSeifalian from University College in London, England.Despite maximum treatment with radiation therapy, the patient’s tumor hadreached approximately six centimeters in length and was extending to the mainbronchus. It was progressing and almost completely blocked the trachea. Since nosuitable donor windpipe was available, the transplantation of the synthetic tissueengineeredtrachea was performed as the last possible option for the patient, referredby Professor Tomas Gudbjartsson of Landspitali University Hospital (Iceland), whowas also part of the surgical team.This represents the first time a synthetic organ has ever been successfully transplantedinto a patient. The key technology behind the surgery was a shoebox-sizedapparatus known as a bioreactor, created by Harvard Bioscience, in which the newtrachea was grown. The bioreactor was loaded with a nanocomposite “scaffold,”designed and built by Prof. Seifalian, and made out of a porous plastic polymer material,in the shape of the patient’s original trachea. Over the course of about twodays, the scaffold was rotated inside the bioreactor while its surface was soakedwith stem cells taken from a bone marrow biopsy from the man’s hip.Over that two-day period, the patient’s stem cells settled into the pores inside thescaffold, and started to grow into each other, gradually transforming from individualcells into real tissue. A few days after the new trachea was implanted, the patient’sown blood vessels actually began to grow into it, making the new organ truly a partof his own body. Because the patient’s own stem cells were used, the patient’s bodyaccepted the transplant without the use of immunosuppressive drugs. The patientwas subsequently discharged from the hospital and is doing well.What does tomorrow hold for this type of bioreactor technology? For the immediatefuture, explains David Green, Harvard Bioscience’s president, the scaffoldapproach to generating synthetic body parts will be limited to tubular organs suchas trachea and blood vessels, rather than more complex organs such as kidneys andlivers. However, other types of organs may become a practical option in time. “Ibelieve the future will witness the widespread adoption of this technique for trachealcancer patients, who number about 1,800 annually,” Mr. Green says. “Beyond that,it is possible that the technique can be applied to other tubular organs like esophagus,blood vessels and ureters.”Should this scenario unfold as some predict, it could spell the dawn of a new erain the treatment of thousands of patients whose lives and health will be significantlyimproved.David Green is President of Holliston, MA-based Harvard Bioscience, a global developer,manufacturer and marketer of a broad range of specialized products, primarilyapparatus and scientific instruments, used to advance life science researchand regenerative medicine. 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