Special Report

Giving new organs, helping cure old ones

BRIAN BERGMAN June 21 2004
Special Report

Giving new organs, helping cure old ones

BRIAN BERGMAN June 21 2004

Giving new organs, helping cure old ones

PIONEERING TRANSPLANTS IN EDMONTON

MIKE POWER was able to hold his tiny son, Avery, for only a few minutes before the newborn was whisked away and prepped for surgery. While still in the womb, the baby had been diagnosed with hypoplastic left heart syndrome, meaning the left half of his heart was dramatically underdeveloped; the right side also, was not performing well. To live, he needed a transplant as soon as possible after birth. When a donor heart became available, Power’s wife, Lesley, 39, had a C-section at Edmonton’s University of Alberta Hospital four weeks prior to her due date. Hours later, Avery received his new heart.

Now five months old, Avery is at home and doing well, his doctors say, though they don’t have a lot of experience to draw on.

That’s because his case is one of only about two dozen newborn heart transplants in the world involving mismatched blood types.

This, too, is a Canadian innovation, announced just three years ago.

Such transplants are possible because babies in their first few months of life haven’t yet developed the antibodies to attack a mismatched heart. Meanwhile, Avery’s parents are simply grateful for the opportunity their son has been given. “This has stretched the limits of my imagination,” says Power, 40. “I would never have dreamed it was possible.”

Pushing the envelope is something the University of Alberta Hospital’s transplant team does well. Each year, the hospital averages about 250 organ transplants—heart, liver, kidney and lung—making it Canada’s second-busiest after Toronto General. In addition to rare operations like the one

performed on Avery by surgeons David Ross and Ivan Rebeyka, researchers here are also finding new ways to fend off post-op infections and organ rejection.

The best-known breakthrough came in 1999—the so-called Edmonton Protocol, a procedure that is giving new hope to those who suffer from Type 1 or juvenile diabetes. Severe diabetics are injected with insulinsecreting cells, known as islets, from donated human pancreases. Eighty per cent of recipients no longer need daily insulin shots and are freed from the wild blood sugar swings and temporary comas that threaten their lives. James Shapiro, director of the clinical islet transplant program at the University of Alberta, is currently overseeing a series of trials at centres throughout North America and Europe to try to have the treatment expanded.

The Edmonton transplant team is also conducting leading edge research into how specific genes can trigger organ rejection. This would help predict when that is about to take place, and allow physicians to intervene. Ultimately, the research would point to treatments for the diseases that lead to transplants, and hopefully prevent the need for surgery.

A newly created Alberta Transplant Institute promises to foster further innovation by bringing clinical practitioners and scientists into closer contact, to share information about breakthroughs. In that regard, little Avery is already doing his bit. “I’m told the information the hospital gathered from his operation will help others,” says Power. “That makes us feel very proud.” BRIAN BERGMAN

The father of a baby saved by a heart transplant says, ‘This procedure stretched the limits of my imagination’