In another leap forward for regenerative/transplant medicine, an international team of surgeons working in Russia have for the first time transplanted completely synthetic pieces of larynx into two patients in procedures that mark the first steps toward creating and transplanting an entire larynx from scratch.

This graft is similar to but also very different from a previous operation that saw a whole lab-grown trachea transplanted into a patient–an operation carried out by the same surgical group that has now replaced a part of the larynx. In that trachea transplant the organ came from a donor but was washed of its native cells and loaded with the patient’s own cells so the new organ would not be rejected.

The latest larynx procedures involved coating synthetic cellular scaffolds (rather than biological material extracted from a donor) with cells from the patients’ bone marrows. Once transplanted, the pieces of larynx–known as the cricoid arch and plate, a hollow segment at the base of the larynx–spawned layers of surface cells native to the patients. In both cases, the patients’ voice boxes had been so severely damaged in car accidents that they couldn’t speak naturally, and in both cases the synthetic larynxes restored their capacities of natural speech almost immediately.

The surgeons that performed the surgeries called them the most ambitious synthetic grafts to date and early steps toward creating a complete synthetic larynx that could be transplanted into those whose voice boxes have been damaged via trauma or disease. That’s still a ways off, but the larynx is a very nuanced, complex part of the human architecture. Every organ is different of course, but if doctors can build a larynx from a patient’s own bone marrow cells and a synthetic scaffold, it certainly compels one to reconsider what’s impossible and what’s not in the realm of regenerative medicine.

New Scientist