A Trachea Today

Transplant surgery's amazing stuff, of this there is no question. A new liver, lung, pancreas, any number of other parts of the body that are less specialized. Organ and tissue recipients have surgical complications to deal with, long arcing scars, and are on immunosuppressive drugs the rest of their life. That is the generally accepted cost of cheating death in this fashion -- if something fails, you can keep going on, despite the problems your Mark I body ended up with. However, the payoff to prevent this is extremely dangerous in some ways -- shutting down the powerful, endlessly adapting immune system opens you up to all sorts of opportunistic infections that no ordinary person would find fatal.

The state of transplant surgery is near and dear to my heart, as it is to so many transpeople. Physical body changes are really only one component of the process, but they are a large component -- and, honestly, most cispeople don't have a good grip on what can happens during GRS or any of the other surgeries typically performed on a transperson's body. Usually, a vague concept of "cutting something off", fueled by popular culture, is what they're aware of.

Popular culture's view is changing, albeit slowly. Society changes at its own (typically grueling) pace. Medical technology, though? Changes in that can be lightning fast, quick as a wink -- and sometimes revolutionize medicine in short order.

I'm thinking here of a recent transplant result that was not only significant for the patient's health but groundbreaking in terms of transplant surgery in general. A recent transplant of a length of trachea was performed on a woman, Claudia Castillo, who experienced a narrowing of her breathing passage on one side. Trachea surgeries aren't terribly interesting on their own, perhaps, but this had a remarkable twist that had some remarkable results -- she required no immunosuppressive drugs.

The tissue was collected from the donor, and placed in a chamber. Several chemical washes were then used to remove the donor's cells, leaving a fibrous tissue template in the shape of the trachea. Then, the fibrous template was soaked in a combination of tissues from the recipient -- stem cells and samples from the donor area -- until it was thoroughly impregnated with them.

So while normally the body recognizes that the transplanted tissues have differing DNA than the rest of the body and attempt to attack it as a foreign body, when the template was implanted in the recipient, it was recognized as if it were her own tissue -- and she required no immunosuppressive drugs at all, as her immune system had no reaction to the new tissue.

She's not expected to require any, ever, either. There was no trace of the donor's DNA left in the tissue, only the samples of the similar tissues and the stem cells; as a result, the implant simply seemed to take root. Two months after the surgery, Claudia's lung function is listed as being at the high end of the normal range.

Now, I'd be lying if I said wasn't imagining some fairly optimistic things as a result of this technology becoming widespread over the next few years; assuming that nerve tissue connections can be dealt with (perhaps through a version of this technology), this would point to the possibility of full-on genital transplants down the road from deceased donors, practically a holy grail for those of us looking for genital surgeries. Of course, nothing is easy -- this would involve a drastic removal of tissues from a body considered, physically, to be "healthy" -- which makes it a hard sell to a surgeon, as well as a difficult, lengthy surgery, from which you'd still be recovering for months, no doubt.

But I think I'm not alone, when I say that I'd gladly be cored like an apple on the table for a reasonable chance at a functional set of genitals I can live with.

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