A 10-year-old British boy has become the first child to undergo a windpipe transplant with an organ crafted from his own stem cells.

It is hoped that using the boy’s own tissue in the nine-hour operation at Great Ormond Street Hospital will cut the risk of rejection.

The world’s first tissue-engineered windpipe transplant was done in Spain in 2008 but with a shorter graft.

Doctors say the boy is doing well and breathing normally.

He has a rare condition called Long Segment Congenital Tracheal Stenosis, in which patients are born with an extremely narrow airway.

At birth his airway was just one millimetre across.

Doctors had previously operated to expand his airway but in November last year he suffered complications from erosion of a metal stent in his windpipe or trachea.

In order to build him a new airway, doctors took a donor trachea, stripped it down to the collagen scaffolding, and then injected stem cells taken from his bone marrow.

The organ was then implanted in the boy and over the next month, doctors expect the stem cells to transform into specialised cells which form the inside and outside of the trachea.

Pioneering

Two years ago, Claudia Castillo, a 30-year-old mother of two, became the first person to receive a transplant organ created from stem cells.

She received a new section of trachea after her own had been damaged by tuberculosis.

The latest operation is a significant advance on that pioneering work, as it is the first time a whole tissue engineered windpipe has been transplanted.

Also in Ms Castillo’s case, doctors grew the new tissue from her stem cells in the laboratory.

But in the UK operation, the donor windpipe was treated with a cocktail of chemicals designed to prompt the stem cells to grow into new tissue once inside the body.

Professor Martin Birchall, head of translational regenerative medicine at University College London, who was part of the team behind the operation, said it was a “real milestone”.

“It is the first time a child has received stem cell organ treatment, and it’s the longest airway that has ever been replaced.

“I think the technique will allow not just highly specialised hospitals to carry out stem cell organ transplants.”

He said more clinical trials were needed to prove the technique worked but that the team was also thinking about transplanting other organs, such as the oesophagus.

Professor Anthony Hollander, ARC professor of rheumatology and tissue engineering at the University of Bristol, said: “The advantage of the new approach is that it can be performed quickly and cheaply and so if successful it could be made available to large numbers of patients at relatively low cost.”

But he said the technique was more unpredictable than that done in the laboratory because there is less control of the type of stem cells being used and a very short time between seeding the cells onto the scaffold and implantation.

Stem cell pioneer Professor Paolo Macchiarini, from Careggi University Hospital in Florence was involved in both the Spanish and UK transplants.

He had also carried out the stem cell procedure on a 53-year-old Italian woman.

One in five deaths in children in England and Wales is due to potentially preventable infections, a study suggests.

Half of the 1,300 infection-related deaths in a two-year period were in children with other health problems.

Health Protection Agency researchers said greater vigilance by doctors could significantly reduce child mortality.

Childhood vaccines have a key role in cutting unnecessary deaths, they said.

The study, which analysed data from 2003 to 2005, is the first to look at the burden of deaths from specific infections in children.

Looking at death certificates in children aged 28 days to 14 years old, they found 20% of a total 6,987 deaths were related to an infection.

Underlying health problems in children dying from infectious disease included prematurity, cerebral palsy and cancer.

In deaths where a specific type of infection was recorded, 59% were bacterial, 31% viral and 8% fungal.

One finding which particularly worried the researchers was a high rate of deaths from some intestinal infections in children with underlying medical problems, as these are infections which would not normally be a problem in healthy children but can often be resistant to treatment.

Prevention

As this is the first time such analysis has been done, the researchers had no data to compare the findings with.

But they said the results backed a recent report on the care of critically ill children in the UK which called for better recognition of serious illness in children and more aggressive treatment.

A study published last year warned that more needed to be done to prevent children with cancer dying from potentially preventable infections.

Writing in the Pediatric Infectious Disease Journal, they said that adding in more vaccines to the routine childhood programme would be one way to cut the number of deaths.

Influenza, hepatitis B, rotavirus, and chicken pox vaccines are among those that are currently available but not included in the schedule.

Dr Shamez Ladhani, study leader and consultant in paediatric infectious disease, said ensuring good uptake of currently used vaccinations would also have an impact on deaths.

“We have very good vaccination programmes in place – but we also need to make sure we are up to date with the latest vaccines out there.”

He added that doctors needed to be more vigilant for infection in seriously ill children to ensure they get treatment quickly enough.

“We also need to look at surveillance and keep an eye out for antibiotic resistance.”

Dr David Vickers, a registrar at the Royal College of Paediatrics and Child Health, said: “We support the need to research whether new vaccinations should be added to the routine childhood immunisation programme.

“Earlier recognition of ill children and more systematic management through the use of clinical protocols both offer the potential to reduce mortality from infection.”

Testing for human papillomavirus during cervical screening does not help doctors identify women at risk of cancer, a study suggests.

A positive HPV test does not accurately predict which women need an urgent follow-up, say doctors.

Each year, millions of UK women have a cervical screening test as part of the national programme.

The NHS is piloting add-on tests for the virus linked to cervical cancer at several UK centres.

Other studies have shown this could be a useful tool for identifying women at high risk of developing cervical cancer.

Around six out of 100 women who have a test receive a borderline or mild abnormality result.

But only a tiny minority of these will go on to develop cervical cancer.

The study, funded by the Medical Research Council, looked at 4,439 women undergoing cervical screening in Grampian, Tayside and Nottingham.

Those with mild abnormalities were tested to see if they were positive for HPV, a sexually-transmitted infection linked to most cases of cervical cancer.

Early signs

But the researchers found 70% of women testing positive for HPV after a mild abnormality result did not develop early signs of cancer during a three-year follow-up.

Dr Maggie Cruickshank, from the Department of Obstetrics and Gynaecology at the University of Aberdeen, led the study.

She said: “The most important thing is to attend for cervical cancer screening – the most effective way of preventing cervical cancer.

“This new additional test may not add any value.

“Our study is showing that HPV is such a common infection in younger women that testing for it doesn’t help decide which is the best action to take.”

But in women over 40, HPV testing might be useful for ruling out further investigations, she added.

Contradictory research

Professor Jack Cuzick is an epidemiologist for Cancer Research UK.

He said other studies have shown that HPV testing is good at detecting abnormalities in women with low-grade tests and can reduce the number who need to be referred for treatment, especially in the over 35s.

He added: “The results of this study are surprising, as they’re very much out of line with most other studies in the field.

“One thing to note is that the type of test used isn’t commercially available, so we need to be careful when considering these results in the context of our national screening programme.”

Julietta Patnick, director of the NHS Cancer Screening Programmes, said the results of the study would be reviewed.