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Teen Takes On Donor's Immune System 231

Posted by Zonk
from the you-will-be-assimilated dept.
Leibel writes "The Australian ABC News is reporting that a 15-year-old Australian liver transplant patient has defied modern medicine by taking on her donor's immune system. Demi-Lee Brennan had a liver transplant. Nine months later, doctors at Sydney's Westmead Children's Hospital were amazed to find the teenager's blood group had changed to the donor's blood type. They were even more surprised when they found the girl's immune system had almost totally been replaced by that of the donor, meaning she no longer had to take anti-rejection drugs. 'Dr. Michael Stormon says his team is now trying to identify how the phenomenon happened and whether it can be replicated. "That's probably easier said than done... I think it's a long shot," he said. "I think it's a unique system of events whereby this happened. "We postulate there's a number of different issues - the type of liver failure that she had, some of the drugs that we use early on to suppress the immune system and also that she suffered an infection with a virus called CMV, or cytomegalovirus, which can also suppress the immune system."'"
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Teen Takes On Donor's Immune System

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  • by kindbud (90044) on Thursday January 24, 2008 @01:50PM (#22169832) Homepage
    Wouldn't her new immune system see the rest of her body apart from the liver as a foreign invader, and attack it?
  • by Babu 'God' Hoover (1213422) on Thursday January 24, 2008 @01:58PM (#22169984)
    a lab error?
  • Accidents (Score:3, Insightful)

    by dj245 (732906) on Thursday January 24, 2008 @02:02PM (#22170052) Homepage
    It often takes accidents or other strange happenstances to spur innovation and invention. See Penicillin or any other number of other examples.
  • Re:Self-rejection? (Score:2, Insightful)

    by Anonymous Coward on Thursday January 24, 2008 @02:12PM (#22170218)
    Huh?
  • by KublaiKhan (522918) on Thursday January 24, 2008 @02:13PM (#22170248) Homepage Journal
    I'd not take that therapy, m'self--I've got AB+, so you can throw pretty much anything into me and I'll take it. Also, it's not just the blood type of the red cells that matters--the plasma has a type, as well, and it turns out that AB+ plasma can be given to anyone without any trouble.

    In addition, there are other possible consequences--some blood types, for instance, survive Bubonic Plague a lot more than other blood types, due to the similarity of surface proteins between certain kinds of blood cells and those found on plague bacteria--changing everyone to the same blood type would thus increase the likelihood that some lucky bacterium could wipe out the human race with a fortuitous mutation. ;-p
  • Re:Self-rejection? (Score:5, Insightful)

    by AgentPaper (968688) * on Thursday January 24, 2008 @02:19PM (#22170350)
    That was precisely my thought - where exactly does this differ from GVH? [wikipedia.org] Any time you have a mismatch between HLA haplotypes on immune cells and other tissue cells, you're going to have an immune reaction, regardless of whose immune cells initiate it. It's rather unique that this occurred in the context of a solid organ transplant - you usually see it with bone marrow - but the underlying process doesn't look any different.

    Of course, ABC News isn't exactly a peer-reviewed journal, so I'll reserve full analysis for such time as this patient is written up in the literature, but I'm not seeing anything outside the realms of modern medicine here.

  • by NIckGorton (974753) on Thursday January 24, 2008 @02:54PM (#22170950)

    Is it normal to transplant livers across blood types?
    You can accept an Rh mismatch for a liver transplantation. And if you are going to die tomorrow, death from rejection in 5 years is a better deal.

    This sounds like a nearly missed case of malpractice.
    No. First of all this was not in the US. It is a uniquely American thing to assume that unless 1) All care is 100% perfect and 2) The outcome is 100% perfect, that you should sue your physician for malpractice.

    Despite the best care, sometimes bad things happen and people die. And sometimes the best care isn't possible, and you do the best you can as the doctors did in this case. The ideal is a perfect blood type and HLA match, however failing to act because you don't have a perfect match would have resulted in this child's death. Perfect in this case is the enemy of good.

    Unfortunately this sort of attitude creates no end to trouble and causes both inappropriately aggressive therapeutics and diagnostics in the US as opposed to elsewhere. There is a saying amongst OB/Gyns - you don't get sued for the C-Section that you do, you get sued for the C-Section you don't do. So surprise.... the US has a higher section rate for women. Similarly, in the US your child with belly pain is much more likely to get a CT scan to rule out appendicitis. Doing the CT doesn't get you sued, but failing to do it eventually will (because there is always going to be that very small number of kids with an appy that presented very atypically.) However, if you do 500 Abdominal CTs in kids less than 15, you will ultimately cause one excess cancer death in that group. But you won't get sued when the kid dies of renal cell cancer in his 40's. So kids with a very low risk of appendicitis instead of being observed (maybe even at home with responsible parents) will more often in the US get a trip to the donut and the resulting dose of radiation to their more vulnerable bodies.

    While it might seem that holding physicians to unreasonable expectations is beneficial, in the long run you will get worse care due to the practice of defensive medicine.
  • by Grym (725290) * on Thursday January 24, 2008 @08:37PM (#22175894)

    Bone marrow transplant isn't what happened to this girl.

    Yes, I realize that. But once you look past the sensationalist headline of "entire immune system" and understand where those cells come from you'll realize that what happened to her is fundamentally no different than what happens to someone who undergoes a bone marrow transplant. The notable things about this case are: (1)the donor's liver cell(s) migrated and differentiated to replace the hematopoietic stem cells and (2) the replacement of the hematopoietic stem cells was not the directed or intended result of any human intervention.

    Her entire immune system replaced itself w/o help or pain. This is what the GP was refering to. So why the /sarcasm?

    First of all, what happened to this girl was a fluke. The article said as much. Her amazing case was the result of a series of unlikely (and clinically undesirable/risky) events and circumstances. Specifically, she was: taking immuno-suppressants, received an organ transplant from a special organ in the body known to regrow itself, was probably infected with cytomegalovirus, and even then benefited from an unusual migration of donor cells into the bone marrow that just happened to differentiate correctly and (even more amazingly) out-compete the host hematopoietic stem cells. She's lucky to be alive and most certainly didn't have a pleasant experience getting through it.

    I'm sorry if my post came off as snarky, but I cannot disagree more with the GP. In fact, I'm almost positive that he doesn't have the slightest clue what he's talking about. Tay Sachs and CJD (which he butchered the spelling for, by the way) has nothing to do with the article at all. I honestly think it's an embarrassment that on a scientifically-centered forum that his comment is rated +5.

    Even his speculation is, in my opinion, is entirely baseless and ill-conceived. It's unlikely that any sort of preventative treatment will ever come out of this case. We already have established methods for "replacing" an "immune system," which, by virtue of its drastic nature would almost certainly be much more reliable. And even if you thought you could replicate the circumstances of this case, there's absolutely no way you could get a human trial ethics board to sign off on giving immuno-suppressants and intentionally infecting people with CMV to develop a preventative measure against an STD, of all things. And even IF you could develop such a treatment you could never give it to the entire population because there would be the obviously disastrous problem of creating an immunological monoculture.

    -Grym

  • by newgalactic (840363) on Thursday January 24, 2008 @09:14PM (#22176266)
    God or no God, that's a bloody miracle. I hope this girl has an amazing and wonderful life.

"Everything should be made as simple as possible, but not simpler." -- Albert Einstein

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