British girl's heart heals itself after transplant

By MARIA CHENG, AP Medical Writer

LONDON – 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, Clark — now 16 years old — has 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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Michael Jackson - Human Nature (John Mayer Cover LIVE) - Michael Jackson

Magazine eyes its heyday with relaunch - Saturday Evening Post to return to its roots

This is of particular interest to me, because I worked for The Saturday Evening Post (Curtis Publishing Company) in 1974/1975.



CHALLENGE: Jeff Nilsson oversees the Saturday Evening Post’s archives. The magazine has begun a yearlong effort to digitize its historical content and offer it online. - DARRON CUMMINGS / Associated Press


INDIANAPOLIS -- The Saturday Evening Post, a centuries-old publication that helped make illustrator Norman Rockwell a household name and showcased some of America's greatest writers, is returning to its roots to show readers the value of a quiet read in an increasingly frenetic digital age.

A redesign launching with its July/August issue combines the Post's hallmarks -- art and fiction -- with folksy commentary and health articles. The revamped Post promises a more relaxing option for people who do much of their reading online, or are simply tired of special-interest magazines crammed into tight niches.
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"There is a void of magazines now that do emphasize art and creative writing and fiction," Publisher Joan SerVaas said.

But industry experts say the Post -- which traces its origins to Benjamin Franklin, though it had a hiatus from 1969 to 1971 -- risks alienating its core readers while trying to buck a decades-long shift away from general-interest magazines.

"The Saturday Evening Post is no longer my father's magazine; it's my grandfather's magazine," said Samir A. Husni, who publishes an annual guide to consumer magazines as director of the Magazine Innovation Center at the University of Mississippi.

Although the Post is making concessions to the digital age, through weekly updates to its Web site and a profile on the social-networking site Facebook, Husni said those efforts could shatter the habits of longtime readers without necessarily drawing new ones.

"Reading the magazine from A to Z should be a complete experience (so) that I don't need to go some other place to fulfill that experience," he said.

The magazine, whose circulation peaked at 6 million in 1960, now has 350,000 readers, most of whom are women over 45. That's low compared with the general interest, health and lifestyle magazines with which it competes, such as Prevention, with circulation of 3.3 million, and Guideposts, at 2 million.

Maureen Mercho, chief operating officer for the Post, said ad sales had dropped because of the recession, prompting the magazine to look for ways to broaden its base. "That probably pushed us" to do the redesign, she said.

Post officials also hope that by mixing the magazine's popular art and health features with such content as commentary by former CBS News "Sunday Morning" host Charles Osgood, poetry by Ray Bradbury and fiction by John Hemingway, grandson of Ernest Hemingway, the magazine could boost circulation to 500,000 in the coming years.

Mercho said some people are surprised that the Post still exists. She suspects that's because the magazine is primarily available only to subscribers; fewer than 5,000 copies an issue are sold on newsstands. But she believes the relaunch will increase awareness of the magazine.

To complement the magazine, the Post has relaunched its Web site, offering new posts each Saturday evening -- naturally -- with retrospective, art, blogs, health coverage and other content.


LONG HISTORY: This Dec. 19, 1899 edition of The Saturday Evening Post is shown in the magazine’s office in Indianapolis. The publication was founded as the Pennsylvania Gazette in 1728 by Benjamin Franklin. The name was changed to The Saturday Evening Post in 1821. - DARRON CUMMINGS / Associated Press

America's love affair with the Post and its predecessor date to 1728, when Benjamin Franklin founded the Pennsylvania Gazette in Philadelphia. New owners changed the publication's name to The Saturday Evening Post in 1821, but it remained a newspaper for decades.

By the 1870s, the content had shifted toward entertainment, with fiction on the front page. The page count began creeping up as the Post became a true magazine with more advertising, human interest features, fiction, poetry and cartoons.

George Horace Lorimer, who became editor in 1899, made the cover into an artists' showcase, featuring J.C. Leyendecker, N.C. Wyeth and others. In 1916, the Post began a nearly 50-year relationship with Norman Rockwell, whose cover work became a hallmark of the magazine.

But mass-market magazines suffered as reading habits changed, more people watched television and specialty publications became popular, Husni said.

The Post ceased publication in 1969, crumpling under financial pressure the TV-print war placed on parent Curtis Publishing. SerVaas' father, Beurt, revived the magazine in 1971 as a quarterly publication after Rockwell announced on television that Beurt SerVaas was considering bringing back the Post, generating broad interest.

The magazine, now published six times a year, has been in the family since, with Joan SerVaas becoming publisher in 2007. It is now owned by a not-for-profit group set up by the SerVaas family that also owns children's magazines Jack and Jill, Humpty Dumpty and Turtle.

http://www.indystar.com/article/20090705/LOCAL/907050381

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