Girl receives pioneering vein transplant

A 10-year-old girl in Sweden is the world's first recipient of a donated vein treated with a patient's own stem cells.

She suffered recurrent blockages in the hepatic portal vein, which drains blood from the gut and spleen into the liver. The condition severely restricted her growth and vitality. Since receiving the vein, she has flourished. "She's fine, and according to her father, she's doing somersaults, going for long walks, and is a totally different child," says Suchitra Sumitran-Holgersson of the University of Gothenburg in Sweden.

Sumitran-Holgersson and her colleagues obtained the 9-centimetre-long section of vein from the groin of a cadaver, and stripped it of all the donor's cells using strong detergents, leaving just the underlying protein scaffold.

Next, they extracted endothelial and smooth muscle cells from the girl's bone marrow. These cells line organs and blood vessels. After multiplying them in the lab, they coated them onto the inner and outer surfaces of the donated vein and implanted it into the girl.

Because it was coated with her own cells, and all the donor's cells had disappeared, the vein was accepted by the girl without any need for immunosuppressive drugs.

In 2009, a Colombian woman became the first to receive a windpipe made in the same way, coated with her own cells. "I'm delighted to see the method we developed for trachea being used now for vein," says Anthony Hollander of the University of Bristol, UK, a member of the team that performed the 2009 procedure. "I always felt that it would be most easily adapted for use in regenerating tubular structures."

Sumitran-Holgersson says she hopes in future to try using blood vessels from animals for re-coating with patients' own cells, as the source would be potentially limitless. A third option would be to use entirely synthetic structures: last year, researchers reported the first implant of a synthetic windpipe coated with a patient's own cells.

Journal reference: The Lancet, DOI: 10.1016/S0140-6736(12)60633-3

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