Kochi hospital maps new heights in tracheal transplant

Trachea Transplant 2911Surgeons at Amrita Hospital carry out first phase of Asia's maiden tracheal transplant�

Kochi (ISJ) ? Surgeons at Kochi-based Amrita Institute of Medical Sciences & Research Centre has successfully carried out the first phase of trachea transplant in Asia for a female patient. The highly complex procedure known as tracheal homograft has been carried out only once earlier in Belgium, though surgeons in Spain and the USA have tried different procedures like tissue engineering or synthetic trachea.

The first trachea transplant was carried out by Dr. Paolo Macchiarini at a hospital in Spain on Claudia Castillo, through tissue engineering.

The second person in the world and the first in the US to receive a synthetic trachea engineered with the patient?s own stem cell was Christopher Lyles of Maryland. But he survived only four months after the surgery and died in 2012.

The patient in Kochi was suffering from cancer of the whole length of trachea ? the wind pipe from voice box to lungs. She had a slow-growing tumour, which blocked breathing due to internal growth, said Professor Subramanian Iyer, Head of Neck and Plastic Reconstructive Surgery at Amrita Institute of Medical Sciences & Research Centre.

?The procedure was done on a lady who was diagnosed to have cancer of trachea. As the cancer was involving the whole length of trachea, tracheal transplant could be the only treatment for her,? said Dr Iyer, confirming the success of the first stage.

The transplantation has been planned in two stages. In the first stage, done on Thursday, the soft tissue and mucosa of the donor trachea was denuded off before it is was placed into the recipient forearm by a complicated and lengthy surgery, which took 12 hours.

In the second stage, two months after the initial surgery and once it is sure that it has taken new blood vessels and become viable, the new trachea in the forearm will be harvested along with its blood vessels to replace the diseased trachea. The success of the procedure can be made sure only after the second stage, said Dr. Krishnakumar Thankappan, who was part of the team alongwith Dr. Iyer.

The patient is at present stabilized by use of a stent to restore the tracheal airway. This was carried out by Dr. Arun Nair, the Interventional Pulmonologist, who is also leading the team treating the patient.� After one-and-a-half or two months, the grafted trachea will be transplanted in its place, through open-chest surgery.

The family of the donor Renjith V. Thomas, a 37-old film director, who suffered an intracranial bleeding leading to brain death, had expressed their desire to donate his organs including trachea, subglottis (airway below the vocal cords and above the trachea), liver, kidney and cornea.

Liver and one kidney was received by a young patient from Kasargod, in northern Kerala, who is being treated at AIMS, the other organs were donated to patients under treatment in different hospitals in the state.�

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