The Operating Theatre Journal February 2022

Karolinska University Hospital First to Give Stem Cells to Foetus with
Severe Osteoporosis
A new treatment is being trialled to help children born with a severe
variant of osteoporosis, osteogenesis imperfecta. It is the first clinical
trial in the world in which bone-forming stem cells are given before
birth. The hope is that this will increase the child’s chances of building
a functioning skeleton.
Osteogenesis imperfecta is a congenital genetic disorder in which
the collagen type 1 protein is defective, or not produced in sufficient
amounts, preventing the bones from storing enough calcium, and
growing strong. The skeleton is also remodelled too quickly, which
contributes to the weakness.
Those living with the severe form of the disease can, without treatment,
suffer hundreds of fractures in their lifetime. They may also suffer from
extreme hyperextension of ligaments, compressed vertebrae, and
severe pain.
- Now, the prognosis for children born with the disease is better,
because a drug exists. Surgery and regular visits to a physiotherapist
also help a lot. However, severe osteogenesis imperfecta still leads to
short stature and broken bones, although not to the same extent as in
the past, says Eva Åström, a doctor at the Astrid Lindgren Children’s
Hospital, and principal investigator for the BOOSTB4 study.
The severe form of osteogenesis imperfecta is very rare; in Sweden,
about 5 children a year are born with it.
On Thursday the 18th of November, the first prenatal (before birth)
transplant of bone-forming stem cells was performed in a patient with
“The severe measures osteogenesis Sir Bruce imperfecta. Keogh outlined The family during came his from speech Germany last night to
will Karolinska be instrumental University in Hospital supporting as part healthcare of the EU professionals BOOSTB4 collaboration. to identify
the early signs and enable them to act, Health Education England’s new
education - Previous and research training shows materials that will there be particularly is a good relevant chance that as will the a
clinical treatment network will be approach beneficial. to care The where theory professionals is that the and stem organisations cells will
work seek out together the skeleton across a where dened they geographical can help with area bone – this formation, helps to bring says
a Cecilia safe, Götherström, standardised and researcher equitable at approach the Karolinska to care. Institute, which is
developing this type of stem cell.
“As This a is college, the first we time have the updated treatment the national has been template given to for a foetus the Personal in this
Child way in Health a clinical Record trial, to but include another information part of for the parents same study, on how stem to cells tell
if of your this type child have is ill, been and for given health to 12 professionals, babies, without have complications.
recently launched
Paediatric Care Online (PCO-UK) – an online decision support tool,
providing - The reason specialist why we diagnostic want to give advice the to stem help cells ensure even children before get birth the is
right that fewer treatment of the at cells the earliest are filtered opportunity. out by the lungs, as foetuses have a
different kind of blood circulation, and have not yet started breathing
“To
normally.
support
Treatment
this, I
is
now
therefore
urge
likely
paediatricians
to be more
and
efficacious.
all healthcare
professionals to utilise the resources Sir Bruce has outlined. Collectively
Being able to influence the child’s bone formation as early in life as
we can slow down the grip of this deadly disease and reduce the number
possible is, of course, also beneficial, says Eva Åström.
of children who come face to face with it.”
Treatment with the stem cells for the foetus is carried out as an
Louise injection Silverton, via the umbilical Director cord for at Midwifery the Centre at for the Foetal Royal Medicine, College the of
Midwives, country’s only said: centre “Severe for sepsis national, can highly and does specialised kill. Though care in it this rare, field. it
can be catastrophic for pregnant and postnatal women.
- It’s the same type of procedure we use when a foetus needs a blood
transfusion, which is something we do 1 – 2 times a week, says Peter
“Sepsis Lindgren, remains operations a leading manager cause at of the maternal Centre for death. Foetal That Medicine. is why it is so
important that we do all we can to identify it as soon as possible so that
it Following can be treated. the procedure, It is also and important meticulous not monitoring forget newborn for 24 hours, babies both who
can mother succumb and son to were infection fine. very The quickly. baby has now been born, and will return
to Karolinska University Hospital to repeat the treatment at the age of
“Midwives 3 – 5 months. should certainly “think sepsis” where there is deterioration
in the health of either mother or baby. This means we need the right
number
So far, three
of midwives
unborn children
so that they
have
can
received
deliver
the
the
treatment,
best possible
which
care,
has
including
been approved
in the
by
postnatal
the Medical
period.
Products Agency and the Ethical Review
Authority. The research project is part of the Horizon 2020 programme,
the EU’s largest investment into research and innovation, and the
“Having Swedish the Research right Council. numbers of staff will also help to ensure continuity
of care and carer for women. Midwives who know the woman will be
better The Karolinska equipped Institute to spot changes is the sponsor in the woman’s of the clinical condition trial. and They identify are
problems manufactured such as at sepsis special developing.” laboratory Vecura at Karolinska University
Hospital.
Royal Oldham extension takes a step
closer to improve patient care for
general and colorectal surgery patients
Groundworks for a new extension to The Royal Oldham Hospital have
begun with a ground-breaking ceremony being held on 18 January.
The new development is part of the Greater Manchester Improving
Specialist Care programme and will enable the Royal Oldham Hospital
to operate as the hub site for high risk and emergency general and
colorectal surgery.
Construction works for the new £28m four-storey extension to the main
hospital building are well underway and existing structures including
the hospital’s old Adult Medicine building have been demolished to
make way for the new building.
Oldham Care Organisation Chief Officer, David Jago, said: “We are
delighted that great progress is being made on the new development.
Today marks an important milestone. We are one step closer to having
a new state-of-the-art theatre for emergency and colorectal surgery,
rehabilitation facilities and most importantly additional beds. These
new facilities will help us to support patients throughout Oldham and
Greater Manchester with serious colorectal conditions and ensure they
receive consistent, high-quality patient care.”
The new building has been designed by architects working alongside
clinicians, operational and support staff and patients to ensure every
detail is captured with patient wellbeing in mind.
The new building will have spacious patient day rooms and equipped
therapy spaces, and the two new 24-bedded general surgery wards will
be located on southern and western elevations to provide outwardlooking
views for patients, maximising natural light. It will also house a
new state-of-the-art theatre for emergency and colorectal surgery for
patients who have conditions affecting the colon and rectum.
Dr Jonathan Moise, Medical Director at The Royal Oldham Hospital, said:
Professor “I am delighted Helen Stokes-Lampard, and excited see Chair the of building the Royal work College underway. GPs, said: The
“Sepsis build will is house a huge wards worry and for facilities GPs as specifically initial symptoms designed can for be general similar
to and other specialist common colorectal illnesses, surgery and the patients. College The is additional putting a lot state of of effort the
into art operating helping family theatre doctors will recognise facilitate potential more laparoscopic sepsis and (“key-hole”)
ensure that
patients surgery to rapidly improve receive patients’ appropriate recovery assessment and experience and treatment. and shorten
hospital stays.”
“We have produced a toolkit, in partnership with NHS England, which
brings
Aside from
together
new state-of-the
existing guidance,
art facilities
training
and improved
materials
care
and
for general
patient
information
and colorectal
to
surgery
encourage
patients,
us all to
it is
‘think
hoped
sepsis,
that the
talk
development
sepsis and treat
will
sepsis’.
also bring many other benefits for the local economy and the people
“We of Greater are pleased Manchester to be working during the with construction NHS England phase to raise including awareness the
and creation improve of employment, outcomes for skills, patients. training It really and supply could chain save lives.” opportunities.
Anna Fiona McLoughlin, Crossley, Professional Senior Project Lead Manager for Acute, at DAY Emergency Project Management & Critical
Care Ltd said: at the “We RCN, are said: thrilled “Sepsis the is new a life-threatening extension is now condition underway and on-site early
identication and is a step closer is the to key providing to survival, improved but it patient can be care difcult facilities to diagnose to The
and Royal often Oldham symptoms Hospital can Estate. be mistaken for a u-like illness. This is why
raising awareness among carers, health care professionals and the
public DAY Project is so vital. Management Even though Ltd there are working has been alongside good progress IHP as to the improve main
diagnosis, contractor a and cohesive DAY Architectural national plan Ltd is as needed the lead to ensure designer that to healthcare deliver the
professionals new extension. are This supported is a fantastic and equipped milestone to to identify celebrate and as treat a team; sepsis we
early. are all excited to deliver this scheme on behalf of the Northern Care
Alliance NHS Foundation Trust”.
“If sepsis is not recognised quickly, it can lead to shock, multiple organ
failure Garry and Bowker, death, IHP which Regional is why Director, early detection said: “After is critical a detailed to start
treatment preconstruction, within design the hour. and Nurses business and case health process, care support it is fantastic workers, to
who reach see this their first patients major milestone a regular in the basis, construction and are often Phase the 4a rst at
healthcare The Royal Oldham worker to Hospital. see them, This are project well placed continues to recognise IHP’s long-standing the signs
of relationship sepsis early with and the raise Trust the at alarm. Royal If Oldham a person and has we signs are or proud symptoms
be
that delivering indicate this possible major investment infection, think at the ‘could hospital, this be which sepsis?’ will increase and act
fast capacity to raise and the provide alarm, significant wherever benefit you are. to patients and staff.”
https://www.england.nhs.uk/wp-content/uploads/2015/08/Sepsis-
The new unit expected to welcome its first patients in the summer of
Action-Plan-23.12.15-v1.pdf
2023. Source: Rochdale Online
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