A child named Easton is believed to be the first to receive a combined heart and thymus transplant, which aims to revolutionize the organ transplant system by helping the recipient's body accept a donor organ. The surgery appears to have been a resounding success and Easton is now doing very well months later.
Joseph W., MD, PhD, chief of pediatric cardiac surgery at Duke University Hospital and one of the surgeons involved in the procedure. "This has the potential to change the face of solid organ transplantation in the future," Turek said. in a statement.
Heart transplant is an extremely complex procedure and even if successful, there is a risk of the recipient's immune system rejecting the foreign organ. In this event, the immune system begins to target organ tissue, eventually attacking and destroying it. Organ rejection is a life-threatening condition.
As a result, organ transplants are carefully matched between donor and recipient, and are often accompanied by an array of immunosuppressive drugs to prevent rejection. These drugs are moderately toxic and are given in two phases that can last for a long period (or even their entire life), leaving the patient more susceptible to opportunistic pathogens – the ongoing COVID During the -19 pandemic, concerns have risen for immunosuppressed people. Simultaneously, the lifespan of a transplanted organ is only 10-15 years due to the persistent toxicity of the drugs.
Instead, researchers at Duke University turned to an alternative. Baby Easton needed a heart transplant because he was born with a weak heart and had problems with his thymus gland, an important part of the immune system that produces T-cells. This combination of conditions made Easton a rare candidate for two different procedures, both transplanting a new donor heart and transplanting thymus tissue. If the thymus was successfully transplanted, the immune system could recognize the donor heart as if it were its own and Easton might not need the cocktail of drugs needed to keep the immune system at bay.
Following FDA approval for the procedure, Easton received a new heart and thymus in August 2021 at the age of six months. Using a technique developed by Duke, the thymus was cultured and processed to treat Easton's specific condition.
The procedure was successful, and tests show that after about six months, Easton's thymus is producing T-cells of a healthy immune system. He currently remains on immunosuppressive drugs, but the team believes that soon he will no longer need them.
Such an achievement has a profound impact not only on solid organ transplantation, but also on other conditions.
"The team's transplantation and transplantation into a patient who lacked significant thymus function provides an excellent opportunity to investigate how allogeneic processed thymus tissue can make a person's immune system more receptive to the donor organ. can shape," Alan D. Kirk, MD, PhD, chair of the department of surgery at Duke University School of Medicine.
"If this can be extrapolated to patients who already have a functioning thymus, it could potentially allow them to reorganize their immune systems so that they are significantly less on drugs that reject transplanted organs." The processing method used for thymus tissue appears to be important and is of great interest."