This week–

IN A transplant operation never

before performed in the west, a

woman has received a new ovary

donated by her sister. While the

surgeon responsible claims this

holds out hope for women without

functioning ovaries, others say

the procedure is dangerous and

unnecessary. The woman could have

got pregnant using a donor egg and

her husband’s sperm, and had any

premature menopause postponed by

hormone treatments, the critics say.

Sherman Silber removed an

ovary from Maeapple Chaney and

transplanted it into her sister,

Joy Lagos, at St Luke’s Hospital in

St Louis, Missouri, on 5 February. All

Lagos’s eggs had been destroyed

when she was given chemotherapy

treatment for cancer three years ago.

In 2002 surgeons at China’s

Zhejiang Medical Science University

reported a whole-ovary transplant

between sisters, though the

transplant was never documented in

the scientific literature and its long-

term success is not known. Since

2004, Silber has transferred grafts of

ovarian tissue between seven sets of

identical twins, resulting in at least

one live birth from the transplanted

graft (New Scientist, 23 October

2004, p 12). These grafts usually

only produce eggs and reproductive

hormones for a few years, Silber says.

He believes that transplanted

whole ovaries may be able to work

for as long as a woman’s own

ovaries, while transplanting a whole

ovary may also make it less likely to

be rejected than a graft, because it is

less prone to inflammation. This

could widen the range of possible

donors to at least include close

relatives, and not just twins, he says.

However, fertility specialists have

questioned Silber’s claims that the

ovary would be less likely to be

rejected than a graft and say it is too

soon to judge whether his latest

operation has been successful. “The

patient could reject the ovary at any

time. The ovary could clot next

week,” says Tommaso Falcone of

the obstetrics and gynaecology

department at the Cleveland Clinic in

Ohio. “We just don’t know the long-

term consequences.” Phil McKenna ●

Is whole-ovary

transplant a cure

or risky gamble?

INDONESIA has launched a high-

stakes bid to ensure it gets a

vaccine against pandemic flu. Last

week, David Heymann, the man

in charge of pandemic flu at

the World Health Organization,

revealed that Indonesia – current

epicentre of H5N1 flu outbreaks –

has refused to send WHO labs any

samples of H5N1 virus since the

start of the year. Its complaint:

the samples are used to make

commercial vaccines from which

the country will get nothing.

Indonesia’s challenge has

worried flu experts. Unless

Indonesian viruses are sequenced

abroad, scientists cannot track the

evolution of the virus in the very

country where an H5N1 pandemic

now seems most likely to emerge.

The WHO has been in talks with

the Indonesian government since

last November trying to settle the

dispute, and this week flu experts

will meet in Geneva to discuss the

issue further.

But the Indonesians may

have already found their own

solution: last week they signed an

agreement with US vaccine maker

Baxter, based near Chicago. A

Baxter spokesman refused to

divulge details, but reports

suggest that researchers will have

free access to Indonesian H5N1,

while Baxter will hold the sole

commercial rights – in return for

helping to build Indonesian

vaccine plants.

It is widely expected that

if a serious pandemic strikes,

countries with vaccine plants will

commandeer vaccine for their

own citizens. Indonesia’s move

seems calculated to ensure its

own supply.

It is not the only country

worried about missing out. “We

are sending out our virus to

rich countries to produce

vaccines,” Thai delegate Suwit

Wibulpolprasert told the WHO

executive board in December.

“And when the pandemic occurs,

they survive and we die.” He

said countries should share viral

samples only if they get any

resulting vaccines in return.

The roots of the crisis go back

decades. Every year countries

donate samples of ordinary flu to

the WHO so that manufacturers

can update vaccines. Developing

countries have previously given

away viruses for vaccines used

mainly in rich countries as “they

never had much demand for flu

vaccine”, says Heymann.

That changed with the threat

of a pandemic. Early last year

the Indonesian government

warned that it would share virus

samples for research but not for

commercial use. Such concerns

from Indonesia and other

countries with H5N1, such as

China, led the WHO to limit access

to its global database of H5N1

genetic sequences to a coterie of

15 labs.

After global protests from

scientists, Indonesia and other

countries agreed last August

to permit public access to their

sequences for research. Then in

January the Australian vaccine

manufacturer CSL, based in

Melbourne, announced it

had submitted for regulatory

approval an H5N1 vaccine based

on Indonesian H5N1 that it would

make for the Australian stockpile.

Indonesian health minister

Siti Fadilah Supari protested that

she had not given permission for

this, and that Indonesia would

seek legal action. CSL claims

it got the virus from the WHO

legitimately. “We have the virus,

we are getting sick, then they take

the virus from the WHO and make

[vaccine for] themselves,” says

Supari. Debora MacKenzie ●

8 | NewScientist | 17 February 2007 www.newscientist.com

“The hope is that transplanted

whole ovaries may be

able to work for as long as a

woman’s own ovaries”

–Time for some give as well as take–

Poor countries hold out for bird flu vaccine

SUPR

I/R

EUTE

RS