In early July 2011, there were reports of a new kind of transplant involving a body part made of a biocomposite. Andemariam Teklesenbet Beyene underwent a trachea transplant that required an artificial windpipe crafted by UK experts then flown to Sweden where Beyene’s stem cells were used to coat the windpipe before being transplanted into his body.

It is an extraordinary story not least because Beyene, a patient in a Swedish hospital planning to return to Eritrea after his PhD studies in Iceland, illustrates the international cooperation that made the transplant possible.

The scaffolding material for the artificial windpipe was developed by Professor Alex Seifalian at the University College London in a landmark piece of nanotechnology-enabled tissue engineering. Tim Harper in his July 25, 2011 posting provides more details about the scaffolding,

A team led by Professor Alexander Seifalian (UCL Division of Surgery & Interventional Science; professor of nanotechnology and regenerative medicine at University College London, UK), whose laboratories are headquartered at the Royal Free Hospital, created a glass mold of the patient’s trachea from X-ray computed tomography (CT) scans of the patient. In CT, digital geometry processing is employed to generate a 3D image of the inside of an object from a large series of 2D X-ray images taken around one single axis of rotation.

Then, they manufactured a full size y-shaped trachea scaffold at Professor Seifalian’s laboratories. The scaffold of the trachea was built using a novel nanocomposite polymer developed and patented by Professor Seifalian. Professor Seifalian worked together with Professor Paolo Macchiarini at Karolinska Institutet, Stockholm, Sweden (who also holds an Honorary appointment at UCL).

Professor Seifalian and his team used a porous novel nanocomposite polymer to build the y-shaped trachea scaffold. The pores were millions of little holes, providing this way a place for the patient’s stem cells to grow roots. The team cut strips of the novel nanocomposite polymer and wrapped them around the glass mold creating this way the cartilage rings that conferred structural strength to the trachea.

After the scaffold construct was finished, it was taken to Karolinska Institutet where the patient’s stem cells were seeded by Professor Macchiarini’s team.

Harper goes on to provide more details and insight into what makes this event such an important one.

Meanwhile, Dexter Johnson’s (Nanoclast blog in the IEEE website) July 21, 2011 posting poses a question,

While the nanocomposite scaffold is a critical element to the artificial organ, perhaps no less important was the bioreactor used to grow the stem cells onto it, which was developed at Harvard Bioscience.

If you needed any evidence of how nanotechnology is not only interdisciplinary, but also international, you could just cite this case: UK-developed nanocomposite for the scaffolding material, US-based bioreactor in which the stem cells were grown onto the scaffolding and a Swedish-based medical institute to perform the transplant.

So I ask, which country or region is going to get rich from the breakthrough?

It’s an interesting question and I don’t think I would have framed it in quite that fashion largely because I don’t tend to think of countries or regions getting wealthy from biomedical products since pharmaceutical companies tend to be internationally based. Is Switzerland richer for Novartis?

I suppose I’m a product of the Canadian landscape from which I spring so I think of trees and mines as making a country or region richer as they are inextricably linked to their environment but pharmaceuticals or biomedical appliances can be manufactured anywhere. Consequently, a synthetic organ could be manufactured anywhere once the technology becomes easily available. Who gets rich from this development? I suspect that will be a person or persons if anyone but, not a region or a country.

Getting back to Beyene, here are more details from the July 7, 2011 BBC News article by Michelle Roberts,

Dr Alex Seifalian and his team used this fragile structure [the scaffold] to create a replacement for the patient, whose own windpipe was ravaged by an inoperable tumour.

Despite aggressive chemotherapy and radiotherapy, the cancer had grown to the size of a golf ball and was blocking his breathing. Without a transplant he would have died.

During a 12-hour operation Professor Macchiarini removed all of the tumour and the diseased windpipe and replaced it with the tailor-made replica [now covered with tissue grown from the patient’s bone marrow tricked into growing like cells found in a trachea].

…

And, importantly, Mr Beyene’s body will accept it as its own, meaning he will not need to take the strong anti-rejection drugs that other transplant patients have to.

Professor Macchiarini said this was the real breakthrough.

“Thanks to nanotechnology, this new branch of regenerative medicine, we are now able to produce a custom-made windpipe within two days or one week.

“This is a synthetic windpipe. The beauty of this is you can have it immediately. There is no delay. This technique does not rely on a human donation.”

He said many other organs could be repaired or replaced in the same way.

A month on from his operation, Mr Beyene is still looking weak, but well.

Sitting up in his hospital bed, he said: “I was very scared, very scared about the operation. But it was live or die.”

My best wishes to Beyene and his family who are also pioneers.