Bypass surgery…least we play God…Posted: June 14, 2012
In what is being reported as a scientific first, Swedish doctors were able pair the groin vein of a dead donor with stem cells from a young girl and implant the healthy vein into the girl, improving both blood flow in her lower body and her quality of life.
The 10-year-old had a rare condition where her portal vein, which is located in the abdomen and tasked with carrying blood from the bowels and other abdominal organs to the liver, was blocked. If this vein is blocked, liver disease, heart failure and certain cancers may develop. The relatively rare condition may also cause weight loss, nausea and pain.
Details of the feat are published online June 14 in The Lancet.
U.S experts were quick to caution that the procedure has only been accomplished in one patient, but they agreed that it could be a game-changer with applications that go far beyond this particular condition.
In the procedure, the transplant team from the University of Gothenburg in Sweden first took a segment of the groin vein from a dead donor, and stripped it of all living cells. They then injected stem cells taken from the girl’s own bone marrow into the remaining vein. Two weeks after this seeding, the newly grown graft was implanted in the girl. E-Z as pie…sounds like good ol’ fashioned gardening.
There were no complications, and the procedure immediately restored normal blood flow. In the year following the operation, the girl grew taller and gained weight. Her blood flow later decreased, and she underwent a second vein replacement surgery a year after the first. Her quality of life has improved since the procedures, and she is now able to take increasingly long walks and participate in light gymnastics. Importantly, she is showing no sign of rejecting the new vein even though she is not taking any immunosuppressive drugs.
“The new stem cells-derived graft resulted not only in good blood flow rates and normal laboratory test values but also, in strikingly improved quality of life for the patient,” wrote the team led by Dr. Michael Olausson, of Sahlgrenska University Hospital in Gothenburg. “The work also establishes the feasibility and safety of a novel paradigm for treatment, in cases of venous insufficiency, obstructed veins or inadequate analogous [from the patient] veins.”
Today, surgeons may approach such cases by harvesting veins from a patient’s neck or leg to re-route around a blockage elsewhere. This can be traumatic and is associated with its own set of risks and complications. In addition, not everyone has healthy veins that can be used in this manner. This is where the new stem cell vein grafting procedure could play an important role.
Are we – Humankind – interfering with the normal schemes of arrangement put forth by God? Before we start completely designing offspring, committing infanticide, and literally sculpting humans on a need to have basis – perhaps we, as well as the entire scientific community should be addressing unintended consequences before some humungous atrocity happens to put even the greatest behind by exponential amounts of time.
The implications are far reaching in that new veins and arteries could be ‘grown’ ahead of time for an anticipated surgery, he said. “It would be interesting to see if these vessels are capable of continued growth in a child, as this is often the reason for re-operation in congenital heart disease.” The grow-your-own approach may one day replace the need for mechanical heart valves and the use of blood-thinning drugs.
Donna Arnett, incoming president of the American Heart Association and chair of epidemiology at the University of Alabama at Birmingham, agreed that its potential is exponential.
“When you have to use an artificial graft, you worry about rejection and need to use immunosuppressant drugs,” she said, and these drugs increase risk of developing infections. “This could be useful for people who don’t have a vein to use from their own body, and it avoids the use of immunosuppressants.”
They may also build on the concept and attempt to engineer arteries, which could be useful for people who require coronary artery bypass grafts to treat heart disease.