Dr. Kulwinder Dua
Professor of medicine, Medical College of Wisconsin
Gastroenterologist and director, Froedtert Hospital
Today, a 33-year-old man can eat and swallow normally thanks to years of work conducted by gastroenterologist Dr. Kulwinder Dua and his team at Froedtert Hospital.
For the first time ever, Dua and his team successfully repaired a seriously damaged organ, in this case an esophagus, through regeneration while it was still inside the patient.
The successful operation has the potential to change the way throat maladies caused by cancer, birth defects or trauma are treated in the future.
“Our aim was to regenerate the esophagus in the body, and the outcome was full-thickness regeneration,” Dua said. “This is a first-in-human operation and one that we undertook as a life-saving measure once we had exhausted all other options.” Dua also is director of the advanced endoscopy program at Froedtert and a professor of medicine at the Medical College of Wisconsin.
In 2007, a 24-year-old patient was admitted to Froedtert with an inability to swallow due to a life-threatening infection in his esophagus. An earlier car accident, which left him partially paralyzed, caused the infection. The infection resulted in a severely disrupted upper esophagus, which made it difficult for the patient to swallow or eat.
Historically, surgery to remove a cancerous or infected esophagus would require pulling the stomach into the chest to re-establish the patient’s gastrointestinal tract, a procedure that causes many significant and lifelong side effects.
Dua treated the damaged organ by stimulating regeneration.
He used FDA-approved self-expanding metal stents to bridge the damaged segment of the esophagus. The stents acted as “scaffolding” for donated human skin regenerative tissue, muscle and plasma produced from the patient’s own blood that helped stimulate growth and promote healing and regeneration.
After four years, the stents were removed and Dua found the esophagus had regenerated.
“The approach we used is novel because we used commercially available products which are already approved for use in the human body and don’t require complex tissue engineering,” Dua said.
As regenerative medicine continues to advance, led in part by Dr. Dua and his team at Froedtert, regeneration of the esophagus has a promising future as an alternative treatment for some patients.