Consider a kiss. The bestower must be able to breathe while pursing his or her lips, so “if there’s no air flow through your mouth or nose, you can’t give somebody a smooch,” said Peter Belafsky, MD, PhD, principal investigator of the laryngeal transplant project at the University of California, Davis, Medical School.
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April 2013In other words, one of the most iconic ways for humans to connect with each other requires a functioning larynx. Intrepid clinicians and researchers are using regenerative medicine techniques to help people whose ability to speak, sing, hear—or yes, kiss—has been impaired.
Engineered Trachea
In Europe, an international team of surgeons and scientists has been transplanting stem cell-based tracheas since 2008. “We stripped the cells off the donor trachea, leaving just the extracellular matrix as a scaffold,” said Martin Birchall, MD, professor of laryngology at University College London Ear Institute. “Then we seeded the scaffold with stem cells taken from the patients’ own bone marrow.” The scaffold was bathed in a cocktail of hormones and growth factors to coax the growth of cell types associated with a normal trachea. In 2010, Dr. Birchall and colleagues, including pediatric cardiothoracic surgeon Martin Elliott, MD, performed the first pediatric, stem cell-based, tissue-engineered transplant, on a 10-year-old boy with congenital tracheal stenosis and pulmonary sling. He urgently needed a new trachea because the metal stent placed soon after his birth had eroded into his aorta, causing it to bleed. The patient, now 13, has a functioning airway.