One Womb to Another

By John Langone

The French parents were distraught and desperate. Soon after their firstborn child died at seven months of a rare form of immune deficiency, they received more heartbreaking news. Their second baby, due in August of last year, was suffering from the same, nearly always fatal hereditary disorder, called bare lymphocyte syndrome. They could have aborted the child or allowed doctors to try the same kind of white-blood-cell transplant after birth that had failed with their firstborn. But the couple, who prefer to remain anonymous, chose a historic third option: to let their child receive the first ever transplant of human fetal cells to a child in the womb.

The experiment took place without publicity last June, and was only recently described at a medical meeting in Paris. The operation was performed when the child, David, was a 30-week-old fetus. So far, the results have been remarkable. Though he has been confined since birth to a germ-free flexible plastic bubble in order to protect him from the outside world, David, now seven months old, appears to have an immune system that is on the mend. If all goes well, David could leave his sterile prison by summer's end. Though his survival is not assured, the experiment could help researchers develop ways to correct other inherited, and congenital, disorders through the transplantation of fetal cells.

The unprecedented procedure was performed by two prominent physicians in Lyons: Dr. Jean-Louis Touraine, an immunologist at Edouard-Herriot Hospital, and Dr. Daniel Raudrant, an obstetrician at Hotel Dieu Hospital. The doctors wanted to treat David while he was still in his mother's womb because they thought if the procedure was done early, it would have better odds of succeeding. They took 7 cc of liquid, containing about 16 million immune cells from the liver and thymus of two aborted fetuses, and injected the material into David's umbilical cord. After he was born, David received an injection of more cells. Blood tests indicate that the transplanted cells have multiplied in David's liver, spleen and bone marrow -- signs that his immune system may become normal.

His doctors remain cautious. "We're not out of the woods yet," said Raudrant. But the boy at least has a chance at a better fate than another ( immune-deficient David: the American "bubble boy" who spent nearly all his twelve years of life in isolation before he died in Houston in 1984.

The use of aborted fetuses for medical purposes is a promising but highly controversial field. Doctors have transplanted fetal organs into infants and used fetal cells to treat Parkinson's disease in adults. Right-to-life advocates object strongly to such procedures unless the fetus comes from a mother who has had a miscarriage. But to David's parents, the issue was clear- cut: only aborted fetuses were available, and without the transplanted cells their boy would have had virtually no chance of survival.

With reporting by Janet Thorpe/Paris