British girl's heart heals itself after transplant
<http://www.breitbart.com/article.php?id=D99DTTT00&show_article=1>http://www.breitbart.com/article.php?id=D99DTTT00&show_article=1
 

Jul 13 09:27 PM US/Eastern
By MARIA CHENG
AP Medical Writer

LONDON (AP) - British doctors designed a radical 
solution to save a girl with major heart problems 
in 1995: they implanted a donor heart directly onto her own failing heart.

After 10 years with two blood pumping organs, 
Hannah Clark's faulty one did what many experts 
had thought impossible: it healed itself enough 
so that doctors could remove the donated heart.

But she also had a price to pay: the drugs Clark 
took to prevent her body from rejecting the 
donated heart led to malignant cancer that required chemotherapy.

Details of Clark's revolutionary transplant and 
follow-up care were published online Tuesday in the medical journal Lancet.

"This shows that the heart can indeed repair 
itself if given the opportunity," said Dr. 
Douglas Zipes, a past president of the American 
College of Cardiology. Zipes was not linked to 
Clark's treatment or to the Lancet paper. "The 
heart apparently has major regenerative powers, 
and it is now key to find out how they work."

In 1994, when Clark was eight months old, she 
developed severe heart failure and doctors put 
her on a waiting list to get a new heart. But 
Clark's heart difficulties caused problems with 
her lungs, meaning she also needed a lung transplant.

To avoid doing a risky heart and lung transplant, 
doctors decided to try something completely different.

Sir Magdi Yacoub of Imperial College London, one 
of the world's top heart surgeons, said that if 
Clark's heart was given a time-out, it might be 
able to recover on its own. So in 1995 Yacoub and 
others grafted a donor heart from a 5-month-old 
directly onto Clark's own heart.

After four and a half years, both hearts were 
working fine, so Yacoub and colleagues decided 
not to take out the extra heart.

The powerful drugs Clark was taking to prevent 
her from rejecting the donor heart then caused 
cancer, which led to chemotherapy. Even when 
doctors lowered the doses of drugs to suppress 
Clark's immune system, the cancer spread, and 
Clark's body eventually rejected the donor heart.

Luckily, by that time, Clark's own heart seemed 
to have fully recovered. In February 2006, Dr. 
Victor Tsang of Great Ormond Street Hospital in 
London, Yacoub and other doctors removed Clark's donor heart.

Since then, Clark­now 16 years old­has started 
playing sports, gotten a part-time job, and plans 
to go back to school in September.

"Thanks to this operation, I've now got a normal 
life just like all of my friends," said Clark, who lives near Cardiff.

Her parents marveled at her recovery, and said 
that at one point during Clark's illness, they 
were told she would be dead within 12 hours.

Miguel Uva, chairman of the European Society of 
Cardiology's group on cardiovascular surgery, 
called Clark's case "a miracle," adding that it 
was rare for patients' hearts to simply get better on their own.

"We have no way of knowing which patients will 
recover and which ones won't," Uva said.

Still, transplants like Clark's won't be widely 
available to others due to a shortage of donor 
hearts and because the necessary surgeries are 
very complicated. In the last few years, 
artificial hearts also have been developed that 
can buy patients the time needed to get a 
transplant or even for their own heart to recover.

Zipes said if doctors can figure out how Clark's 
heart healed itself and develop a treatment from 
that mechanism, many other cardiac patients could benefit.

At the moment, doctors aren't sure how that 
regeneration happens. Some think there are a 
small number of stem cells in the heart, which 
may somehow be triggered in crisis situations to heal damaged tissue.

Experts said Clark's example is encouraging both to doctors and patients.

"It reminds us that not all heart failure is 
lethal," said Dr. Ileana Pina, a heart failure 
expert at Case Western Reserve University and 
spokeswoman for the American Heart Association. 
"Some heart failure patients have a greater 
chance of recovery than we thought."

___

On the Net:

http://www.lancet.com

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