X-Message-Number: 27802
From: "Basie" <>
Subject: First lab grown organs transplanted in humans
Date: Tue, 4 Apr 2006 13:19:14 -0400

 Lab Grows Bladders From Cells of Patients By

BOSTON - At age 16, Kaitlyne McNamara is different beyond her defective 
spine, crutch, leg braces and 54 surgeries. She has one of the world's first 
re-engineered bladders.

It is the first time a complex human organ like the bladder has been mostly 
replaced with tissue grown from a patient's own cells. Only simpler 
tissues - skin, bone, and cartilage - have been lab-grown and transplanted 
in the past.

"It's really science fiction at its best," said Kaitlyne's mother, Tracy 
McNamara.

The bladder transplants, performed on seven patients ages 4 to 19, were 
being reported online Tuesday in The Lancet medical journal - a breakthrough 
that could hold exciting promise for someday regenerating ailing hearts and 
other organs.

"This suggests that tissue engineering may one day be a solution to the 
shortage of donor organs in this country for those needing transplants," 
said Dr. Anthony Atala, the lead researcher.

Growing other organs will likely hold unforeseen challenges, however, since 
organs are so specialized in their functions, scientists stress.

Even for people with bladder disease - and there are an estimated 35 million 
in the United States alone - Atala's technique requires testing on more 
patients and for longer times, researchers say. Replacing an entire bladder 
would pose many more problems, including reconnecting urine tubes, blood 
supply and nerve signaling, according to Dr. Steve Y. Chung, an Illinois 
urologist who wrote a commentary for The Lancet.

Still, he called the work "a tremendous, tremendous advance."

For the children and teenagers in the study, the transplants reduced leaking 
from their bladders - a potentially big gain in quality of life. For 
Kaitlyne McNamara, the transplant has meant a new social life.

Since birth, the teen from Middletown, Conn., has coped with spina bifida, a 
defect that leaves the spine incompletely closed. She's trudged through a 
grinding series of medical tests, treatments and procedures.

There was the urinary infection that nearly killed her as a toddler. There 
were the surgeries to correct her spine and legs. By age 11, there was the 
kidney damage from her weak bladder that again put her life in jeopardy.

Yet maybe the worst part, for a teenager, was simply being different. "I 
didn't fit in with the kids," she said. "Sometimes the kids made fun of me."

It wasn't necessarily her crutch, braces, or 4-foot-2 height that set her 
apart, at least in her mind. It was more the accidents from her diseased 
bladder, which would frequently leak.

That was before her surgery five years ago. Now, her kidneys are working 
again, and she no longer wears a diaper. Instead, she was waiting for 
alternations on a low-cut champagne-colored dress for her junior prom.

"Now that I've had the transplant, my body actually does what I want it to 
do," she said last week. "Now I can go have fun and not worry about having 
an accident."

Scientists, marveling at how animals like salamanders regenerate lost limbs, 
have long toyed with the futuristic possibilities of regrowing worn-out or 
injured human parts.

Over the past decade, researchers began fashioning better scaffold-like 
platforms that hold growing cells and dissolve inside the body. The study of 
stem cells, which can mature into all the body's other tissues, has also 
supercharged progress in regenerative medicine.

The researchers at Children's Hospital in Boston used a more mature cell 
type known as a progenitor. They first operated on the patients to remove 
bad tissue that made up more than half their bladders. They fished out 
muscle and bladder wall cells, seeded them on cup-like bladder-shaped 
scaffolds of collagen, then let the cells reproduce in the lab for seven 
weeks. Starting with tens of thousands, they ended up with about 1.5 billion 
cells. The cell-bearing molds were then surgically sewn back to the remnants 
of the patients' original and partly working bladders, where the 
lab-nurtured cells kept maturing.

The team, which began its work in 1999, followed the last patient for almost 
two years. In undergoing the experimental procedure, the patients skirted 
the typical side effects of grafts that would otherwise have been made with 
their own intestinal tissue.

Atala, who has since moved to Wake Forest University, has already begun 
commercializing his transplant techniques through Tengion, a company he 
helped found in King of Prussia, Pa. It has licensing rights to patents on 
his work.

Some researchers were more cautious about the promise shown with the new 
procedure, saying the study lacks any direct comparison group of patients 
getting the traditional graft.

Dr. Joseph Zwischenberger, who edits the journal of the American Society of 
Artificial Internal Organs, questioned how well the new bladders worked in 
the first few patients and raised a "red flag" about two patients who left 
the study for personal reasons and were ultimately omitted from the results. 
He also said Atala's attempts to commercialize the technique should add some 
skepticism toward the findings, which he nonetheless called "very 
interesting preliminary data."

The patients in the study must still deal with the ravages of spina bifida, 
which can turn off nerve signals that keep the bladder healthy. It causes 
the stiff, leathery bladder to leak frequently.

The rebuilt bladders, though, were up to three times more elastic and better 
at holding urine, the researchers report. In all seven patients, kidney 
function was preserved, the study said. The patients must still empty their 
bladders regularly with a tube but can avoid leaking in between.

"You don't want your little girl to wear a diaper all her life," said Tracy 
McNamara.

She used to worry about her daughter dying from kidney damage or urinary 
infections. That's all faded into the past. Now, she worries about all the 
time her daughter fritters away on the telephone, talking to friends.

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