Girl's Heart Regenerates With Artificial Assist

Socguy writes with news about a 15-year-old girl who has become the first Canadian to have an artificial heart removed after her own heart healed itself. "Doctors at the Stollery Children's hospital implanted the Berlin Heart, a portable mechanical device that keeps blood pumping in an ailing heart, so she could survive until a transplant became available. But over the next few months, Melissa's overall condition improved dramatically, and her heart muscle regained much of its strength. After 146 days on the Berlin Heart, Melissa underwent surgery to have the device removed."

She isn't the only one...

[MacDork]

A 13 year old boy recovered [timesonline.co.uk] without a transplant with the help of one of these things as well.

Re:I want to know why she healed - what caused it

[arivanov]

Her heart just needed a rest until it heals. There were a few cases here in the UK as well and implanting a parallel pump to assist is now considered a standard procedure in many cases where the transplant was the only option. Especially in kids and especially in cases where the heart has been damaged by inflammation. It is a safe bet really - if it heals good, if it does not the patient has a much better chance to survive until a suitable transplant is found. It is a pity that most pumps can take load only off some portions of the heart and not all of it (too much blood in the coffee subsystem to remember which).

Common occurence : apparentely 1 in 3 child recove

[aepervius]

Quote from the article you cited :

As one in three children recover from myocarditis on their own, the medics decided to wait and see if Jack's own heart could grow strong enough to work on its own without the need for a transplant.

Re:is this that special?

[compro01]

or is it only under certain conditions that weren't met this time?

presumablely her heart just needed a reduction in workload to allow it to heal, so they used this neat gadget to temporarily assist it until it was fully functional again.

Re:is this that special?

[myc]

actually, the human heart has very poor healing capacity. This is why ischemic heart disease eventually kills you; your damaged heart heals by scarring, which leads to decreased cardiac output and eventually apoptotic or necrotic cell death of cardiomyocytes.

IANAHRBMWI (I am not a heart researcher but my wife is)

Sorry to piggyback your post

[Anonymous Coward]

Better article [edmontonsun.com] with quotes and a picture of her and the Berlin Heart.

Re:Sometimes...

[mgv]

I'll second that. In addition, without a transplant, she stands a decent chance of living a long full life. Transplant patients don't last that long, on average.

I think that you are being a bit harsh there.

Survival figures vary - overall in the USA the five-year survival [americanheart.org] rate is 71.2 percent for males and 66.9 percent for females. Its better than that in some units. This person's survival after a transplant would be alot higher than this as young people do better on average than older recipiants.

Over 2/3 alive at 5 years, and actually pretty similar at 10 years - bearing in mind that most of bad outcomes are in the first year, and that this is all causes of death, including deaths that were unrelated to the transplant.

The main bad thing about heart transplants is not getting enough hearts.

Having said this, you will see a significant number of people who do not require transplantation due to spontaneous recovery of function.

They still require two major operations - the VAD insertion and the VAD removal - so its not exactly a walk in the park.

And the VAD's such as this can have quite significant complications. The are good but not necessarily the only solution.

Michael

Re:Acute illness

[eam]

Congratulations. You managed to guess the truth. It might have been easier to just read the article, but you managed to figure out what was going on anyway.

The second sentence in the article:

"Melissa Mills arrived at Edmonton's Stollery Children's Hospital last year after a sudden illness made her critically ill and a candidate for a heart transplant."

It wouldn't be slashdot if people didn't ask questions that were answered by the article ;-)

Re:I want to know why she healed - what caused it

[MMC Monster]

It's not that the heart "healed". What happens after a serious injury to the heart (whether a heart attack, viral infection, or anything else), is that the heart becomes weaker and tries to adapt. Things that physicians do to help the heart adapt in the right way (as opposed to the wrong way) include assist devices that will pump the blood forward. These include artificial hearts, left ventricular and biventricular assist devices, and intra-aortic balloon pumps. Other things that help people along are medications that help the heart rest and prevent the maladaptation that the heart will do on it's own if left to it's own means (the maladaptation is known as negative remodelling).

Given enough time, the heart may beat more effectively. I know a number of people whos hearts are pumping out less than 10 percent of the blood that enters it (normal is to pump out ~60 percent). Some of these people are crippled and await heart transplantation. A few, however, are out chasing the girls (and boys), and you wouldn't have any idea that they had a medical problem until you saw the number of medications that they take to stay well.

Re:Let forth...

[Lord Pillage]

See the original press release here [capitalhealth.ca].

Livers as well as hearts

[EdwinFreed]

There was a story a couple of years ago about a clinical trial at Cedars Sinai of an artificial liver developed by Dr. Achilles A. Demetriou. The device uses a bioreactor containing cells from pig livers The people they tried this on were all in end-stage liver failure and about to die. The idea was to tide them over until a transplant became available.

A couple of them died from the effects of the surgery. Some others lasted long enough to finally get a transplant. But in several others their own livers managed to regenerate to the point where a transplant was no longer needed.

This led to a bigger study at 20 US research centers. The results were that artificial liver reduced mortality by 44 percent:

http://www.innovations-report.de/html/berichte/med izin_gesundheit/bericht-28316.html [innovations-report.de]

Re:I wish they had given my Rachel one...

[Anonymous Coward]

If you go to the Berlin Heart website, they explicitly tell you that none of their products are FDA approved.

Damned paper-pushing fuck-tards.

I really feel bad for you, OP. And that's like the understatement of the year.

Needless to say, the lesson here to any americans should be, If you're having a serious heart condition, GO TO CANADA.

OK, I doubt it

[Hoi Polloi]

Heart cells are a specialized form of muscle cell, not smooth muscle cells. According to your article they think they are seeing stem cells reproducing, not cardiac muscle cells.

The next challenge, according to Anversa, is to find the source of the dividing myoctyes. "Are these cells a sub-population of known cells that retain the capacity to divide, or are they multiplying cells that originate from stem cells present in the heart?" he asks.

"There are preliminary indications that primitive cells like stem cells exist in the human heart. Stem cells may have the ability to develop into the various cardiac cell types and form new healthy functioning myocardium. If we can prove the existence of cardiac stem cells and make these cells migrate to the region of tissue damage, we could conceivably improve the repair of damaged heart muscle and reduce heart failure," says Anversa.

Cardiac muscle cells, however, do not reproduce after a certain point: [hhmi.org]

Not all cells from multicellular organisms are still able to divide, though. Once the heart is full sized, the heart cells in a human body do not divide anymore. They no longer have that ability. When a person has a heart attack and some heart cells die, the heart is permanently damaged the heart can't just replace those dead cells.

According to Doris Taylor (Departments of Medicine and Surgery at Duke University Medical Center. She did post-doctoral work in cardiac (heart) molecular biology at Albert Einstein College of Medicine in New York.)

The heart cannot repair the damaged muscle because its muscle cells cannot reproduce, Doris explains. You are born with all the heart cells you will ever have. Your heart grows because the cells become larger, not because they multiply. However, other muscles do have the ability to repair themselves because they contain cells called myoblasts, which can reproduce.

Re:I want to know why she healed - what caused it

[Hoi Polloi]

They've only seen reproduction in neural stem cells and glial cells. Neurons lack centrioles [cancer.gov] so they cannot reproduce. There is evidence of neural stem cells reproducing in the hippocampus and olfactory areas. [jneurosci.org]

Re:Sometimes...

[sjames]

Furthermore, with a transplant, she would be required to take anti-rejection medication for life and would suffer many more illnesses as a result.

Compared to death or a short bedridden life, a transplant is a great option. However, where feasible, a temporary VAD and recovery of the original heart is much better.

There is a form of heart transplant where the new heart is connected in parallel with the original. The procedure is more complex but offers better survival should rejection occur. I'm not sure how it does for survival in general vs. a full replacment.