BOSTON-Combined liver and bone marrow transplantation seems to hold promise for patients with end-stage liver disease related to CD40 ligand deficiency.
The British Broadcasting Corporation reported that the two transplants, carried out in 1998 in 18-year-old Hugo Hennessy of Belfast, represented "the world's first" such combined procedure.
In the February 3 issue of The New England Journal of Medicine (2000;342:320-324), doctors at King's College Hospital in London called the procedure a success more than a year afterward. Nedim Hadzic and colleagues gave Mr. Hennessy a left lateral segment of a liver from a cadaveric male donor in October 1998, and they performed the bone marrow transplant from a matched, unrelated donor 34 days later. Thirteen months after the bone marrow transplant, "the patient was in excellent health, with satisfactory function of both grafts," the authors said.
"As our findings demonstrate, the combination of liver and nonmyeloablative bone marrow transplantation is a promising treatment approach for patients with end-stage liver disease related to CD40 ligand deficiency. Bone marrow transplantation should be performed as soon as liver-graft function is satisfactory in order to promote immunocompetence and prevent reinfection with opportunistic pathogens," they wrote. Mr. Hennessy reportedly had only a few months to live when the transplants were carried out. The same hereditary disease killed his brother in 1983.
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