Kochi hospital performing trachea transplant surgery

In what could possibly be the first instance of trachea transplant in the country, a 43-year-old woman with tumour in the wind pipe would get a new trachea if the first stage of the complex transplant procedure at Amrita Institute of Medical Sciences (AIMS) is successful.

The woman diagnosed with adenoid cystic carcinoma was so severely affected that doctors advised tracheal transplant for the patient who needed a stent pushed into her trachea to breathe. According to hospital authorities the transplant could be only the second in the world.

The retrieved trachea from the donor was sewn into the forearm of the recipient after removal of the inner lining cells that usually caused rejection. The operation was led by Dr Subramanya Iyer, head, plastic and reconstruction surgery, AIMS, along with pulmonologist Dr Arun Nair.

In the procedure the trachea is vascularised and the technique called the forearm to trachea transplant was first done by a team of Belgian doctors led by Dr Pierre Delaere at the University of Leuven in 2010.

The trachea transplant procedure would be complete only with the removal of the trachea from the forearm, after two months and it is stitched to the actual position of the wind pipe.

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 transplantation at Amrita Hospital was planned in two stages and in the first stage, done on Thursday, the soft tissue and mucosa of the donor trachea was stripped off before grafting to the recipient forearm in a complicated and lengthy surgery, which took 12 hours.

In the second stage, two months following the initial surgery and once it was certain that it had taken new blood vessels and become viable, the new trachea in the forearm would be harvested along with its blood vessels to replace the diseased trachea.