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首例量身定做移植手术取得成功
来源:中国新闻网

    西班牙科学家近日成功利用患者本身的干细胞，完成全球首例量身定做的移植手术。这项医学技术上的重大突破意味着细胞移植**可在不发生排斥的状态下进行，患者出院后的生活可以完全恢复正常。专业医学杂志《柳叶刀》上公布的这项研究报告说，患者已出院5个月，目前身体状况非常好。
   来自欧洲的医学专家据此认为，今后，接受量身定做的器官移植手术将不再是难事。30岁的克劳迪娅•卡斯蒂略曾经患肺结核，左胸气管严重损坏，不但呼吸困难，而且容易发生感染，无法照顾两个小孩。在找到适当的气管捐赠人选后，手术团队用强力化学剂和酶清洗捐赠者的气管，将他的细胞完全**，只剩下一个由纤维蛋白胶原组成的细胞骨络。手术团队从克劳迪娅体内取出骨髓干细胞，并培养成软骨细胞，并通过特殊的培育器具，将克劳迪娅的细胞植入捐赠者的气管中，避免排斥。
西班牙巴塞罗那医院外科医生马基亚罗尼教授在6月份对患者施行了手术。他说，“我一直很担心。以前，我们只在猪身上做过试验。”他表示，这个量身定做的气管看起来与正常的人的气管一样，患者现在可以过正常人的生活。（创赛新闻中心 canspecsci.com）

     创赛推荐原始出处：

    Lancet，doi:10.1016/S0140-6736(08)61598-6，Paolo Macchiarini，Martin ABirchall
  
     Clinical transplantation of atissue-engineered airway
   
     Prof Paolo Macchiarini MD a b c , PhilippJungebluth MD a, Tetsuhiko Go MD a, M Adelaide Asnaghi MSc d,Louisa E Rees PhD h, Tristan A Cogan PhD g, Amanda Dodson BSc h,Jaume Martorell PhD f, Silvia Bellini PhD e, Prof Pier PaoloParnigotto PhD e, Sally C Dickinson PhD g, Prof Anthony P HollanderPhD g, Sara Mantero PhD d, Maria Teresa Conconi PhD e, Prof MartinA Birchall MD h
    
    Summary

    Background
    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 suitablematrix, cells, ideal mechanical properties, and the absence ofantigenicity. We aimed to bioengineer tubular tracheal matrices,using a tissue-engineering protocol, and to assess the applicationof this technology in a patient with end-stage airway disease.

    Methods
   We removed cells and MHC antigens from a human donor trachea, whichwas then readily colonised by epithelial cells and mesenchymalstem-cell-derived chondrocytes that had been cultured from cellstaken from the recipient (a 30-year old woman with end-stagebronchomalacia). This graft was then used to replace therecipient's left main bronchus.

    Findings
   The graft immediately provided the recipient with a functionalairway, improved her quality of life, and had a normal appearanceand mechanical properties at 4 months. The patient had noanti-donor antibodies and was not on immunosuppressive drugs.

   Interpretation
    The results show thatwe can produce a cellular, tissue-engineered airway with mechanicalproperties that allow normal functioning, and which is free fromthe risks of rejection. The findings suggest that autologous cellscombined with appropriate biomaterials might provide successfultreatment for patients with serious clinical disorders.

    Funding
   Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III,Fondo de Investigación Sanitaria, Spain; Charles Courtenay-CowlinFund, University of Bristol; UK Arthritis Research Campaign; andthe James Tudor Foundation.
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