title: Clinical transplantation of a tissue-engineered airway.
abstract: The loss of a normal airway is devastating. Attempts to replace large airways have met with serious problems. Prerequisites for a tissue-engineered replacement are a suitable matrix, cells, ideal mechanical properties, and the absence of antigenicity. We aimed to bioengineer tubular tracheal matrices, using a tissue-engineering protocol, and to assess the application of this technology in a patient with end-stage airway disease.
  
  
  
  We removed cells and MHC antigens from a human donor trachea, which was then readily colonised by epithelial cells and mesenchymal stem-cell-derived chondrocytes that had been cultured from cells taken from the recipient (a 30-year old woman with end-stage bronchomalacia). This graft was then used to replace the recipient's left main bronchus.
  
  
  
  The graft immediately provided the recipient with a functional airway, improved her quality of life, and had a normal appearance and mechanical properties at 4 months. The patient had no anti-donor antibodies and was not on immunosuppressive drugs.
  
  
  
  The results show that we can produce a cellular, tissue-engineered airway with mechanical properties that allow normal functioning, and which is free from the risks of rejection. The findings suggest that autologous cells combined with appropriate biomaterials might provide successful treatment for patients with serious clinical disorders.
authors.affiliation: Department of General Thoracic Surgery, Hospital Clinic, Barcelona, Spain.
authors.forename: Paolo
authors.initials: P
authors.lastname: Macchiarini
authors.forename: Philipp
authors.initials: P
authors.lastname: Jungebluth
authors.forename: Tetsuhiko
authors.initials: T
authors.lastname: Go
authors.forename: M Adelaide
authors.initials: MA
authors.lastname: Asnaghi
authors.forename: Louisa E
authors.initials: LE
authors.lastname: Rees
authors.forename: Tristan A
authors.initials: TA
authors.lastname: Cogan
authors.forename: Amanda
authors.initials: A
authors.lastname: Dodson
authors.forename: Jaume
authors.initials: J
authors.lastname: Martorell
authors.forename: Silvia
authors.initials: S
authors.lastname: Bellini
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Parnigotto
authors.forename: Sally C
authors.initials: SC
authors.lastname: Dickinson
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Hollander
authors.forename: Sara
authors.initials: S
authors.lastname: Mantero
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Conconi
authors.forename: Martin A
authors.initials: MA
authors.lastname: Birchall
mesh_terms: D000328:Adult; D055091:Bronchomalacia / Q000503:physiopathology* / Q000628:therapy; D002102:Cadaver; D019902:Chondrocytes / Q000166:cytology*; D005260:Female; D006801:Humans; D011184:Postoperative Period; D012129:Respiratory Function Tests; D023822:Tissue Engineering / Q000379:methods*; D014132:Trachea / Q000166:cytology / Q000637:transplantation*