Health News - Doctors celebrate world first in windpipe transplant - operation at RFH and GOSH hailed a success
Published: 13 May, 2010
by TOM FOOT
THE medical fraternity was in rapture last month after experts and surgeons at the Royal Free and Great Ormond Street hospitals announced they had combined to carry out the world’s first successful windpipe transplant on a child.
But this milestone operation was not the first time the Royal Free had played a ground-breaking role in the complex field of transplant surgery.
Professor Stephen Powis, the Royal Free’s medical director and professor of renal medicine, said the Hampstead trust had been at the forefront of transplant medicine since the first kidney transplants in the early 1950s.
“What at first seemed untransplantable has become transplantable,” he said.
In 1959, the renowned Royal Free surgeon Sir Roy Calne developed the country’s first liver transplant programme. He later pioneered the use of the important immunosuppressant drug Ciclosporin in the 1970s and 1980s after a working with a colleague whose mother had posted over some pure olive oil from Greece.
Calne and his team realised that by placing the dense Ciclosporin in olive oil it could be more easily dissolved.
Professor Powis said: “With science, technology and a little serendipity, one of the most important drugs in the development of transplant medicine entered clinical use.”
He said that in 2010, his expert team was continuing to innovate and push back the boundaries of their speciality.
He added: “Successful transplantation requires three things – surgery, immunosuppressant and public engagement to encourage donors.”
The nine hour transplant operation on the 10-year old boy at Great Ormond Street was coordinated by Martin Birchall, professor of laryngology at the Royal National Throat, Nose and Ear Hospital. Dr Mark Lowdell, director of cellular therapeutics, helped prepare stem cells from the patient’s bone marrow which were used to “seed” the donor trachea.
Immunosuppressant helped prevent organ rejection – but there is also a price to pay for patients, according to Professor Powis.
He said: “They cause complications because the immune system is deliberately suppressed. For example, the patient is more likely to get infections.“The history of transplants has been about getting the balance right, between rejection and infection.”
In the 1990s, Royal Free surgeon Dr Peter Amlot developed Basiliximab – an antibody designed in the laboratory which targets the cells that cause rejection. Basiliximab is now in routine clinical use worldwide.
And more recently the Trust was given permission to carry out the first full face transplant by the independent ethics committee for the Royal Free.
Professor Powis concluded: “Transplant medicine has overcome successive barrier after successive barrier.”Mr Powis was speaking at a “Medicine of Members” event at the Royal Free. The next lecture is by diabetes expert, Dr Miranda Rosenthal, is on Tuesday night on June 22.