Then, in 2005, an echocardiogram showed that while her own heart was functioning normally, the function of the donor heart had become impaired. This was because doctors had needed to reduce Hannah's immunosuppressant drugs to help her fight PTLD, leading to symptoms of rejection of the donor heart. And since her PTLD was seemingly incurable, doctors decided to remove the donor heart so that immunosuppression could be stopped altogether. This was a medical "first".
Surgery to remove the donor heart took place at Great Ormond Street Hospital, London, UK, in February, 2006, just over a decade after the original operation. The surgery team was led by consultant Victor Tsang and Professor Sir Magdi Yacoub. Following surgery, the immunosuppressant drugs were removed altogether, and Hannah has since made a complete recovery from the EBV PTLD.
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The authors say: "Her post-operative course was uncomplicated and the outcome was excellent. Three and a half years after surgery, the patient remains well, in complete remission from her PTLD, and has normal cardiac function."
Professor Yacoub adds: "Apart from the overriding human element in this report, Hannah's case has provided many lessons relevant to biology, transplantation, heart recovery and malignant disease. We all hope that this will stimulate further research and progress in this area."
Tsang adds: ""Hannah's case highlights that in cases of infant 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. This is an important piece of knowledge as we are now gaining more experience with mechanical support for the failing heart in children."
Hannah Clark says: "Thanks to this operation, I've now got a normal life just like all of my friends. I've just done my GCSEs (examinations for a General Certificate of Secondary Education), and I've now got a Saturday job looking after animals, which I couldn't have done before. I'm really glad that I don't have to rely on life-saving drugs anymore."
For full Article, see: http://press.thelancet.com/cardiectfinal.pdf
For diagram (see: http://press.thelancet.com/hannahhearts.jpg
Source: Lancet Press ReleaseBack to HCB News