Ground-breaking windpipe-transplant child 'doing well'

Skooter reporting 07/26/12

A thirteen-year-old boy is the first child to have innovative surgery at London’s Great Ormond Street Hospital in 2010 to restore his windpipe with his own stem cells is doing all right, in fact he is back in school.

His immune system would not reject, and attack the organ if his own cells are used to rebuild his windpipe. Things were going okay so far and that Ciaran could live the life of a normal teenager, his surgeons said.

Ciaran was born with long-segment tracheal stenosis, which set off breathing complexities. His lungs gave up on the day he was born and he had major surgery to rebuild his airways when he was six days old.

Metal tubes were used to keep his airways open, but in 2009 one instigated massive amounts of bleeding when it damaged the main blood vessel coming out of the heart.

It was at this moment surgeons tried a ground-breaking operation. Instead of creating a new windpipe, they removed a donor windpipe and cleaned it out of all the donor's cells. What remains was a three-dimensional web of collagen fibers which was transplanted into the boy.

In the interim, stem cells, which can develop into any other type of cell, from nerve to skin cells, were taken from Ciaran's bone marrow and were then showered onto the newly transplanted windpipe.

The revolutionized procedure had been tried once before in Spain in 2008, on a 30-year-od woman, but Ciaran was the first child. The boy has been followed up for the past two years and there has been no indication of the transplant being rejected. The boy is alive, growing, had normal lung function and is back in school.

Martin Elliott, director of the national service for severe tracheal disease in children at the hospital, was quoted as saying, "The ideal outcomes for tracheal transplants in children are normal airway and lung function, good general growth, a decent quality of life, and no further surgical interventions. So far we have achieved this, but we are at the edge of medicine and, similarly to first attempts of organ transplantation in the 1950s, many challenges remain."

BBC