A foreign patient underwent trachea transplantation in Krasnodar

A 42-year-old patient from Jordanian, who underwent a unique tracheal transplantation performed with the use of bioengineered scaffold seeded with patient’s own cells, was dismissed from Krasnodar regional clinical hospital №1. According to Hospital press-office, postoperative care lasted for about a month; the patient is doing well now.  

The transplantation was carried out on August 9, 2013 by the regenerative medicine professor of Karolinska Institute (Sweden), the leading scientist of the governmental Megagrant Paolo Macchiarini, the head doctor of the RCH №1, corresponding member of RAMS, Professor Vladimir Porkhanov and his deputy, thoracic surgeon, candidate of medical science Igor Polyakov together with other members of surgical team.

Almost 20 years passed from the day when Hanaan S., the patient, was badly injured in a car accident. Long-term artificial lung ventilation caused a tracheal stenosis. He had breathing difficulties and wasn’t able to move and talk. He underwent a number of surgeries, having just a temporary effect, and as time passed the tracheal lumen grew smaller. He was afraid to fall asleep, since he suffered from sleep apnea caused by the collapse of softened trachea.  As a doctor, Hanaan kept trying to find some information on more effective technologies that could help him. In 2006 he was examined in Boston (USA), however he was denied a surgery, his case was considered too difficult (it is believed that there is no chance to help a patient when such a large patch of trachea is damaged).  At last he revealed about professor Macchiarini’s method and the fact that regenerative medicine technologies grow rapidly in Krasnodar and two artificial trachea transplantations with the use of patients’ own cells were performed in summer 2012. By that time Paolo Macchiarini had performed 6 transplantations of this kind in the frames of international clinical trial all over the world.

Hanaan’s surgery was difficult and lasted for more than 6 hours. “I had no doubt that everything will be fine”, - said the patient, who was able to breathe and speak normally almost immediately after anesthesia recovery.

Process was the same as that of the previous surgeries: 48 hours before the transplantation mononuclear cells were isolated from patient’s bone marrow sample by means of special equipment. An artificial scaffold was seeded with these cells and then it was placed into a bioreactor, where cell proliferation and adhesion occurred. In 48 hours the scaffold is ready to be transplanted.

“However the technology is a little bit changed and refined each time – that is the essence of translational medicine, - says professor Macchiarini. In this particular case our partners from the USA and Germany improved the composition of the scaffold and the bioreactor based on previous experience. The entire scaffold seeding was performed by the specialists from Krasnodar Hospital, who were trained in Karolinska Institute last year, without exterior help at their own laboratory. And they did it excellent!”  

It is planned to continue conduction of  surgeries, the next transplantations are planned for the nearest future.