Home' Trinidad and Tobago Guardian : June 20th 2013 Contents B17
Thursday, June 20, 2013 www.guardian.co.tt Guardian
TAKE NOTICE that a Default Summons and Affidavit in support of the said
Summons together with exhibits annexed thereto were duly filed against JOAN
CIPRIANI, ID# 19530826022, formerly of 1C Bridge Road, San Juan, on the 3rd
day of December 2012 in the Petty Civil Court of Port-of-Spain as P.C.C. Action
Number 485 of 2012, by British American Insurance Company (Trinidad)
Limited, and that the validity of the said Summons has been renewed to the 3rd
day of July 2013 for service to be effected prior to this date, by the Order of the
Honourable Magistrate Justice Nalini Singh, made on the 28th day of May
AND TAKE NOTICE that the said Default Summons and Affidavit together with
Exhibits are being served on the said JOAN CIPRIANI by virtue of this adver-
tisement, to be deemed effective Service, pursuant to the said Order. AND TAKE
NOTICE that unless within 10 days of this Service the said JOAN CIPRIANI
applies to the said Court for leave to defend this Action, the said Company may
proceed to judgment and execution.
NEW YORK---By the time ten-
year-old Sarah Murnaghan finally
got a lung transplant last week,
she d been waiting for months,
and her parents had sued to give
her a better chance at surgery. Her
cystic fibrosis was threatening her
life, and her case spurred a debate
in the US on how to allocate scarce
donor organs for transplant.
But what if there were another
way? What if you could grow a
custom-made organ in a lab?
It sounds incredible. But just a
three-hour drive from the Philadel-
phia hospital where Sarah got her
transplant, another girl is benefiting
from just that sort of technology.
Two years ago, Angela Irizarry
needed a crucial blood vessel.
Researchers built her one in a lab-
oratory, using cells from her own
bone marrow. Today the five-year-
old sings, dances and dreams of
becoming a firefighter---and a doc-
tor.Growing lungs and other organs
for transplant is still in the future,
but scientists are working toward
that goal. In North Carolina, a 3-
D printer builds prototype kidneys.
In several labs, scientists study how
to build on the internal scaffolding
of hearts, lungs, livers and kidneys
of people and pigs to make cus-
Here s the dream scenario: A
patient donates cells, either from
a biopsy or maybe just a blood draw.
A lab uses them, or cells made from
them, to seed onto a scaffold that s
shaped like the organ he needs.
Then, says Dr Harald Ott of Mas-
sachusetts General Hospital, "We
can regenerate an organ that will
not be rejected (and can be) grown
on demand and transplanted sur-
gically, similar to a donor organ."
That won t happen anytime soon
for solid organs like lungs or livers.
But as Irizarry s case shows, simpler
body parts are already being used
as researchers explore the possi-
Just a few weeks ago, a girl in
Illinois got an experimental wind-
pipe that used a synthetic scaffold
covered in stem cells from her own
bone marrow. More than a dozen
patients have had similar opera-
Dozens of people are thriving
with experimental bladders made
from their own cells, as are more
than a dozen who have urethras
made from their own bladder tissue.
A Swedish girl who got a vein made
with her marrow cells to bypass a
liver vein blockage in 2011 is still
doing well, her surgeon says.
In some cases the idea has even
become standard practice. Surgeons
can use a patient s own cells,
processed in a lab, to repair cartilage
in the knee. Burn victims are treated
with lab-grown skin.
In 2011, it was Irizarry s turn to
wade into the field of tissue engi-
Angela was born in 2007 with a
heart that had only one functional
pumping chamber, a potentially
lethal condition that leaves the body
short of oxygen. Standard treatment
involves a series of operations, the
last of which implants a blood vessel
near the heart to connect a vein to
an artery, which effectively
rearranges the organ s plumbing.
Yale University surgeons told
Angela s parents they could try to
create that conduit with bone mar-
row cells. It had worked for a series
of patients in Japan, but Angela
would be the first participant in a
"There was a risk," recalled
Angela s mother, Claudia Irizarry.
But she and her husband liked the
idea that the implant would grow
along with Angela, so that it would-
n t have to be replaced later.
So, over 12 hours one day, doctors
took bone marrow from Angela and
extracted certain cells, seeded them
onto a biodegradable tube, incu-
bated them for two hours and then
implanted the graft into Angela to
More patients getting lab-grown body parts
grow into a blood vessel.
It s been almost two years and Angela
is doing well, her mother says. Before
the surgery, she couldn t run or play
without getting tired and turning blue
from lack of oxygen, she said. Now, "she
is able to have a normal play day."
The researchers in charge of Angela s
study had been putting the lab-made
blood vessels into people for nearly a
decade in Japan before they realised that
they were wrong in their understanding
of what was happening inside the body.
"We d always assumed we were mak-
ing blood vessels from the cells we were
seeding onto the graft," said Dr Christo-
pher Breuer, now at Nationwide Chil-
dren s Hospital in Ohio. But then studies
in mice showed that in fact, the building
blocks were cells that migrated in from
other blood vessels. The seeded cells
actually died off quickly. "We in essence
found out we had done the right thing
for the wrong reasons," Breuer said.
Other kinds of implants have also
shown that the seeded cells can act as
beacons that summon cells from the
recipient s body, said William Wagner,
director of the McGowan Institute for
Regenerative Medicine at the University
of Pittsburgh. Sometimes that works
out fine, but other times it can lead to
scarring or inflammation instead, he
So far, the lab-grown parts implanted
in people have involved fairly simple
structures---basically sheets, tubes and
hollow containers, notes Anthony Atala
of Wake Forest University whose lab
also has made scaffolds for noses and
His pioneering lab is using a 3-D
printer to make miniature prototype
kidneys and other structures for research.
Instead of depositing ink, the printer
puts down a gel-like biodegradable scaf-
fold plus a mixture of cells to build a
kidney layer by layer. Atala expects it
will take many years before printed
organs find their way into patients.
Another organ-building strategy used
by Atala and maybe half a dozen other
labs starts with an organ, washes its
cells off the inert scaffolding that holds
cells together and then plants that scaf-
folding with new cells.
"It s almost like taking an apartment
building, moving everybody out ... and
then really trying to repopulate that
apartment building with different cells,"
says Dr John LaMattina of the University
of Maryland School of Medicine. He s
using the approach to build livers.
One goal of that process is humanising
pig organs for transplant, by replacing
their cells with human ones.
"I believe the future is ... a pig matrix
covered with your own cells," says Doris
Taylor of the Texas Heart Institute in
Houston. She reported creating a rudi-
mentary beating rat heart in 2008 with
the cell-replacement technique and is
now applying it to a variety of organs.
Ott s lab and the Yale lab of Laura
Niklason have used the cell-replacement
process to make rat lungs that worked
temporarily in those rodents. Now
they re thinking bigger, working with
pig and human lung scaffolds in the lab.
There are plenty of challenges with
this organ-building approach. One is
getting the right cells to build the organ.
Cells from the patient s own organ might
not be available or usable. So Niklason
and others are exploring genetic repro-
gramming so that, say, blood or skin
cells could be turned into appropriate
cells for organ-growing.
Others look to stem cells from bone
marrow or body fat that could be nudged
into becoming the right kinds of cells
for particular organs. In the near term,
organs might instead be built with donor
cells stored in a lab, and the organ recip-
ient would still need anti-rejection drugs.
How long until doctors start testing
solid organs in people? Ott hopes to see
human studies on some lab-grown organ
in five to ten years. Wagner calls that
very optimistic and thinks 15 to 20 years
is more realistic. Niklason also forecasts
two decades for the first human study
of a lung that will work long-term.
But LaMattina figures five to ten years
might be about right for human studies
of his specialty, the liver.
"I m an optimist," he adds. "You have
to be an optimist in this job." (AP)
Claudia Irizarry, left, plays with her daughter Angela at their home in
Lewisburg, Philadelphia, on May 23. Two years ago, Angela needed a
crucial blood vessel. Researchers built her one in a laboratory, using cells
from her own bone marrow. Today the five-year-old sings, dances and
dreams of becoming a firefighter---and a doctor. AP PHOTOS
Dr Anthony Atala holds
the "scaffolding" for a
human kidney created by
a 3-D printer in a
laboratory at Wake
Forest University in
Carolina, on May 8. The
various ways to create
replacement organs for
from altering animal
parts to building them
from scratch with a
patient's own cells.
Others look to stem cells from bone marrow or body fat that
could be nudged into becoming the right kinds of cells for
particular organs. In the near term, organs might instead be
built with donor cells stored in a lab, and the organ recipient
would still need anti-rejection drugs.
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