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The rare tale of the piggy-back heart

Tom Feilden | 11:33 UK time, Tuesday, 14 July 2009

Pick up almost any paper today and you'll see the shyly smiling face of Hannah Clark beaming back at you. (See the Sun, the Daily Mail and the Independent) And it's no wonder. Hannah's tale is that very rare thing: an unalloyed good news story.

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Born with cardiomyopathy, a relatively rare condition which effects the muscle of the heart, Hannah's prognosis was poor to say the least. Her only real hope was for a heart transplant, and in 1995 aged just 2, that's what happened.

Hannah ClarkeBut as the Lancet reports in its online edition this week this was no ordinary heart transplant operation.

In a revolutionary new procedure nicknamed "piggy-backing", the team - lead by pioneering heart surgeon Sir Magdi Yacoub - grafted the donor organ onto Hannah's own heart, so that it took over much of the function of circulating blood around her body.

That gave Hannah's heart some respite, and the chance to slowly recover from its diseased state.

Ten years later Sir Magdi came out of retirement to oversee a second - reverse - transplant operation to remove the donated heart.

The problem with all transplant operations is the issue of immune rejection - the patient's own natural defences identifying the transplanted organ as alien, and attempting to destroy it. Hannah could have had a conventional heart transplant, but that would have condemned her to a lifetime on immuno-suppressant drugs and all the consequential illness that goes with it.

As it was Hannah was very ill for much of the time her donor heart was in place. She had problems with her lungs and spinal chord, and suffered from a particular form of cancer associated with transplant patients known as Epstein Barr Virus or EBV.

Illustration of the "piggy-back" donor heartGiven her age, Sir Magdi wanted to give Hannah the chance of a normal life. Implanting a donor heart to take the pressure off her own while it recovered, and then removing it at a later date, offered that possibility.

The benefits of that far-sighted decision were only too clear in the bashful, giggling - but healthy - 16-year-old who came into the studio this morning.


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