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Laryngectomy developments

Building new organs

In 2008, I was privileged to co-lead the team that provided the word’s first stem cell based organ transplant to a woman from Colombia (Claudia Castillo: see picture). Her windpipe, damaged by tuberculosis, was replaced by a donor organ seeded with her own cells.

 

Almost four years’ later, she is well and working fulltime. In 2010, we were able to repeat the process for a 10-years’ old boy from Northern Ireland. Although he had a lot of problems for months afterwards, he is now at school, growing and very well.

 

These cases show us that it is technically possible to build new organs from stem cells. However, they remain isolated patients, as there remain a lot of hurdles to overcome.

Ideally, we need to have organs that can be implanted ‘off-the-shelf’, but this requires a source of stem cells from another individual, with possible risks of rejection (as for conventional transplants); the scaffolds would need to be made from a synthetic material, but early experience with such scaffolds has not been wholly successful and better materials are needed; there are huge ethical, financial and regulatory hurdles that researchers have to negotiate to get such treatments into clinical trials.

 

However, on the starting blocks are not just windpipes, but also hearts, lungs, kidneys and…larynxes! As the number of donors for conventional organ transplants continues to fall, and the number of needy patients increases, this type of technology is sorely needed. Perhaps one day, though, we may indeed, and I hope we will, be able to produce a ‘voice-box in a box’!

 

Martin Birchall

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