WATCH ABOVE: Health Matters segment on the Stollery’s new anti-rejection therapy for heart transplants + fundraising efforts for a ‘home away from home’ for military members and their families.
EDMONTON- Meet Abigail Fraser: a rambunctious three-year-old with a rare congenital heart disease that made it medically unlikely that she would ever receive a heart transplant.
However, with the Stollery Children’s Hospital’s breakthrough anti-rejection therapy, she was able to overcome these odds and receive a new, healthy heart.
Abigail, like her older sister Hailey was born with Hypoplastic Left Heart Syndrome. The disease leaves the left ventricle of the heart severely underdeveloped and it cannot pump blood properly. One in 100 children is born with congenital heart defects and HLHS accounts for only between one and three per cent of these.
Typically, the syndrome requires three surgeries. One within the first week of life, another at three to six months and the last at two to three years.
Hailey successfully had these surgeries, but Abigail’s road to a healthy heart was a little rockier.
“Through her medical journey and through Hailey’s medical journey, never did we say we’re not going to try,” said their mother Nancy Fraser. “I knew that we had to.”
Abigail had the first surgery, but experienced severe complications. She went into cardiac arrest and doctors said her heart was too weak to follow through with the other two surgeries.
When Abigail was only three months old, Fraser spoke with Dr. Simon Urschel, a pediatric cardiologist at the Stollery about an alternative and innovative option.
“We were with our back to the wall,” said Urschel.
“We didn’t have a chance to find an organ that would really suit her and that would be successful in being transplanted.”
Abigail posed a difficult challenge for doctors. Because she had already received transplant tissue to reconstruct her heart vessels, her body had built up antibodies to virtually every human organ or tissue. If she had a heart transplant, doctors felt her body would immediately reject it.
“Every heart that we would have put in there – similar to a vaccination – she would have already been ready to fight it and reject it,” explained Urschel.
Abigail’s inability to accept a new heart lead to the breakthrough anti-rejection therapy.
A team of doctors at the Stollery and the University of Alberta developed a therapy that combines the cancer treatment drug Rituximab with intravenous immunoglobulin. This combination slows down the production of antibodies that would reject a donor organ while providing enough antibodies to fight off infection.
“It was scary, but if you saw how she was… she wasn’t going to make it,” Fraser said.
“It was this or nothing.”
Abigail responded to the anti-rejection therapy and, when a donor organ became available a few months later, was able to receive the transplant.
“This therapy has worked so well in Abigail is because she was so young when she got it,” said Urschel. “It’s two-and-a-half years after, and she doesn’t have any of the antibodies.”
Urschel says this protocol will become standard for complicated patients like Abigail.
She was the first person in Canada to receive this kind of transplant and celebrated her third birthday in June.
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