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Chirurdzy z Mount Sinai przeprowadzili pierwszy na świecie przeszczep tchawicy

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Zespół chirurgów z Mount Sinai Hospital w Nowym Jorku przeprowadzili pierwszy na świecie przeszczep tchawicy. Osiągnięcie to może zrewolucjonizować terapię pacjentów z wrodzonymi wadami tchawicy oraz chorobami układu oddechowego, a także cierpiących z powodu oparzeń lub urazów spowodowanych intubacją.

Transplantacja tchawicy przeprowadzona przez chirurgów z Mount Sinai pod kierunkiem prof. Erica M. Gendena trwała 18 godzin. W operacji wzięło udział ponad 50 specjalistów – chirurgów, pielęgniarek, anestezjologów oraz rezydentów. Biorcą przeszczepu była 56-letnia pracownica opieki społecznej z Nowego Jorku, u której doszło do poważnych uszkodzeń tchawicy spowodowanych kilkukrotną intubacją po ataku astmy. Próby operacyjnej rekonstrukcji tchawicy doprowadziły do dalszego pogłębienia urazu. Z powodu rozległych uszkodzeń u pacjentki wykonano tracheostomię.

Pierwszy oddech od sześciu lat

Podczas zabiegu chirurdzy z Mount Sinai pobrali od dawcy tchawicę wraz z przylegającymi naczyniami krwionośnymi. Następnie tchawicę poddano rekonstrukcji u biorcy, począwszy od płuc, aż do krtani. Chirurdzy wykonali serię zespoleń mikronaczyniowych. Dzięki wykorzystaniu części przełyku i tarczycy do zapewnienia dopływu krwi do tchawicy udało się wykonać skuteczną rewaskularyzację. Wykonana z sukcesem operacja pozwoliła na usunięcie tracheostomii, dzięki czemu pacjentka po raz pierwszy od sześciu lat mogła zaczerpnąć oddech przez usta.

U pacjentki nie stwierdzono powikłań ani oznak odrzucenia przeszczepu. Kobieta pozostaje pod obserwacją lekarzy, którzy monitorują proces rekonwalescencji i przebieg terapii immunosupresyjnej.

Szansa na leczenie

Jak podkreśla prof. Eric M. Genden, specjalista w zakresie otolaryngologii, neurochirurgii i immunologii z Mount Sinai Hospital, który kierował zespołem chirurgów, osiągnięcie jego zespołu może mieć przełomowe znaczenie dla pacjentów cierpiących na ciężkie schorzenia i urazy dróg oddechowych, w tym również chorych na COVID-19:

– Po raz pierwszy jesteśmy w stanie zaoferować realną opcję leczenia pacjentom z zagrażającymi życiu defektami i urazami tchawicy. Nasze osiągnięcie zmieni standardy opieki nad tymi pacjentami. Biorąc pod uwagę rosnącą liczbę pacjentów z COVID-19, u których w wyniku intubacji doszło do uszkodzeń tchawicy, jest to szczególnie istotne. Opracowany przez nasz zespół protokół przeszczepu i rewaskularyzacji tchawicy jest niezawodny, powtarzalny i technicznie prosty – podkreśla prof. Eric M. Genden. – Przez lata w świecie medycyny utrzymywał się konsensus, że przeszczepu tchawicy nie da się wykonać ze względu na złożoność narządu. Poprzednie próby transplantacji tchawicy kończyły się niepowodzeniem. Osiągnięcie naszego zespołu to zwieńczenie 30 lat badań – podsumowuje ekspert.

Źródło: mountsinai.org, news-medical.net

Przeczytaj także: Badania przesiewowe całego ciała kluczowym czynnikiem we wczesnej diagnostyce czerniaka u osób z grup wysokiego ryzyka

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