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Transplanting New Voices

In an interesting development in stem cell therapeutics, a boy in the UK had a trachea transplant performed in which the transplanted organ was regrown using his own stem cells. The boy has a rare and potentially fatal condition called Long Segment Congenital Tracheal Stenosis, in which patients are born with an extremely narrow airway. To build the transplanted organ, doctors took a donor trachea, stripped it down to its collagen scaffolding, and subsequently injected stem cells taken from the boy’s bone marrow. The organ was then transplanted into the boy, where it is hoped that the stem cells will specialize into the cells which constitute the inner and outer layers of the trachea. He appears to have responded well, breathing normally and speaking shortly after the operation.

Although stem cell-grown portions of organs have previously been transplanted, this marks the first time an organ proper of that sort has been transplanted — bearing in mind that donor collagen scaffolding was used. Medical team member Dr. Martin Birchall (also head of translational regenerative medicine at University College London) called the discovery a “milestone”, noting that: “[This] is the first time a child has received stem cell organ treatment, and it’s the longest airway that has ever been replaced.” He predicts that, if it bears the weight of clinical trial testing, the team’s technique could lead to the popularization of stem cell-related transplants in less specialized hospitals.

It is especially interesting that this new step in stem cell therapeutics was first taken with a child.  The involvement of children in stem cell tourism – viz., out-of-country travel for the specific purpose of treatment by unproven stem cell-based interventions – has long been an issue of controversy and commentary. Does the fact that this procedure was conducted in a reputable UK institution under the supervision of experts make the first attempt at an experimental intervention on a child ethically unproblematic?  What are the consent issues when a child is subjected to an experimental intervention?  In what ways are those issues modulated by the severity of the child’s affliction?

- CJ Murdoch

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