Young Girl Stirs up the World of Transplant Technology

karrie

OogedyBoogedy
Jan 6, 2007
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SYDNEY (AFP) - An Australian girl spontaneously changed blood groups and adopted her donor's immune system after a liver transplant, in what doctors treating her said Thursday was the first known case of its type

Demi-Lee Brennan was aged nine and seriously ill with liver failure when she received the transplant, doctors at a top Sydney children's hospital told AFP.
Nine months later they discovered she had changed blood types and that her immune system had switched over to that of the donor after stem cells from the new liver migrated to her bone marrow.
She is now a healthy 15-year-old, Michael Stormon, a hepatologist treating her, told AFP. He said he had given several presentations on the case around the world and had heard of none like it.
"It is extremely unusual -- in fact we don't know of any other instance in which this happened," Stormon told AFP from the Children's Hospital at Westmead.
"In effect she had had a bone marrow transplant. The majority of her immune system had also switched over to that of the donor."
An article on the case was published in Thursday's edition of the leading US medical journal The New England Journal of Medicine.
Brennan's mother Kerrie Mills described the recovery as "miraculous" while the patient herself told a news conference that doctors had given her life back to her.
"I just can't thank them enough. It's like my second chance at life," Brennan said.
Doctors who treated Brennan are interested to know if the case could have other applications in transplant surgery, where rejection of donor organs by the recipient's immune system is a major hurdle.
Stormon said it appeared that Brennan may have been fortunate because a "sequence of serendipitous events", including a post-transplantation infection, may have given the stem cells from her donor's liver the chance to proliferate in the bone marrow, where blood cells develop.
The task now was to establish whether the same sort of outcome could be replicated in other transplant patients, he said.
"The challenge for us now is to try and figure out how this occurred," Stormon said.
One possibility is that the series of events she experienced all weakened her immune system enough for the stem cells to migrate to the bone marrow and proliferate, Stormon said.
These factors include the particular type of liver failure she had, a post-operation infection with the virus cytomegalovirus, and immunosuppressive drugs.
"To try to replicate that is easier said than done," Stormon said, but added the case could still potentially be of crucial importance.
"The holy grail of transplant medicine is immuno-tolerance. She exemplifies that this can occur."
 

Praxius

Mass'Debater
Dec 18, 2007
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Additional Info:



http://www.ctv.ca/servlet/ArticleNe...25/liver_transplant_080125/20080125?hub=World
 

karrie

OogedyBoogedy
Jan 6, 2007
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I like that they used the one critical word that the other article neglected.

Miracle.
 

Lester

Council Member
Sep 28, 2007
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The most Amazing things are discovered by accident- I don't think it's a miracle, but it's really cool how the donors stem cells replaced the bone marrow changing the immune system and therefore tricked the hosts body into not rejecting, but accepting the liver as it's own. No anti rejection drugs- if they figure out how it happened there's a nobel prize in it for them. never mind the benefits for the recipients - my brother had a liver transplant and it's the anti-rejection drug cyclosporin that's killing him by suppressing his immune system- another plug for stem cell research.

Lester
 

Niflmir

A modern nomad
Dec 18, 2006
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That is positively amazing. "Seredipitous" was the reason I got out of chemistry and into physics. I wanted the success of my work to be a little less dependent on random chance. Hopefully they can learn something about our bodies through all this.
 

Unforgiven

Force majeure
May 28, 2007
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Hmm question here, what's with the stem cells? Stem cells from the transplanted liver changed her blood type on the bone marrow level? Where did the donor liver come from and how old was it?
 

Lester

Council Member
Sep 28, 2007
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It may have something to do with the liver being the only organ that you can remove 80% of and it will grow back- that might have something to do with it

lester
 

amagqira

Nominee Member
Oct 15, 2006
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I am curious, if she adopted her donor's immune system, that's fine as it will protect her against rejection of the liver but .... she has other organs which have their own immunological code... will her immune system now attack the other organs ?

Hope her immune system has merely added coding for the transplant liver and she now has a sort of hybrid immune system encoding.
 

Lester

Council Member
Sep 28, 2007
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I am curious, if she adopted her donor's immune system, that's fine as it will protect her against rejection of the liver but .... she has other organs which have their own immunological code... will her immune system now attack the other organs ?

Hope her immune system has merely added coding for the transplant liver and she now has a sort of hybrid immune system encoding.
That's a good question - but it doesn't appear to be happening as they report that she is a healthy 15 year old.
 

Tonington

Hall of Fame Member
Oct 27, 2006
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Well, she became ill while on drugs that suppress the bodies propensity to reject foreign code. Very strange, and very interesting from a physiological viewpoint. Showcases how little we know about the human body.

But on that note, I wonder how much of her acquired immunity remains. During the switch-over, do the new leukocytes still recognize the proteins from antigens that she encountered before the change?

This will provide a new approach for stem cell biologists to investigate. Think of the possibilities for treatment, if foreign stem cells can make such a change. Then patients wouldn't need their own stem cells. I wonder what her bloodwork can elucidate on this new found mechanism?

Profound would be my choice word.
 

amagqira

Nominee Member
Oct 15, 2006
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Alberta
Acquired immunity is divided into cellular and humoral immunity - with the former the more important since humoral immunity can be reacquired - protection against bacteria and such. Cellular immunity is much more complex and depends on the body's ability to recognize foreign ( non-self ) cells and protect against infection by viruses and certain bacteria and protozoa as TB and Toxoplasmosis and even cancers such as Lymphoma - things which AIDS sufferers really struggle with.

If the lassie is now healthy and does not use some immunosuppressant drug, the only logical conclusion I can come to is that her body has accepted the new liver cells as self, and she now has an altered immunological encoding which accepts the liver cells as self.

It would be a huge step forward if incorporation of the immunological encoding of foreign cells can be used in future transplants.
 

Lester

Council Member
Sep 28, 2007
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Almost like a natural gene therapy - where as the hosts immune system is weakened just enough for the foriegn stem cells to rewrite host codes kind of like a patch you would download (may sound simplistic but I am neither biologist nor physician)-I still think it might have something to do with the livers' regenerative abilities, maybe there is something diiferent about stem cells from the liver?