A New Heart-Thymus Transplant Could Someday Let Kids Live Without Anti-Rejection Drugs

Image of two surgeons and a patient.  Scientists at Duke University have created a combined heart and thymus transplant procedure.

picture: Photos: Shutterstock Graphics: Vicky Leta

Scientists and surgeons at Duke University are the winners of the 2023 Gizmodo Science Fair For pioneering a combined heart-thymus transplant procedure.

the question

Can you convince a person’s immune system to accept a donated organ, without the need for a lifelong course of anti-rejection drugs?


Duke University staff, led by Joseph Turek, chief of pediatric cardiac surgery, performed the first procedure of its kind on six-month-old Easton Cinnamon in the summer of 2021. Easton was born with severe heart problems that necessitated a transplant. , but he also had severely deficient thymus — a gland in the middle of the chest that helps certain immune cells mature.

Turek and his colleagues believe that Easton’s situation provides a unique opportunity to test a theory they’ve had in mind for years. One of the main functions of the thymus gland is to help T cells learn how to distinguish friend from foe. They reasoned that giving someone a new heart and thymus from the same donor might allow the recipient’s immune system to recognize the heart as their own, which could greatly reduce or completely eliminate the need for anti-rejection medications.

The experimental procedure, which has been specially approved by the Food and Drug Administration, It was a huge success. The 2-year-old Easton is still in great shape and is meeting all of his developmental milestones on time. Tests showed no signs of acute rejection, even as doctors steadily reduced the amount of immunosuppressant medication he was taking. The typical regimen for a heart transplant patient is two drugs, but Easton is currently only using half a dose of one.

Why did they do that

“Easton is showing us that we can do this in an immunocompromised child. I think we will be able to almost reset the immune system in a way that we can perform heart and thymus transplants even in patients who have competent immune systems — and we are working,” Turek said. On it in the lab.” “I think this might be the future of pediatric heart transplantation.”

Image for article titled New heart-thymus transplant may one day allow children to live without anti-rejection drugs

clarification: Vicki Lita

Why are they winners?

One of the sacred things in the field of transplantation is finding a permanent solution to organ rejection. And although Easton’s case is very special, the lessons learned from him may help us get there for many more patients in the future.

Collaboration was key to this achievement. Decades ago, Duke researchers led by Marie-Louise Markert began the project that would one day allow donated thymus tissue to be safely processed and successfully transplanted into humans—a technology consent by the Food and Drug Administration in 2021 for the treatment of children born without a thymus.

said Laura Hill, a Duke pathologist and immunologist who has long worked with Markert and now works with Toric.

What then

In mid-2023, the Duke team will run tests that will determine whether Easton’s immune system has already become tolerant of the new heart. And if all goes well, they’ll try to wean him off treatment entirely. They also hope to conduct clinical trials of the procedure in a few years.

the team

Aside from Marie-Louise Markert, Joseph Turek, and Laura Hill, the Duke University team includes dozens of researchers and medical staff in the fields of pathology, surgery, and even veterinary medicine. Easton’s care team alone has more than 25 people.

See the full list of Gizmodo Science Fair winners


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