Friday, August 06, 2010

First child in the world to undergo the breakthrough procedure to transplant his trachea with one grown from his own stem cells.

I was very intrigued by this article because of the breakthrough technique to use the patient's own stem cells to coat the donor windpipe and then transplanting it into the recipient. This eliminates the need for anti-rejection drugs and the associated complications and it is hoped the technique will eventually replace almost all transplant surgery.

Ciaran Finn-Lynch pictured with his parents Colleen and Paul Photo: PA

First child to have 'miracle' operation leaves hospital

An 11-year-old British boy who came close to death after being born with a windpipe just one millimeter wide is now able to breathe normally again following pioneering surgery doctors have described as a 'kind of miracle'.

By Rebecca Smith, Medical Editor,

Ciaran Finn-Lynch became the first child in the world to undergo the breakthrough procedure to transplant his trachea with one grown from his own stem cells.

He had been born with a windpipe just one millimeter wide and went through repeated surgery from a young age.

Although he managed well with a series of metal devices to hold his trachea open, they repeatedly burrowed into a major blood vessel causing 'massive bleeding'.

Speaking for the first time about her son's ordeal yesterday, Ciaran's mother Colleen told how she thought she had lost him. But now, four months after the operation, she said she had been 'given her boy back'.

The technique involved taking a windpipe from a dead donor and stripping it of its living tissue, before squirting the leftover scaffold with stem cells taken from Ciaran's bone marrow.

The trachea was then transplanted into his throat almost immediately where the stem cells have grown into normal tissue to cover the scaffold and provide a new windpipe. While the tissue was growing, his windpipe was supported by a temporary scaffold which will dissolve naturally.

The technique avoids complications associated with straight transplantation when the body can often reject donor organs without powerful drugs to keep the recipient's immune system in check.

As the trachea transplanted in Ciaran is covered with tissue that has grown from his own cells, his body will not reject it and he does not need any anti-rejection drugs.

A similar operation was carried out in Barcelona, Spain, two years earlier but in that operation that stem cells were grown on the windpipe scaffold in the laboratory and it was only transplanted four months later.

Speaking yesterday as her family prepared to leave Great Ormond Street Hospital in London for their home in Northern Ireland, Ciaran's mother said they were not daunted by their son being the first child to undergo such a procedure.

She said: "We didn't have much choice when it came to the operation.

"If Ciaran had one more bleed I don't think he would have made it."

She said they had "100 per cent faith" in the transplant team, led by Great Ormond Street's Professor Martin Elliott.

"When they initially suggested the procedure we agreed to it, knowing it would be the first time it had been tried in a child, as we have 100% faith in them and the work they do.

She said Ciaran's recovery had been "up and down" but he kept his spirits up.

"Because it's so new, nobody knows what's ahead, or how long his full recovery is going to be, but we are on the right road now," she said.

"We're just so grateful, we are delighted they gave Ciaran a chance, we've got our boy back."

Ciaran, who turned 11 last month, is looking forward to going home and is likely to return to school in September.

A keen drummer, he is most excited about being able to play in his band again, and even started practising with a lesson in the hospital's intensive care unit recently.

The donor was found for Ciaran four months before his operation, from a 30-year-old Italian woman.

Colleen said: “We are obviously also incredibly grateful and indebted to Ciaran’s donor and are aware of the heartbreak that family went through in losing someone.

"They have displayed courage and selflessness and we would like to use this opportunity to urge people to think about signing up to the organ donor register.”

It is hoped the technique will eventually replace almost all transplant surgery.

Prof Martin Elliott, director of the tracheal service at Great Ormond Street, said 'enormous numbers' of patients could benefit from this technique in future. In many types of surgery pieces of tissue from animals or plastic substitutes are used but that could all be replaced with the patient's own stem cells.

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