全球首例 自體骨髓幹細胞培育人造氣管
| 瑞典卡洛林斯卡大學醫院七日宣布，完成全球首例幹細胞人造氣管移植手術。該院指出，這項手術的成功為等不到合適捐贈器官的病患帶來一線生機，特別是對獲取捐贈氣管率遠不及成人的兒童。
自體幹細胞重建 無排斥問題 該手術由卡洛林斯卡大學醫院醫學教授馬基亞里尼組成的一個國際醫療團隊進行。他們採用倫敦大學學院研究人員利用塑膠材料與奈米科技所打造出的一個支架，並利用美國麻州哈佛生物科技公司所製造的一種特殊生物反應器（提供體外細胞培養生長反應的容器），將患者的幹細胞播散在支架上，而當幹細胞在支架上生長兩天後便進行移植手術。 卡洛林斯卡大學醫院聲明說︰「由於用來重建氣管的細胞是患者自己的細胞，所以沒有移植排斥問題，病患也沒有服用抗排斥藥物。」 這起在瑞典進行的氣管移植手術是使用人造器官的首例，在此之前的一起氣管移植用的是捐贈氣管與患者自己的幹細胞，而主持的醫師也是馬基亞里尼，他利用患者的骨髓幹細胞製造數以百萬計的上皮與軟骨細胞，並將之覆蓋在哥倫比亞病患的新氣管上。 此外，比利時醫療團隊曾將一個捐贈氣管埋入患者的手臂，以恢復其供血並生長新的組織，之後再移植入患者的喉部。這兩起病例都是利用患者自己的細胞來覆蓋捐贈氣管，因此無須服用抗排斥藥物。 專家指出，人造結構可被用來打造單純的器官，比如氣管、食道或膀胱，然而要在實驗室中打造出心臟、腎臟等較為複雜的器官，可能還需數年之久。 被用來做成人造氣管的塑膠聚合物之前也被用來製成淚管與血管，其多孔的表面可加速細胞生長。人造氣管製造者認為，可立即受惠於該技術的當屬氣管癌與喉癌患者，這類癌症病患通常被診斷出罹病時已屬末期階段，可做的治療選擇已無多。馬基亞里尼指出，今年底前預計再進行三例類似的人造氣管移植手術，其中包括兩名成人、一名兒童。 |
卡洛林斯卡大學醫院指出，一名罹患氣管癌的三十六歲男子因末期癌症幾乎完全阻塞氣管，加上無法取得合適的捐贈氣管，因此他別無選擇的於上月九日接受該移植手術，目前他的康復情形十分良好，並定於八日出院。資料來源:http://www.taiwandaily.net/gp2.aspx?_p=kSF1c9zU9HScIqpKVIuqsf5xU80xv+d3
Patient gets world's first artificial trachea
A patient will be discharged from a hospital in Sweden on Friday after his cancerous windpipe was removed and replaced by the world's first artificial trachea, made of his own stem cells grown on a man-made plastic matrix.
Just as remarkable as the man-made windpipe, he says, is how quickly it was produced. Collaborators in Sweden, London and the U.S. created the trachea from scratch in just two days for a 36-year-old man whose cancer was so far advanced that only emergency surgery offered him any chance of survival.
Macchiarini performed a similar procedure in 2008 in Barcelona. A patient named Claudia Castillo received a windpipe that had been removed from an organ donor and, over a period of weeks, cleared of all of its original cells, leaving just a matrix that could be coated with the patient's own stem cells. He has performed about 10 implantations using donor windpipes since then, he says.
He says he began by removing the patient's bone marrow and filtering out certain cells, called mononucleocytes. These cells, when treated with growth factors and other substances, morph into the cells that form the rings on the trachea. Then a team led by Alexander Seifalian at the University College of London worked round-the-clock to produce a Y-shaped matrix that would replace the cancerous portion of the patient's windpipe and connect with his lungs.
David Green's team at Harvard Biosciences in Holliston, Mass., traveled to Stockholm and placed the matrix and the solution of cells into a custom-made device called a bioreactor. The bioreactor keeps the body temperature constant at 98.6 degrees and rotates the matrix once per minute just as a rotisserie turns a chicken.
With every revolution, the lower part of the matrix dips into the cell broth, coating it and at the same time exposing the living cells to oxygen.
Within 48 hours, the man-made windpipe was ready for implantation. Doctors not only replaced Teklesenbet's windpipe, they gave it a blood supply by sliding a section of tissue from his stomach up through his diaphragm, which is a standard technique, Macchiarini says.
Green says similar bioreactors are being used to engineer heart and lung tissues, which so far have been tested only in rodents. Macchiarini says, "My dream as a surgeon is, rather than doing transplants of the heart, liver and lungs, is to use regenerative medicine to restore the function of cells damaged by aging and disease."
Teklesenbet says the dream has come true for him. "It is a wonderful thing for me," he said in a telephone interview, still hoarse from surgery. "I know about transplantation, but I never thought transplantation of the airway could happen."