Children's Hospitals Today - Spring 2023 - 7

INNOVATION / ROUNDS
breed, frequently leaves them with little
function in their hindquarters. By their
post-surgery re-check at 4 months old,
Darla and Spanky were able to walk,
run and play.
First human trial
When Emily and her husband Harry
learned that they would be first-time parents,
they never expected any pregnancy
complications. But the day that Emily
learned her developing child had spina
bifida was also the day she first heard
about the CuRe trial. For Emily, it was
a lifeline that they couldn't refuse, even
though it meant temporarily moving to
Sacramento from Austin, Texas, for the
fetal surgery and then for weekly followup
visits during her pregnancy.
Farmer and Wang's team manufacture
clinical-grade stem cells-mesenchymal
stem cells-from placental tissue in the
UC Davis Health's CIRM-funded Institute
for Regenerative Cures. The cells are
known to be among the most promising
type of cells in regenerative medicine.
The lab is a Good Manufacturing Practice
(GMP) Laboratory for safe use in humans.
It is there that they made the stem cell
patch for Emily's fetal surgery.
" It's a four-day process to make the
stem cell patch, " says Priya Kumar,
the scientist at the Center for Surgical
Bioengineering in the Department of
Surgery, who leads the team that creates
the stem cell patches and delivers them to
the operating room. " The time we pull out
the cells, the time we seed on the scaffold,
and the time we deliver is all critical. "
A first in medical history
During Emily's historic procedure,
a 40-person operating and cell preparation
team did the careful dance that
they had been long preparing for. After
Emily was placed under general anesthetic,
a small opening was made in
her uterus, and they floated the fetus
up to that incision point so they could
expose its spine and the spina bifida
defect. The surgeons used a microscope
to carefully begin the repair.
Then the moment of truth: The stem
cell patch was placed directly over the
exposed spinal cord of the fetus. The
fetal surgeons then closed the incision
to allow the tissue to regenerate.
" The placement of the stem cell patch
went off without a hitch. Mother and
fetus did great! " Farmer says. The team
declared the first-of-its-kind surgery
a success.
God, I think she's wiggling her toes!' " says
Farmer. " It was amazing. We kept saying,
'Am I seeing that? Is that real?' "
Both mom and baby are at home and
in good health. Robbie just celebrated
her first birthday. The CuRe team is
cautious about drawing conclusions
and says a lot is still to be learned during
this safety phase of the trial. The team
will continue to monitor Robbie and the
other babies in the trial until they are 6
Surgeons perform
historic procedure in
utero, placing a stem
cell patch on the
fetus's spinal cord.
Delivery day
On Sept. 20, 2021, at 35 weeks and five
days gestation, Robbie was born via
C-section at 5.10 pounds and 19 inches.
" One of my first fears was that I wouldn't
be able to see her, but they brought her
over to me. I got to see her toes wiggle for
the first time. It was so reassuring and
a little bit out of this world, " Emily says.
For Farmer, this day is what she had
long hoped for, and it came with surprises.
If Robbie had remained untreated, she
was expected to be born with leg paralysis.
" It was very clear the minute she was
born that she was kicking her legs and
I remember very clearly saying, 'Oh my
years old, with a key checkup happening
at 30 months to see if they are walking
and potty training.
" This experience has been larger than
life and has exceeded every expectation, "
Emily says. " I hope this trial will enhance
the quality of life for so many patients
to come. We are honored to be part of
history in the making. "
Tricia Tomiyoshi is senior public
information officer at UC Davis Children's
Hospital in Sacramento, California.
Tell your hospital's story. Email
magazine@childrenshospitals.org.
CHILDREN'S HOSPITALS TODAY Spring 2023
7
Children's Hospitals Today - Spring 2023

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