Outstanding Arabs: Sir Magdi Yacoub

From the Royal Society website...

Sir Magdi Yacoub has performed more transplants than any other surgeon in the world and, as a scientist, his interest in the basic mechanisms of heart structure and function in health and disease has improved transplant surgery and patient care. He retired from the NHS in September 2001, but continues to head his research programme at Harefield Hospital, which he sees as, "treating patients in the future." Why did the society award this fellowship? Magdi Yacoub was born and raised in Cairo where he qualified as a doctor in 1957. He came to Britain in 1962 and since then has made pioneering strides in cardiothoracic surgery. Under his leadership, Harefield Hospital became the countrys leading transplant centre, performing over 200 operations a year. Madgi specialised in working with children with congenital heart defects and performed complex operations on the tiny hearts of babies in their first days of life. In a career spanning over four Decades, Magdi has been involved in a number of firsts. He was involved in the first UK heart transplant, performed the first UK live lobe lung transplant and the first ever domino operation, in which one patient with failing lungs is given a new heart and lungs, with a second patient receiving the first patients fully functioning heart.He has always combined surgical work with scientific research, which he sees it as the key to improving patient care and ultimately eliminating heart disease. He has conducted research looking into organ rejection after transplantation and is working to produce a tissue-engineered aortic heart valve."Operating on patients with heart disease leads you to ask, why did this organ go wrong in the first place and what can we learn about the basic mechanisms of the heart that can help us understand heart failure better," says Magdi. "There is a massive amount of heart disease in this country and elsewhere - we are almost flooded - wouldnt it be great if we could abolish it completely or, at least, reduce the numbers of people affected. My research is driven by the search to find answers to patients problems. The more you look into a problem, like heart failure, the more you find. Heart transplants were regarded as pie in the sky when I started out in medicine. Research is a chance to help treat the patients of the future." How has this work helped society? Magdi Yacoub's work is all about helping people live longer and more fulfilling lives and describes "seeing people who are not well getting so much better" as the most satisfying part of his job. His strong sense of social responsibility led him to establish the Chain of Hope charity, which sends teams of medics to the developing world to treat children suffering from heart disease free of charge. With all the knowledge we have scientifically, we have a responsibility to help," he says. Magdi is personally involved in the charitys missions and had just returned from Mozambique.As well as treating children, the charity works to build up developing countries capacity to do operations and carry out research themselves. It helped to establish Maputo Heart Institute in Mozambique, which is training doctors and investigating how to treat EMS, a neglected heart disease. This disease affects up to 15% of children and young adults and leads to premature death. The charity also brings promising doctors from Mozambique to the UK for further training. Similarly 2 or 3 children from the developing world come to London for operations each month."The charity is called a Chain of Hope, because of the chain of people involved in the work we do - people donating money, people acting as host families for children and people donating their medical expertise," Magdi says.

What current areas of research are being investigated? Magdi's team of 75 scientists are looking at new ways they can improve heart transplantation and repair damaged hearts. One emerging area is stem cell research. Stem cells are the master cells of the body and have the ability to develop into specific kinds of cells, such as heart cells. Magdi hopes that they can be used to help the damaged heart regenerate itself and repair its own function. Currently, his team is creating heart cells in the lab. Clinical trials will be needed before stem cells can be a part of everyday patient care, but nevertheless believes that the future for this technology, "could be near".He is also researching techniques to improve the treatment of valvular heart disease. Valves guard the entrances and exits of the two pumping chambers of the heart and a disease or damaged valve can affect the flow of blood and put extra strain on the heart. Magdi is exploring whether tissue engineering can be used to restore valve function.Some work is also being carried out on xenotransplantation. However, Magdi has reservations about this area. "There are still ethical problems about the risk of introducing new infections, which could be very dangerous to mankind," he says. "There is a type of virus in the genome of the pig that could have a devastating impact if it crossed over to humans." Why did you decide to get involved in the Royal Societys Role Models project? Magdi is chairing a Royal Society project looking at how effective role models are in changing young people's view about science and engineering. The aim of project is to produce best practice guidelines and advice for organizations working in science education."I got involved in this project because Im conscious of the fact there is massive amount of intellect that we need to look after. I know from interacting with young researchers in my own lab, how excited and enthused young people can be about science. This enthusiasm needs to be encouraged as it contributes to the intellectual power in the community."Indeed, Magdi knows first-hand how experiences early in life can make a lasting impression. He decided to become a heart surgeon as a young boy. His father was a general surgeon in Egypt and he was fascinated by the work he did. He was drawn to heart surgery, in particular, after the death of his youngest aunt - who died of mitral stenosis (a narrowing of the heart valve), a correctable heart condition."She was very young, in her twenties, and I was left with the impression that she didnt need to die. This motivated me to become a heart surgeon," he says. Fellowship Sir Magdi was made a Fellow of the Royal Society in 1999. He is currently Chair of the Role Models Project. He was knighted in 1992 by HM Queen Elizabeth II. Professor Yacoub is a Fellow of the Royal College of Surgeons, Licentiate of the Royal College of Physicians and Fellow of the Royal Society of Medicine. He holds honorary degrees from Brunel University, Cardiff University, The University of Loughborough, University of Middlesex and also from the University of Lund in Sweden. He holds honorary posts in Lahore, Pakistan and University of Siena, Italy. He has received many awards and distinctions among which the Clement Prize Thomas Award of the Royal College of Surgeons of England in 1989. In 1999 he was elected a Fellow of The Royal Society and presented with the Lifetime Outstanding Achievement Award in recognition of his contribution to Medicine by the Right Hon. Frank Dobson, MP,Secretary of State for Health. In April 2004 he was presented with a Lifetime Achievement award by the International Society for Heart & Lung Transplantation. A touching story... courtesy of the BBC website 13 April 2006 Heart transplant reversed A young girl has had her donor heart removed and her own heart replaced and restarted in a pioneering operation ten years after her original transplant. Doctors at London's Great Ormond Street Hospital acted after discovering the body of 12-year-old Hannah Clark was rejecting her donor heart. Retired coronary specialist Sir Magdi Yacoub advised the surgeons who removed it and reconnected the dormant heart. Hannah, from Mountain Ash in south Wales, left hospital after five days.

The ground-breaking surgery was carried out on 20 February. Sir Magdi performed Hannah's original heart transplant when she was two.

Heart size doubled

The original operation saved her life because she had cardiomyopathy, which made her heart double the size it should have been and therefore likely to give out within a year.

Experts said a modern approach to the problem would see the enlarged heart removed to rest, while a mechanical heart took over its job temporarily.

Her donor heart worked fine until last November when a routine check-up showed that her body was rejecting it.

Hannah's mother, Elizabeth Clark, said the operation, which had been expected to take at least eight hours, was finished in just four.

The piggy-back heart allowed the patient's own heart to take a rest Professor Peter Weissberg

She said: "They also said she could be in intensive care for weeks, maybe months - they just didn't know because it was the first time it had been done.

"Hannah recovered so well she was able to come home within five days.

"Nobody thought she would be like she is now.

"She is just enjoying her life and is looking forward to going back to school after Easter."

Cancer battle

Following the operation, Hannah no longer needs to take strong anti-rejection drugs she had to take with the donor heart.

She has also battled lymph cancer in recent years but is now in remission following a successful course of chemotherapy in January.

Hannah Clark is looking forward to going back to school

Professor Peter Weissberg, medical director of the British Heart Foundation, described the operation as "an exciting and important event".

He said: "Surgeons have thought for some time that if a heart is failing because of acute inflammation, it might be able to recover if rested.

"This seems to be exactly what has happened in this case.

"The piggy-back heart allowed the patient's own heart to take a rest.

'Surprising result'

"Today the approach would be to implant a mechanical heart, called a ventricular assist device, to take over the work of the inflamed heart in the hope that the heart will recover and the device can be taken out after a few months.

"Ten years ago such devices were not sufficiently reliable, which is why Hannah received a donor heart alongside her own.

"This is a great example of how a pioneering and novel approach to a medical problem can lead to surprising results that tell us a lot about how some heart diseases progress.

"In the past, patients with inflamed hearts either died or were transplanted before their own hearts had any chance of recovery."