Girl With Two Hearts Heals Spontaneously

July 14, 2009— -- A British teen who survived a dire heart condition as an infant, thanks to transplant surgery that gave her two hearts, has made a "magic" recovery, her doctor said.

A decade after her first heart transplant and years after surviving bouts of cancer, Hannah Clark's fledgling heart healed itself. Clark, 16, recovered so well, that doctors risked reversing her heart transplant in 2006 to save her from Epstein-Barr-virus-associated post-transplant lymphoproliferative disorder. Her surgeons report today in the online version of the journal Lancet that Clark is living cancer-free with her original heart alone.

"The possibility of recovery of the heart is just like magic," said Dr. Sir Magdi Yacoub, who was the lead surgeon in Clark's first transplant.

"The heart, which was not contracting at all at the time, we put the new heart to be pumping next to it and take its work, now is functioning normally," said Yacoub, who worked with Dr. Victor Tsang to remove the same transplant 10 years later.

Clark quietly sat through a news conference Monday while tears welled in her eyes. But she had to leave the room at one point, as doctors discussed the years she lived on immunosuppressant drugs while fighting cancer.

Yacoub and leading cardiologists say Clark's remarkable recovery will influence future research into heart transplants and research for artificial hearts, which now help many people suffering from Clark's condition.

Clark of Cardiff Wales was 8 months old when she was rushed to Harefield Hospital in Middlesex, U.K., with heart failure from cardiomyopathy -- a condition marked by enlarged or inflamed heart tissue that can slow blood flow through the heart, cause blood clots and lead to heart failure.

At 11 months, Clark underwent a heart transplant to save her life. Yacoub grafted a donor heart onto the weak side of Clark's heart. By age 4, doctors noticed both hearts were functioning normally. Somehow, the extra help had allowed Clark's weakened heart to heal.

Recovery of Girl With Two Hearts May Lead to Medical Advances

Dr. Douglas P. Zipes, editor-in-chief of the journal HeartRhythm, said the transplant "allowed the heart to 'rest' and recover."

But Zipes said doctors still need to research exactly how this happened, to help future patients with heart troubles.

"[Doctors need] to find the mechanism by which the heart repairs itself and then use it," said Zipes, who is also a professor at the Indiana University School of Medicine in Indianapolis.

"That's the whole key: regenerative powers of the heart," he said.

Years ago, he said, doctors thought the heart was an "end-stage organ" and that, if a cell died, there was no hope for regrowth, aside from scar tissue.

But Zipes said researchers have now observed the heart's ability to regenerate. Patients have also experienced a regeneration of heart tissue through medical devices that support pumping, such as the Left Ventricular Assist Device (LVADs) -- a therapy more commonly used in the United States than secondary heart transplants -- and CRT, or cardiac resynchronization therapy. to help reset a faulty electrical problem in the heart.

"The next steps are, 'How does it do this and how can we capitalize on this process,'" Zipes said.

Researchers at Cedars-Sinai Medical Center in Los Angeles are trying to harvest heart-stem cells from adult patients with heart problems, grow them in a petri dish and infuse them back into the adult patient to get the heart to grow.

Although Clark's heart had recovered with the help of the transplant before she started kindergarten, her struggle was far from over. Doctors did not want to risk surgery to remove the grafted heart.

But to keep her donor heart, she needed to take powerful immunosuppressant drugs. For years, the drugs were saving her second heart but they also put her at risk for Epstein-Barr-virus-associated post-transplant lymphoproliferative disorder.

"There are obviously side effects in all drugs, but this is the chance you've got to take," Clark's father, Paul Clark said at the news conference. "You do anything to keep them alive really."

By age 8, Clark was in a long cancer battle. She'd beaten the cancer only to fall back into remission again. Finally, doctors made the unprecedented decision to take Clark off the immunosuppressant drugs and just remove the donor heart.

Three years later, Clark seems to have finally beaten the cancer, and she's living medication free, able to go "swimming and shopping."

At the moment, Clark's debating a career in a hospital.

"I think I want to work with animals or with children in a hospital," she said at Monday's news conference, "even though I've been there all my life."