Child gets trachea made from own stem cells
Daily News Article — Posted on May 2, 2013
(by Lindsey Tanner, WQOW.com) CHICAGO (AP) – A 2-year-old girl born without a windpipe now has a new one grown from her own stem cells, the youngest patient in the world to benefit from the experimental treatment.
Hannah Warren has been unable to breathe, eat, drink or swallow on her own since she was born in South Korea in 2010. Until the operation at a central Illinois hospital, she had spent her entire life in a hospital in Seoul. Doctors there told her parents there was no hope and they expected her to die.
The stem cells came from Hannah’s bone marrow, extracted with a special needle inserted into her hip bone. They were seeded in a lab onto a plastic scaffold, where it took less than a week for them to multiply and create a new windpipe. About the size of a 3-inch tube of penne pasta, it was implanted April 9 in a nine-hour procedure.
Early signs indicate the windpipe is working, Hannah’s doctors announced Tuesday, although she is still on a ventilator. They believe she will eventually be able to live at home and lead a normal life. “We feel like she’s reborn,” said Hannah’s father, Darryl Warren.
“They hope that she can do everything that a normal child can do but it’s going to take time. This is a brand new road that all of us are on,” he said in a telephone interview. “This is her only chance but she’s got a fantastic one and an unbelievable one.”
Warren choked up and his wife, Lee Young-mi, was teary-eyed at a hospital news conference Tuesday. Warren said he hopes the family can bring Hannah home for the first time in a month or so. Hannah turns 3 in August. “It’s going to be amazing for us to finally be together as a family of four,” he said. The couple also has an older daughter.
Only about one in 50,000 children worldwide are born with the windpipe defect. The stem-cell technique has been used to make other body parts besides windpipes and holds promise for treating other birth defects and childhood diseases, her doctors said.
The operation brought together an Italian surgeon based in Sweden who pioneered the technique, a pediatric surgeon at Children’s Hospital of Illinois in Peoria who met Hannah’s family while on a business trip to South Korea, and Hannah – born to a Newfoundland man and Korean woman who married after he moved to that country to teach English.
Hannah’s parents had read about Dr. Paolo Macchiarini’s success using stem-cell based tracheas but couldn’t afford to pay for the operation at his center, the Karolinska Institute in Stockholm. So Dr. Mark Holterman helped the family arrange to have the procedure at his Peoria hospital, bringing in Macchiarini to lead the operation. Children’s Hospital waived the cost, likely hundreds of thousands of dollars, Holterman said.
Part of OSF Saint Francis Medical Center, the Roman Catholic hospital considers the operation part of their mission to provide charity care, but also views it as a way to champion a type of stem-cell therapy that doesn’t involve human embryos, the surgeons said. The Catholic church [and bible-believing Christians of every denomination] oppose using stem cells derived from human embryos [embryonic stem cells] in research or treatment.
Macchiarini has been involved in 14 previous windpipe operations using patients’ own stem cells – five using man-made scaffolds like Hannah’s but in adults; and nine using scaffolds made from cadaver windpipes, including one in a 10-year-old British boy.
He said only one patient died, a 30-year-old man from Abingdon, Md., who had the operation in November 2011 to treat late-stage cancer of the windpipe. He died about four months later of uncertain causes, Macchiarini said.
Similar methods have been used to grow bladders, urethras and last year a girl in Sweden got a lab-made vein using her own stem cells and a cadaver vein.
Scientists hope to eventually use the method to create solid organs, including kidneys and livers, said Dr. Anthony Atala, director of Wake Forest University’s Institute for Regenerative Medicine. He said the operation on Hannah Warren “is really showing that the technique is workable.”
Hannah had breathing difficulties at birth and Korean doctors soon discovered the missing windpipe. They reconfigured her esophagus so that a breathing tube could go down it from her mouth to her lungs. The esophagus normally runs behind the windpipe and carries food to the stomach.
Korean doctors said she couldn’t live long with the tube and told her parents there was nothing more they could do.
Hannah outlived their expectations and has thrived despite the grim prognosis and other abnormalities including an undeveloped voice box that prevented her from speaking. Now that she has a windpipe and can breathe more normally, doctors expect the larynx to grow and function normally. She will work with speech therapists to help her learn to talk.
Holterman said Hannah will likely need a new windpipe in about five years, as she grows.
She breathes with help from a ventilator but no longer has a tube in her mouth that she’d lived with since shortly after birth, Holterman said. She’s not yet able to eat normally, but doctors let her have her first taste ever of food – a few licks on a lollipop. Her father said she already has discriminating taste and prefers chocolate Korean lollipops to the American kind.
“I asked her, ‘Is it good?'” he said, “and she immediately nodded her head.”
[Scroll down to watch a news report on Hannah’s story — posted under “Resources.”]
From an Associated Press report. Reprinted here for educational purposes only. May not be reproduced on other websites without permission from ABC News WQOW. Visit the website at wqow.com.
Background
A stem cell is essentially a “blank” cell, capable of becoming another more differentiated cell type in the body, such as a skin cell, a muscle cell, or a nerve cell. Microscopic in size, stem cells are big news in medical and science circles because they can be used to replace or even heal damaged tissues and cells in the body. They can serve as a built-in repair system for the human body, replenishing other cells as long as a person is still alive.
Adult stem cells are a “natural” solution. They naturally exist in our bodies, and they provide a natural repair mechanism for many tissues of our bodies. They belong in the microenvironment of an adult body, while embryonic stem cells belong in the microenvironment of the early embryo, not in an adult body, where they tend to cause tumors and immune system reactions.
The primary role of adult stem cells in humans is to maintain and repair the tissue in which they are found. While we call them adult stem cells, they are more accurately called somatic (from the Greek word soma = body) because they come virtually any body tissue, not only in adults but children and babies as well.
The stem cell issue is filled with questions, confusion, and controversy about science, cures and the best ways to find those cures. Often ignored in the discussion is one glaring, indisputable fact: certain kinds of stem cells - called adult stem cells - are already helping people with cures and treatments, with the real promise and hope that more can be done. If one hears in the news about stem cells helping people, you can be sure that it is the result of adult stem cells, as that is the only type of stem cell helping people today.
Background on Adult Stem Cells vs. Embryonic Stem Cells: (from pbs.org, a Newshour Extra report on the Stem Cell Research Debate by Lisa Prososki)
Stem cells are universal cells that have the ability to develop into specialized types of tissues that can then be used throughout the body to treat diseases or injuries. Stem Cell Research is a topic embroiled in much controversy. Scientists are hopeful that one day stem cells will be used to grow new organs such as kidneys or spinal cords as well as different types of tissues such as nerves, muscles, and blood vessels. The controversy sparked by the use of stem cells and research in this area comes from the fact that…these cells are taken from embryos that are just days old. As a result of this, the embryo, which is a developing human life, is destroyed. Many people feel it is immoral and unethical to destroy embryos for the sake of science. To further the debate, while these cells are easily cultured, replicate quickly, and have a relatively long life, embryonic stem cells have not yet been successfully used to provide any kind of therapy for humans and pose risks such as tumor growth and rejection by the body.
On the other side of the issue is the use of adult stem cells for research. Adult stem cells are available from a variety of sources including blood from the umbilical cord, the placenta, bone marrow, and even human fat. ….they may have some limitations in the type of tissues they are able to form. For many years, adult stem cells have been used to provide a number of different therapies to people with a relatively high rate of success. Recent research has shown that adult stem cells taken from one area of the body are able to regenerate and form tissues of a different kind. In addition to the proven therapies and research, the use of adult stem cells from a patient’s own body decreases the risk of rejection because the cells are not seen as foreign invaders.
All in all, many scientists believe that the use of adult stem cells should be the primary focus of stem cell research based on past success, lower chances of patient rejection, and the idea that adult stem cell research does not spark the moral, ethical, and political debate seen so frequently when the use of embryonic stem cells is considered. (from a 2008 report)
- Adult stem cell research has been on-going for 20-30 years, is not under any government restriction, and does not require the destruction of human life. These stem cells have already been used to treat spinal cord injuries, Leukemia, and even Parkinson’s disease . Adult stem cells are derived from umbilical cords, placentas, amniotic fluid, various tissues and organ systems like skin and the liver, and even fat obtained from liposuction.
- In contrast, embryonic stem cells are obtained by harvesting living embryos generally 5 to 7 days old, which are destroyed in the process. Most importantly, embryonic stem cells have never yet been successfully used to help cure disease. In fact, in animals they have caused tumors and other complications. Embryonic stem cells are also being touted by some as a possible treatment for repairing the brains of Alzheimer’s patients, but stem cell researchers confess that this is a distortion that is not being aggressively corrected by scientists.
- A new poll, conducted by International Communications Research, reveals that once Americans understand the difference between adult and embryonic stem cells, Americans strongly prefer funding adult stem cell research that does not destroy human life, by a margin of 61% to 23%. So, what is driving the biotech industry and many government officials to press for government money to subsidize embryonic stem cell research? Free money, and research without ethical limitations.
- Private industry has not been willing to put up any large sums of money on their own for embryonic stem cell research, because they are not sure it will yield the results they hope for. However, some drugmakers are getting into the field of research utilizing adult stem cells from umbilical cord blood and bone marrow . Investors are now taking notice that adult cells are actually working with human patients, and researchers are finding that these cells appear to be as flexible as the embryonic type. (from a 2008 report)