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Stem cell windpipe gives Korean toddler new life

2-year-old girl born without trachea gets a bioengineered organ in a landmark transplant operation in U.S.

Hannah Warren, a 2-year-old born without a windpipe, has been given a new life after a groundbreaking transplant in the U.S. of the organ made from her own stem cells.

An international team of surgeons performed the landmark operation at the Children’s Hospital of Illinois at Saint Francis Medical Center in Peoria, Illinois, on April 9 to help the Korean toddler breathe on her own. Early signs show that the stem cell windpipe is working, doctors said, although she is still in the recovery process and relies on a ventilator. She will be able to return home soon with her family and have a normal life, they added.

“I am very happy that Hannah is doing well and is recovering from this very complex operation,” Dr. Paolo Macchiarini, the surgeon who led Hannah’s operation, told The Korea Herald via email.

The hospital said she was the youngest person in the world to receive the treatment. The stem cells were extracted from Hannah’s bone marrow and were seeded, with nonabsorbant nanofibers, onto a plastic frame. It took less than a week for them to grow into a new windpipe, or trachea, doctors said.

Now with the windpipe made from her own stem cells, she is expected to breathe, eat, drink and swallow outside of the hospital.
Darryl Warren and Lee Young-mi visit with their 2-year-old daughter Hannah Warren in a post-op room at Children’s Hospital of Illinois in Peoria after having received a new windpipe in a landmark transplant operation April 9. Hannah was born in South Korea without a windpipe but received a new one made from her own stem cells. (AP-Yonhap News)
Darryl Warren and Lee Young-mi visit with their 2-year-old daughter Hannah Warren in a post-op room at Children’s Hospital of Illinois in Peoria after having received a new windpipe in a landmark transplant operation April 9. Hannah was born in South Korea without a windpipe but received a new one made from her own stem cells. (AP-Yonhap News)

Born in Goyang, Gyeonggi Province, in 2010 to a Korean mother and a Canadian father, the girl never left the hospital in Korea before her operation in the U.S. She has been breathing through an artificial windpipe connected to her esophagus.

Without the tube that allows for air to be ventilated into her lungs, she could have died at any moment. Her story was first published in The Korea Herald on June 29, 2011. The newspaper also interviewed her parents at a hospital in Seoul in July last year while Hannah was waiting for this life-saving operation in the United States.

The operation was possible thanks to efforts initiated by an American doctor, Mark Holterman, who currently leads the pediatrics division at the University of Illinois Medical Center. The doctor first met Hannah two years ago through a Korean-American nurse who suggested the case to him.

Determined to save her life, he teamed up with Dr. Macchiarini, who performed the world’s first stem cell-based tracheal transplant surgery in November 2008, and arranged for the family to have the operation at his hospital.

The operation was funded by donors, hospitals and medical foundations.

Her parents, Darryl and Young-mi, hope to bring Hannah home for the first time in her life soon. Ever since she was born in Korea, she had been at the Seoul University Children’s Hospital. Her parents were not allowed to stay overnight at the hospital but instead watched her grow during visiting hours.

“It’s been a long journey for her. We are so blessed that we’re able to get this unbelievable opportunity. She really had only one chance and she has it,” Darryl Warren, Hannah’s father, said at a tearful news conference at the hospital on Tuesday.

About 1 in 50,000 children worldwide are born without a trachea, according to reports. Most children with her condition, tracheal agenesis, usually don’t survive long after birth.

However, her successful transplant using the stem-cell technique will open a new door for other children with birth defects and diseases, doctors and scientists say.

The bioengineered organ, created by the latest stem-cell technology, has eliminated the chances of one’s immune system rejecting the transplant.

“This opens us a whole new area where we could fix a lot of our children with birth defects that we don’t have a good surgical solution for,” Holterman said at the conference.

Because Hannah’s new trachea was made from stem cells that are not derived from human embryos, there was no ethical issue involved, he added.

Hannah now has a 7-centimeter-long and 11-millimeter-wide windpipe transplanted into her body that will soon allow her to breathe normally and also to speak. Doctors said her voice box has started to work and she will be able to speak with help from speech therapists.

“She could not only have a life saved but a wonderful life opportunity to speak for the first time,” said Macchiarini, an Italian surgeon who has been leading in the regenerative medicine technology at Karolinska Institute in Stockholm.

She is likely to have another operation in the next five years as her body grows, he added.

By Cho Chung-un (christory@heraldcorp.com)
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