Pioneering placental stem cell operation that may have saved baby’s life

A heart surgeon says he “probably saved the life” of a baby by performing an “unprecedented” operation using stem cells from the placenta.

Massimo Caputo, from the Bristol Heart Institute in the UK, used a pioneering stem cell “scaffold” to correct the baby’s heart defect, called Finley.

He hopes to develop the technology so that children born with congenital heart disease don’t have to undergo as many operations.

Finley, now two years old, is “a happy boy in development”.

But he was born with the main arteries of his heart reversed, and at just four days old, he underwent his first open-heart surgery at the Bristol Royal Hospital for Children in the UK.

Unfortunately, surgery did not fix the problem, and his heart function deteriorated significantly, with the left side of his heart suffering a severe lack of blood flow.

“We were prepared from the start that the chances of him surviving were not good,” says mum Melissa, who is from Corsham in Wiltshire, UK.

“After 12 hours, Finley was finally out of surgery, but he required a cardiac and pulmonary cardiopulmonary bypass machine to stay alive, and his heart function had deteriorated significantly.”

After weeks in the Intensive Care Unit (ICU), it seemed like there was no conventional way to treat Finley’s condition — and he was dependent on medication to keep his heart working.

But a new procedure has been tried, involving stem cells from a placental bank.

Caputo injected the cells directly into Finley’s heart, hoping they would help the damaged blood vessels heal.

So-called “allogeneic” cells were grown by scientists at the Royal Free Hospital in London, and millions of them were injected into Finley’s heart muscle.

Allogeneic cells have the ability to transform into tissue that is not rejected — and, in Finley’s case, regenerated damaged heart muscle.

“We weaned him off all the drugs he was taking, we took him off ventilation,” says Caputo.

“He was discharged from the ICU and is now a happy growing boy.”

Using a bioprinter, a scaffold of stem cells is made to repair abnormalities in blood vessel valves and to patch holes between the heart’s two main pumping chambers.

Typically, artificial tissue is used for heart repairs in babies, but it may not work and it may not grow with the heart — so as children grow, they need more operations.

Caputo hopes to see a clinical trial of stem cell “dressings” within the next two years, following successful lab work.

The clinical trial of the stem cell bandage offers hope for patients like Louie, from Wales, who has several congenital heart defects.

The 13-year-old underwent his first open-heart surgery with Caputo when he was just two weeks old, and then again at age four to replace the material repairing his heart.

But as the materials are not completely biological, they are unable to grow with the patient, and he has to repeat the operations.

Like Louie, around 13 babies are diagnosed every day in the UK with a congenital heart defect — a condition that develops before the baby is born, according to the British Heart Foundation.

Because the materials used to repair the heart can be rejected by the patient’s immune system, they can scar the heart that can lead to other complications, and it can gradually stop working over just a few months or years.

A child may therefore have to undergo the same heart surgery several times during childhood – around 200 repeat operations for congenital heart defects are performed each year in the UK.

Louie hopes the discovery will significantly reduce the number of operations he faces, thanks to stem cell technology and tissue able to grow with his body.

“I don’t like going through the motions,” he says.

“It’s not good in the long run, knowing that every two years I need surgery, so that would make me a lot more relaxed.”

Caputo and his team say that stem cell technology could save the NHS, the UK’s public health system, around £30,000 (approximately R$ 193,000) for each operation that is no longer needed, saving millions of pounds each year.

Stephen Minger, an expert in stem cell biology and director of SLM Blue Skies Innovations Ltd, applauded the research.

“Most studies that I know of in adults with dysfunction or heart failure show only minimal therapeutic benefit from stem cell infusion,” he says.

“I’m happy that the clinical team is going to do a standard clinical trial that should tell us whether this was an isolated success, and also give us a better understanding of the mechanisms behind it.”

This text was originally published here.