Transplant 'miracle' for teen (changes blood group)

The Australian ^ | January 24, 2008 | Tamara McLean

[Dundee]

A YOUNG transplant patient has defied medical science by spontaneously switching blood types and taking on her donor's immune system

NSW teenager Demi Brennan is believed to be the first person in the world to completely accept a donated organ to the extent where her immune system entirely changed.

Demi, now 15, suffered liver failure and had a liver transplant at the age of nine in 2001.

Several months on from the transplant, her doctors at Westmead Children's Hospital say they were shocked to discover her blood type had changed to match the blood type of her deceased male donor.

On closer inspection, specialists found that stem cells from the donor liver had penetrated her bone marrow, effectively resulting in a naturally occurring bone marrow transplant.

Her doctor, Michael Stormon, said she was able to come off the anti-rejection drugs which most transplant patients needed to take for the rest of their lives.

"We were stunned, absolutely stunned, and also very puzzled," said Dr Stormon, who reported the case in the New England Journal of Medicine.

"Even going through the literature and seeking advice internationally we weren't able to find any other cases like it."

Demi's mother, Kerrie Mills, described it as "miraculous"...

A team of scientists has started research into the case, with hopes their findings will improve treatments and outcomes for other transplant patients.

[gruna]

Amazing. If that’s not a miracle, it’s close enough.

[coconutt2000]

This would be bigger news if the male donor had been an embryo... because then this would be a success story for embryonic stem cells.

Adult stem cells strike again...

[naturalman1975]

The donor organ came from a twelve year old boy. Though certainly not an embryo, he wasn’t an adult either. And the age of the donor may have been a factor in what happened here - they just don’t know yet.

[coconutt2000]

The donor organ came from a twelve year old boy. Though certainly not an embryo, he wasn’t an adult either. And the age of the donor may have been a factor in what happened here - they just don’t know yet.

Actually, adult stem cells refers to the entire class of stem cells that are found to be present in children and adults. Technically speaking, the stem cells were adult stem cells, regardless of the age of the donor in this case.

Tragic though.

[Getready]

The patient was 9 when transplanted. So probably her
immune system wasn’t quite set...plus she was still
growing so her bone epiphyseal plates had probably
not closed yet, and there was an avenue for the
cells from the donor body part to get a foothold...

It would be interesting to see if the antirejection
medications she was taking suppressed her system enough
for the other cells to take over.

There have been for some time, reports of transplant
patients accepting their transplanted organs, and
eventually not needing any immunosuppressive drugs, but
these patients a few.

Many intruiging questions and followups will occur
due to the finding.

[coconutt2000]

And the age of the donor may have been a factor in what happened here - they just don’t know yet.

I have doubts that the age of the donor had anything to do with what happened. Stem cells can do some rather remarkable things. I'm leaning more toward the age of the girl being the key factor. (Note that she was 11 when she had the transplant, and this would put the last four years in a critical age range for puberty as well as significant skeletal/bone growth.)

[bmwcyle]

This is wonderful.

[coconutt2000]

Correction:

Patient was 9 years old when the transplant occurred. Still means that following the transplant, she underwent a lot of growth as well as puberty, just more of it.

[naturalman1975]

I am aware of the somatic/adult stem cell definition, and should have been clearer.

Doctors in this case believe the age of the donor may be relevant because they feel that the division of stem cells into embryonic and somatic classifications isn’t enough.

That what has happened here may not have happened with cells from a mature adult.

I had dinner with a Doc from the hospital the other night, and he talked about it in some detail. I would have paid more attention if I’d known it was going to become a major news story.

[MDspinboyredux]

I think you missed the point of cocconut's post.

It was a jab at the media's belief that only through the use of embryonic stem cells can things like this occur.

Since this event didn't result from embryonic cells (their chosen medical dogma), it didn't merit coverage.

[syriacus]

A team of scientists has started research into the case, with hopes their findings will improve treatments and outcomes for other transplant patients.

Neat!

[Anonymous Rex]

This is not an uncommon thing to have happen in those receiving bone marrow transplants.

[GovernmentShrinker]

It may be that this has happened a number of times before, but wasn’t detected because the recipient already had the same blood type as the donor. It seems that that easy-to-detect change is what tipped them off, but there are a whole bunch of other factors involved in immunological rejection of transplants. They should be aggressively checking same blood type transplant recipients to make sure they all really still need to be on anti-rejection drugs. Frankly, I’m surprised that a blood type match isn’t required for a transplant, and I suspect it’s usually strongly preferred if available.

[GovernmentShrinker]

had a liver transplant at the age of nine in 2001. Several months on from the transplant, her doctors at Westmead Children's Hospital say they were shocked to discover her blood type had changed

More perplexing than the medical phenomenon itself, is why it took over 5 years for this extraordinary discovery to be reported.