Doctors achieve in vivo esophageal regeneration using human tissue
American surgeons have successfully reconstructed an esophagus from donated skin tissue and metal stents.
Surgeons from the Medical College of Wisconsin (WI, USA) have successfully reconstructed an esophagus from donated skin tissue and metal stents.
The esophagus was created in order to re-establish swallowing in a 24 year old male patient, paralyzed as the result of a car crash with a 5-cm full-thickness esophageal segment destroyed by a mediastinal abscess. Under normal circumstances doctors would attempt to repair the esophagus using a tube from the patient’s digestive system but, given the extent of the man’s injuries, this was not possible.
Furthermore, the team aimed to induce esophogeal repair using use readily available materials, as, although promising, tissue engineering approaches are not at the stage where they are applicable for widespread clinical application.
The team endoscopically inserted a fully covered, self-expanding, metal stent (diameter 18 mm, length 120 mm) as a scaffold, which was covered by a commercially available matrix and sprayed with autologous platelet-rich plasma adhesive gel. The stents were removed after 3.5 years, upon which the surgeons saw full-thickness regeneration of the esophagus with stratified squamous epithelium, a normal five-layer wall, and peristaltic motility with bolus transit. Four years after the stents were removed doctors reported that the patient was eating normally and maintaining a healthy weight.
"We initially thought (the results) were too good to be true," commented Kulwinder Dua Medical College of Wisconsin (USA). "But the proof in the pudding is that this guy is now eating and drinking normally."
In the past, scientists have formed windpipes, blood vessels and nostrils. They were also able to create an esophagus using pig tissue. This particular technique, however, had only previously been tested in dogs.
Nonetheless, Dua emphasized the need for further trials: "This is not a recommendation for mainstream use. There are still a lot of unanswered questions."
– Written by Daphne Boulicault