NOEL KING, HOST:
A medical team in New York says it has performed the first-ever complete surgical transplant of a windpipe. Trachea transplants have been one of the last big transplant challenges. Here's NPR science correspondent Richard Harris.
RICHARD HARRIS, BYLINE: About six years ago, Sonia Sein ended up in the hospital after a particularly nasty asthma attack. To help her breathe, she says doctors inserted a tube down her throat.
SONIA SEIN: I was intubated too long, so the trachea was damaged. So I went to surgery after surgery trying to repair it.
HARRIS: No go. Finally, surgeons cut a hole in her throat and threaded in a breathing tube. Sein is a former social worker who is now 56 and lives in the Bronx with her daughters and grandkids. She grew so tired of that tube that she figured there must be a better way to live
SEIN: I researched trachea transplant because I figured they do transplants for everything. There should be something for tracheas.
HARRIS: She found that a lab at Mount Sinai Hospital in New York City was indeed working on that idea.
SEIN: I called them and, you know, leave them a message. So I wait two days. And I call back. I wait another two days. And I kept calling back until somebody called me and gave me an appointment. I think they got tired of me calling.
HARRIS: But at that time, the surgeons at Mount Sinai weren't ready to try this operation in humans. Seine even thought of checking into hospice and having them removed the breathing tube, which would end her life. But she held on. And late last year, she heard back from Dr. Eric Genden at Mount Sinai and the Icahn School of Medicine. He said he was finally ready to give it a try, despite a long history of disappointment for this kind of surgery.
ERIC GENDEN: Although it seemed like a pretty straightforward kind of thing because it just at first sight seems like a tube. Turns out it's a highly complex organ system.
HARRIS: The biggest problem is getting blood to the trachea. For decades, doctors thought that the blood supply was supported by a network of tiny vessels, which would be impossible to reconnect surgically.
GENDEN: This dogma kind of stuck. And so if you look at the literature, you'll see hundreds and hundreds of articles that start out with, here's our way that we are going to try to reconstruct the trachea because we can't transplant it.
HARRIS: Synthetic tubes aren't a permanent solution. Some surgeons have temporarily tried transplanting tracheas into people's arms and letting them develop a new network of blood vessels before moving them to the throat. Other surgeons have replaced the trachea with a large blood vessel. But Genden's research revealed that, in fact, blood to a trachea could be provided by reconnecting just a few vessels about the diameter of spaghetti. In January, he was finally ready to try that technique in a person. And Sonia Sein became a pioneer. It was an 18-hour surgery and, thus far, a success.
GENDEN: So it's really kind of the holy grail of what we've all been after.
HARRIS: One of Genden's old mentors, Dr. Alec Patterson at Washington University in St. Louis, has been watching this with interest.
ALEC PATTERSON: So it is promising. I really think it's exciting.
HARRIS: But at this stage, Patterson doesn't see this as an operation that will become routine.
PATTERSON: I don't think it's a very practical option for patients who have a tracheal tumor, for example.
HARRIS: That's because transplant patients need to be treated with drugs that suppress the immune system to prevent organ rejection. And that's risky in cancer patients. Patterson says the surgery would also be challenging in newborns with trachea defects because the blood vessels that support the trachea are even tinier than in adults. But people like Sonia Sein with damaged tracheas are potentially good candidates. She will be grateful to be free of the restrictions she lived under when she breathed through a tube in her throat.
SEIN: The first thing I'm going to do when it gets a little warmer is take a walk on the beach. I haven't done anything six years. So I'm going to walk down the beach and just feel the sand through my toes.
HARRIS: Richard Harris, NPR News.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.