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- MEDICINE, Page 71One Womb to AnotherA historic fetal-cell transplant may have saved a boy's life
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- The French parents were distraught and desperate. Soon after
- their firstborn child died at seven months of a rare form of immune
- deficiency, they received more heartbreaking news. Their second
- baby, due in August of last year, was suffering from the same,
- nearly always fatal hereditary disorder, called bare lymphocyte
- syndrome. They could have aborted the child or allowed doctors to
- try the same kind of white-blood-cell transplant after birth that
- had failed with their firstborn. But the couple, who prefer to
- remain anonymous, chose a historic third option: to let their child
- receive the first ever transplant of human fetal cells to a child
- in the womb.
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- The experiment took place without publicity last June, and was
- only recently described at a medical meeting in Paris. The
- operation was performed when the child, David, was a 30-week-old
- fetus. So far, the results have been remarkable. Though he has been
- confined since birth to a germ-free flexible plastic bubble in
- order to protect him from the outside world, David, now seven
- months old, appears to have an immune system that is on the mend.
- If all goes well, David could leave his sterile prison by summer's
- end. Though his survival is not assured, the experiment could help
- researchers develop ways to correct other inherited, and
- congenital, disorders through the transplantation of fetal cells.
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- The unprecedented procedure was performed by two prominent
- physicians in Lyons: Dr. Jean-Louis Touraine, an immunologist at
- Edouard-Herriot Hospital, and Dr. Daniel Raudrant, an obstetrician
- at Hotel Dieu Hospital. The doctors wanted to treat David while he
- was still in his mother's womb because they thought if the
- procedure was done early, it would have better odds of succeeding.
- They took 7 cc of liquid, containing about 16 million immune cells
- from the liver and thymus of two aborted fetuses, and injected the
- material into David's umbilical cord. After he was born, David
- received an injection of more cells. Blood tests indicate that the
- transplanted cells have multiplied in David's liver, spleen and
- bone marrow -- signs that his immune system may become normal.
-
- His doctors remain cautious. "We're not out of the woods yet,"
- said Raudrant. But the boy at least has a chance at a better fate
- than another immune-deficient David: the American "bubble boy" who
- spent nearly all his twelve years of life in isolation before he
- died in Houston in 1984.
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- The use of aborted fetuses for medical purposes is a promising
- but highly controversial field. Doctors have transplanted fetal
- organs into infants and used fetal cells to treat Parkinson's
- disease in adults. Right-to-life advocates object strongly to such
- procedures unless the fetus comes from a mother who has had a
- miscarriage. But to David's parents, the issue was clear-cut: only
- aborted fetuses were available, and without the transplanted cells
- their boy would have had virtually no chance of survival.