French surgeon builds windpipes from arteries

Paris, May 20: Where others failed, sometimes spectacularly, French surgeon Emmanuel Martinod has helped people whose windpipes have been ravaged by cancer and other diseases to live and breathe normally again.

At least one of his patients, sporting a new trachea, has taken up long- distance running.

Since 2009, Martinod and his team at Avicenne Hospital near Paris have carried out more than a dozen trachea transplants using donor aortas reinforced with custommade internal scaffolding, called stents.

Hailed by one US throat surgeon as a “major advance”, the reconstructive technique was detailed Sunday in the Journal of the American Medical Association ( JAMA), and presented at a medical congress in San Diego, California.

Previous efforts to rebuild the windpipe and airways from scratch had focused on using artificial tubes seeded with the patient's own stem cells.

This approach was made famous — and then notorious — by disgraced Italian surgeon Paolo Macchiarini, who performed synthetic trachea transplants on eight patients from 2011 to 2014. Seven died from complications, and the whereabouts of the eighth is unknown.

It was later revealed that Macchiarini falsified results in published studies.

Martinod struck on the idea of using aortas — the largest artery in the body — from deceased donors to replace damaged sections of trachea, the roughly 10- centimetre ( four- inch) tube of cartilage and tissue that connect the larnyx to bronchial tubes feeding into the lungs.

The thick walls of aortas are designed to withstand a lifetime of pressure, chaneling blood pumped by the heart.

Harvested from donors, the arteries can be frozen to minus 80 degrees Celsius ( minus 112 degrees Fahrenheit) and stored, ensuring an ample supply.

The freezing process, Martinod discovered, had another huge advantage: it removed the need for a life- long regimen of medications to prevent the immune system from rejecting a transplanted organ or body part.

Follow- ups on the first patients to receive new windpipes brought even more good news.

“We went from surprise to surprise, because we saw a regeneration of epithelium,” he told AFP.

The inside of a healthy trachea is lined with a thin film, called epithelium, that moistens and protects the airways. It also functions as a barrier to disease.