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Thymus transplants gives hope to babies with fatal immune disease

surgery. Since the gland is large and covers the heart in infants, surgeons must remove all or part of it to gain access to the heart. The removed thymus tissue is grown in culture for several weeks in a laboratory while researchers ensure that there are no diseases present in the tissue. Strips of tissue are then implanted in the baby's thigh, where they attract a blood supply and begin to act like a thymus gland. Within three to four months, mature T cells begin to appear in the bloodstream.

The latest Duke analysis followed the first 54 children with DiGeorge anomaly referred to Duke for possible thymus transplantation. Of those, 44 received the procedure. So far, 32 of the children who received the transplant are alive, with a follow up of as long as 13 years.

Markert said the 12 deaths occurred within one year of the transplant. The deaths were caused by various infections and were not a result of the surgery itself, she said.

"These babies are very frail when they get here, so it is crucial that they are nourished and supported during this period after transplant to strengthen and maintain them as their immune systems rebuild," Markert said. "We have a remarkable team that takes care of these children in tightly controlled conditions during this important early period."

Typically, children remain in the hospital for two to three months after transplantation as physicians work to keep infections at bay as the child's immune system develops. In Dave'yana's case, Harding returned to the hospital in Missouri after about a month. She received treatment for a viral infection at the Children's Hospital of St. Louis for four months after which her immune system was strong enough to get rid of the virus and prevent other infections. Dave'yana then went home.

"If it wasn't for Dr. Markert and her team, my baby would not be here right now," Harding said. "They really fought for my baby to get the transplant."


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Contact: Richard Merritt
Merri006@mc.duke.edu
919-684-4148
Duke University Medical Center
15-May-2007


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