A major leap for organ transplants
Photo by OIST (Flickr)
by Natalia Dec
As published in Nature Communications, scientists at the UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, and the Francis Crick Institute have recently succeeded in growing an oesophagus for the first time. The oesophagus is a complex organ, made up of different tissue types, which acts as a pipe for the food and liquid travelling from your mouth to the stomach, and is an indispensable part of the gastrointestinal tract.
In the lab, a rat oesophagus was used and the cells were removed, creating a collagen scaffold. The scaffold was then seeded with early rat cells, as well as early-stage muscle and connective tissue taken from both humans and mice. These went on to form the inner oesophageal lining. Grown oesophagus parts were then cut into sections measuring 2cm and implanted into mice abdomens. Upon implantation, it was recorded that the sections were fully capable of muscle contraction, and thus, food transportation.
Co-author and group leader at both the Francis Crick Institute and UCL Great Ormond Street Institute of Child Health, Dr Paola Bonfanti, stated that the researchers “were amazed to see engineered tissue [that] had both the structure and function of a healthy oesophagus” and was “hooked up with nearby blood vessels within a week of transplantation".
"This is a major step forward for regenerative medicine, bringing us ever closer to treatment that goes beyond repairing damaged tissue and offers the possibility of rejection-free organs and tissues for transplant,” says Professor Paolo DeCoppi, a co-author as well as consultant surgeon at the Great Ormond Street Hospital.
Approximately one in three thousand children are born with oesophageal abnormalities, such as gaps between the lower and upper sections of the oesophagus, or a lack of connection with the stomach. Despite the success of the research, clinical trials are still several years away, with more trials involving larger mammals as well as other animals being a necessity.
In 2016, research into engineered organ transplants suffered a major setback because of the surgeon Paolo Macchiarini. Previously, he was considered a pioneer in using scaffolds seeded with patient stem cells as windpipe transplants and was on a temporary contract at Karolinska Institute in Sweden from 2010. However, he was accused of research falsification and medical misconduct, as well as performing unethical surgeries on healthy patients. Nine of his patients had received a synthetic windpipe, and of those, seven passed away. The two survivors received replacement surgeries with donor tracheas.
The team working at the Great Ormond Street Hospital and Francis Crick Institute said that the controversy surrounding Macchiarini and his scandal made them determined to proceed carefully in any further research, as well as possible clinical trials.
The ultimate goal of the team is to create a bio-engineered oesophagus taken from a pig, which they would then inject with stem cells belonging to the patient. This would minimise the risk of rejection, and present a hope for children born with damaged oesophagi, or parts of them missing, who could then receive healthy and functioning organs to better their life quality.
