Renowned Children's Hospital Surgeon Lauded by Pediatricians, Surgeons

By Phyllis Brown

Michael Harrison

Renowned fetal surgeon Michael R. Harrison, MD, was honored by two of the nation's most prestigious medical professional organizations last week, the American Academy of Pediatrics and the American College of Surgeons, for his contributions to both fields. Harrison is universally regarded as the founder of the field of fetal surgery and director of the Fetal Treatment Center at UCSF Children's Hospital, the first fetal treatment center in the United States. Hear a podcast with Harrison here. Harrison was presented with the American Academy of Pediatrics' Arnold M. Salzberg Mentorship Award, which recognizes the contributions of a pediatric surgeon who has distinguished himself as a mentor of other pediatric surgeons. He also was honored by the American College of Surgeons with a major address, the I. S. Ravdin Lecture in the Basic Sciences, in which he discussed the past, present and future of fetal surgery. That future could include stem cell therapies for diseases of adulthood, like sickle cell anemia, which would be conducted while the patient was still in utero. The pediatrics award was presented at the annual conference in Atlanta; the surgery recognition occurred at the surgeons' annual clinical congress in Chicago. Harrison said he was exceptionally honored to have received the Salzburg Award because it recognized his work in mentoring what has become the majority of the world's fetal surgeons. "They account for almost all of the surgeons at fetal treatment programs in the world today," he said. "It was an opportunity for me to recognize people with whom I have worked and their accomplishments. I am very proud of all they have achieved." Harrison's own achievements are legendary. In 1981, he performed the first successful fetal surgery using a special device to correct a life-threatening urinary tract obstruction in a fetus. Today, that fetal patient is a 25-year-old. Shortly thereafter, Harrison's team performed the first successful open fetal surgery. His 30-year-long career has dramatically altered the prospects for families of babies with otherwise fatal birth defects that can only be treated in utero, such as urinary tract obstructions and congenital diaphragmatic hernia, a condition in which an opening in the fetus's diaphragm permits the contents of the abdomen to enter the chest cavity. The UCSF Fetal Treatment Center currently is involved in a multicenter, randomized trial comparing repair of spina bifida lesions in the womb with waiting until after birth to make repairs. Promise of Future Therapies Harrison told the audience for the Ravdin Lecture that he believes the past two and a half decades of fetal treatment are only the beginning of a future when fetal therapies will address adult, as well as pediatric conditions. "The future involves moving from surgery to less invasive techniques and applying our beautiful new science to the fetus, with noninvasive prenatal diagnosis and the application of stem cell transplantation," Harrison said. Stem cell transplants could be performed in fetuses before they have developed the ability to reject foreign cells, Harrison said. The fetus would make the new stem cells its own, thereby becoming a "chimera," an individual with two sets of DNA. Sickle cell anemia is caused by defective blood-making stem cells. Fetuses could be provided new stem cells while in utero, eliminating the disease and potentially avoiding the rejection response, he said. Research in fetal medicine may also hold promise for solving the problem of scarring, Harrison said. Scar tissue can cause a variety of medical problems, but it has been noted that when procedures are done early enough in utero, scarring does not occur. In addition to last week's honors, last summer, Harrison was honored by the International Fetal Medicine and Surgical Society (IFMSS), many of whose delegates trained with him and his colleagues at UCSF. Harrison came to UCSF in 1978, and was promoted to associate professor in 1982 and to professor in residence in 1988. He is a professor of surgery, pediatrics, and obstetrics, gynecology and reproductive sciences. Harrison served as division chief in pediatric surgery at UCSF Children's Hospital while also studying the pathophysiology and natural history of a number of life-threatening fetal abnormalities, and developing surgical techniques for treatment of many fetal abnormalities. Related Links: Father of Fetal Surgery Looks Ahead The Fetal Treatment Center at UCSF