Trachea Transplant


NEW YORK, N.Y.  (Ivanhoe Newswire)— It’s a medical milestone that has the potential to save thousands of people with birth defects, cancer, or injury to their windpipes from COVID-19 intubation. A team of surgeons in New York successfully transplanted a human trachea into a critically ill patient. One year later, that patient is surviving and thriving and now wants others with badly damaged windpipes to know they may have a life-saving option, trachea transplant.

Fifty-seven-year-old Sonia Sein takes nothing for granted, including daily walks through her neighborhood with her niece, Monique. Sein had a severe asthma attack in 2014 and had to have several emergency intubations to save her life.

“They kept removing it to see if I could breathe on my own and them doing that, they damaged the trach,” explained Sein.

Sein had to breathe through a surgical hole in her neck and still has the opening there.

“I have a plug that I have to push in. It holds the air so I can talk,” Sein continued.

For years, Sein was in constant danger of having her trachea collapse and then suffocating.

“The trachea is a little bit like the Rodney Dangerfield of organs. It never gets much respect. It looks like a tube, but it’s actually a very complex organ system,” stated Eric Genden, MD, Icahn School of Medicine at Mount Sinai.

Dr. Genden says the difficulty with human transplantation is re-establishing blood flow.

“We’re using a high-powered microscope, hooking up these little blood vessels, using a suture that’s thinner than a human hair. It’s actually difficult to see without a microscope,” said Dr. Genden.

Sein knew there were serious risks involved with transplantation, but she also knew she was running out of time.

“I didn’t know what would happen. I told him all I want is five minutes to be able to take that air in normally,” shared Sein.

Last January, in an 18-hour long surgery, doctors removed Sein’s damaged trachea, and replaced it with a donor organ and blood vessels. Sein is still recovering but can play with her grandkids and stroll with her niece. She wants her survival story to inspire others.

“I want people to see that just because there’s a setback in your life, doesn’t stop. You can still get up and do whatever you want, but you’ll get there,” smiled Sein.

Sonia Sein also wants to continue to get stronger so she can return to her job as a social worker. Sein has had no complications or signs of organ rejection, and doctors continue to monitor her closely. Doctors hope in the future to be able to close the hole in her neck, which would allow her to do one activity she says she’s missed over the past seven years. She really wants to go to the beach to go swimming.

Contributors to this news report include: Cyndy McGrath Producer; Kirk Manson, Videographer; Roque Correa, Editor.

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REPORT:       MB #4997

BACKGROUND: The trachea is a conduit between the outside world and the parenchyma of the lungs. Oxygen from the atmosphere travels to the lungs during inspiration and carbon dioxide is ventilated from the lungs to the atmosphere during expiration. The trachea is a cartilaginous tubular structure connecting the larynx and the main bronchi.  The lower edge of the cricoid cartilage defines the beginning of the trachea, and the end of the trachea is marked by the carina, the steep-angled take off of the right main bronchus, and the takeoff of the more horizontal left main bronchus. The carina is usually found at the level of the T4 vertebral body but its vertical position changes with the phases of respiration.


DIAGNOSING: There are two main types of trachea disorders. Tracheal stenosis is a narrowing of the trachea, or windpipe, that prevents air from fully reaching the lungs. The effects of this narrowing can range in severity from mild to more severe. In the most severe cases, the patient may be dependent on a tracheotomy tube to breathe. Tracheomalacia is the second trachea disorder and is a condition characterized by cartilage in the walls of the trachea that has broken down, causing weakness or floppiness in the windpipe. The trachea should be rigid for normal breathing. Infants can be born with tracheomalacia, but adults can also acquire it in later life. Tracheal tumors, while rare, can cause narrowing of the windpipe which prevents air from fully reaching the lungs.


NEW STUDY: The goal of The Tracheal Transplant Program at Mount Sinai is to offer patients who have sustained extensive damage to the trachea a lasting alternative to current treatments, including tracheostomy. Existing treatments are only effective in approximately half of the surgeries performed, may only be temporary and are often associated with complications, such as scarring or airway obstruction. The donor tracheal transplantation offers new hope to candidates, particularly those who have suffered trauma/accidents to the trachea, intubation damage, airway tumors, and congenital tracheal defects. Surgeons at Mount Sinai, who have been researching tracheal function for more than 20 years, recognized that the trachea was not merely a tube, as the cilia, which are short hair-like or shag carpet-like structures lining the trachea, performed a critical function of clearing pollutants from the human airway. They also discovered that the replacement trachea needed to withstand the pressures of breathing/respiration.



Lindsey Diaz-MacInnis

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