SHARE Kulwinder S. Dua

By of the

Doctors at Froedtert and the Medical College of Wisconsin have successfully repaired a patient's damaged esophagus by regrowing the organ inside the patient, an important milestone in the field of regenerative medicine and a discovery that could lead to improvements in the treatment of esophageal cancer.

The breakthrough, reported Friday night in the journal The Lancet, involved a 24-year-old man who was brought to Froedtert back in 2007, unable to swallow due to a life-threatening infection. The infection followed a serious car accident that had left the man partially paralyzed.

"This is a first in-human operation and one that we undertook as a lifesaving measure once we had exhausted all other options," said Kulwinder S. Dua, a 61-year-old gastroenterologist at Froedtert and the Medical College of Wisconsin, who led the effort. "The use of this procedure in routine clinical care is still a long way off as it requires rigorous assessment in animal studies and phase 1 and 2 clinical trials."

The medical team at Froedtert created a scaffolding using special, FDA-approved metal stents to bridge a damaged section of the esophagus, the muscular tube that connects the throat to the stomach.

The scaffolding was populated with donated human skin regenerative tissue (often used to treat wounds or burns), muscle and platelet-rich plasma that came from the man's own blood. These generated high concentrations of growth factors, substances that cause cells to grow, and attracted stem cells that helped the tissue heal and regenerate.

Four years after the surgery, the patient's stents were removed and "he is eating a normal diet, maintaining his weight and swallowing normally," Dua said.

Similar work had been done previously in dogs, but the scientists said they found no evidence to suggest an esophagus has ever been regrown inside a human patient. In 2012, The Lancet reported a case in which doctors were able to regrow the trachea of a 12-year-old child.

The procedure reported Friday may help doctors treat children who require removal of the esophagus.

The work may also point the way toward improvements in the treatment of esophageal cancer. Now, removal of the esophagus due to cancer requires pulling the stomach into the chest, a procedure that causes significant, lifelong side effects for a majority of patients.

Dua, lead author of the paper in The Lancet, said he plans to apply for grants to launch the animal studies and clinical trials needed to gain approval for the treatment.

Co-authors on The Lancet paper included: Walter J. Hogan, another gastroenterologist at Froedtert; Mario Gasparri, cardiothoracic surgeon at Froedtert; and Abdul A. Aadam, an assistant professor of medicine at Northwestern University.