An 18-hour operation with 50 specialists including surgeons, nurses, anesthetists, airway specialists and trainees who alternated in the operating room for the first complete trachea transplant in the world. The exceptional surgery was performed at Mount Sinai Hospital in New York on a 56-year-old woman whose trachea had been damaged six years earlier after a series of intubations due to asthma attacks. The operation took place on January 13th and the patient is currently in good health.
The trachea is the ‘tube’ that connects the larynx to the lungs, and has always been considered very difficult to transplant due to the complexity of the blood vessels that run through it. The trachea was taken from the donor and rebuilt in the recipient, and the different small blood vessels that carry oxygen to the organ were connected, meanwhile using a portion of the esophagus and thyroid to supply blood to the tissue that was being rebuilt. “For the first time we can offer a therapeutic option to patients with severe tracheal defects,” he says Eric Genden, leading the team – this is particularly timely given the growing number of patients with tracheal problems due to intubation for Covid. Our transplant and revascularization protocol is reliable, reproducible and technically advanced “.
In the past decades there have been several attempts to intervene on the trachea. The Italian surgeon Paolo Macchiarini he tried the path of organ reconstruction with stem cells, but his line of research was strongly contested by the Karolinska Institut in Stockholm, where he operated, and never caught on. In 2018, a donor’s aorta was used in France, stabilized by an artificial structure and ‘transformed’ into a trachea.
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The new path of transplantation has great potential for application: patients with congenital tracheal defects, untreatable diseases of the airways, burns, tumors or severe damage to the trachea resulting from intubation.
“Despite the extensive research on the vascular supply to the organ and the animal and human models on which it is studied – observes Genden – we are never really prepared to conduct an operation like this. We did not know how much the graft would tolerate the transplant, for which we tried to work quickly. After 18 hours, we realized that we had achieved a result never obtained before, and everything went well. I think the feeling we felt is indescribable – comments the surgeon – it reminded us why we do what we do. we do, to make a difference “.
The patient had no complications or signs of rejection, doctors are closely monitoring her condition to assess progress and reactions. “Mount Sinai hospital boasts the collaboration of various excellences – he declares Sander S. Florman, Professor of Surgery at the hospital’s Miller Transplantation Institute – and this result was possible thanks to the patient’s strength and confidence. The Transplant Institute is proud to support Dr. Genden’s efforts and to be able to help make this procedure a possibility for many people. “
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