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首例量身定做移植手術取得成功
來源:中國新聞網

    西班牙科學家近日成功利用患者本身的干細胞，完成全球首例量身定做的移植手術。這項醫學技術上的重大突破意味著細胞移植**可在不發生排斥的狀態下進行，患者出院后的生活可以完全恢復正常。專業醫學雜志《柳葉刀》上公布的這項研究報告說，患者已出院5個月，目前身體狀況非常好。
   來自歐洲的醫學專家據此認為，今后，接受量身定做的器官移植手術將不再是難事。30歲的克勞迪婭?卡斯蒂略曾經患肺結核，左胸氣管嚴重損壞，不但呼吸困難，而且容易發生感染，無法照顧兩個小孩。在找到適當的氣管捐贈人選后，手術團隊用強力化學劑和酶清洗捐贈者的氣管，將他的細胞完全**，只剩下一個由纖維蛋白膠原組成的細胞骨絡。手術團隊從克勞迪婭體內取出骨髓干細胞，并培養成軟骨細胞，并通過特殊的培育器具，將克勞迪婭的細胞植入捐贈者的氣管中，避免排斥。
西班牙巴塞羅那醫院外科醫生馬基亞羅尼教授在6月份對患者施行了手術。他說，“我一直很擔心。以前，我們只在豬身上做過試驗?！彼硎?，這個量身定做的氣管看起來與正常的人的氣管一樣，患者現在可以過正常人的生活。（創賽新聞中心 canspecsci.com）

     創賽推薦原始出處：

    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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