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Kuan · #1 07-14-2009, 10:37 AM

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090714/transplant_090714/20090714?hub=Health

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U.K. girl's heart heals after donor heart removed

Updated Tue. Jul. 14 2009 8:31 AM ET

CTV.ca News Staff

A British girl who had a donor heart directly implanted onto her own failing heart has become the world's first heart transplant patient to make a full recovery after having her donor organ removed.

For 10 years, Hannah Clark lived with two hearts. Her own heart had begun to fail when she was two years old and doctors had put her on a waiting list to get a new heart.

Clark's heart difficulties worsened while she waited and caused her lungs to start to fail, meaning she also needed a lung transplant.

To avoid a risky heart and lung transplant, doctors decided to try something different. Sir Magdi Yacoub of Imperial College London suspected that if Clark's heart were only allowed to "rest' for a while, it might be able to recover. So in 1995, Yacoub and a surgical team grafted a donor heart from a five-month-old directly onto Clark's own heart.

For four and a half years, she did well with two parallel hearts pumping her blood. But then Clark developed another life-threatening emergency: the powerful immunosuppressive drugs she was taking to prevent her from rejecting the donor heart allowed cancer to develop.

A type of cancer that sometimes affects transplant patients, called Epstein-Barr-virus-associated post-transplant lymphoproliferative disorder (EBV PTLD), had become serious.

Even when doctors lowered the doses of drugs to suppress Clark's immune system and put Clark on chemotherapy, the cancer spread.

Clark's body eventually rejected the donor heart. So in 2006, surgeons stopped the immunosuppressive drugs and removed the donor organ -- something that had never been done before.

Doctors were pleased to find that Clark's own heart had recovered enough that it could do the job of pumping her blood on its own.

Not long after, Clark made a full recovery from the cancer. Now 16, she has started playing sports, has a part-time job working with animals, 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," Clark told reporters Monday, between tears of joy.

Clark's heart surgery team, who report the case in this week's Lancet medical journal, say her remarkable recovery is proof that the heart can heal itself - something that many experts had thought impossible.

"Now we are a lot more confident (about this procedure)," Yacoub told reporters. "The heart muscle itself, which was not doing anything at all, has recovered."

Victor Tsang from Great Ormond Street Hospital, who was the other surgery team leader, said Clarke's case offered hope for other patients with heart failure.

"Hannah's case highlights that in cases of cardiomyopathy such as hers, it is possible for the patient's own heart to make a full recovery if it is given adequate support to do so," Tsang told reporters.

Doctors hope to figure out exactly how Clark's heart healed itself, in hopes of developing new treatments from the mechanism.

Doctors note that cases like Clark's are rare and similar surgeries can't be made widely available to others because a shortage of donor hearts and the complicated surgeries involved. As well, since Clark's first surgery 14 years ago, artificial hearts have become more widely used in cases of heart failure.

Those devices can buy patients the time needed to get a transplant or, rarely, for their own heart to recover.