A Boy With Two Heart Transplants : Team Effort Helps 10-Year-Old in a Desperate Struggle

Ten months ago Leonard Pattnett, a healthy 10-year-old who loved playing ball and going camping, had no inkling that he was about to undergo two heart transplants in desperate attempts to save his life.

But by spring, doctors at Childrens Hospital of Los Angeles decided Leonard had just one chance to live anything near a normal functional life: a heart transplant. On May 14, in surgery at Stanford Medical Center at Palo Alto, he received a donor heart. A few weeks later his body rejected it.

On July 1 the Stanford doctors tried again, transplanting a second heart they hoped might be better matched to Leonard in size, age and tissue. All seemed well and his mother, Earline Carr, was looking forward to bringing Leonard home to Los Angeles.

Then he was found to be rejecting the new heart, too.

“We were ready to come home when all of a sudden the doctors found the second heart was rejecting,” Carr said from Palo Alto. “He was readmitted Aug. 31 and given medication, the same medication he had received just before his surgery, for three days. Then they put him on another medication and they seem to have found one that is working now.

‘Coming Home Soon’

“His biopsy is clear. He is still on medication, but we should be coming home soon, the end of September or before.”

With Leonard’s release Sept. 13 from Stanford Children’s, that dream seems to be coming true, although he remains in Palo Alto so doctors can monitor his progress.

That’s good news to Leonard and his family, which includes two sisters, a brother and his grandfather, in addition to his mother--and to the team of professionals at Childrens Hospital of Los Angeles that has cared for the boy and become a sort of Leonard Pattnett cheering section.

On his return Leonard will see Dr. Barry Marcus, a cardiologist at Childrens of Los Angeles, where Leonard was hospitalized the beginning of last February.

In an interview in May, Marcus explained that Leonard never recovered fully from a bout late last November with what appeared to be the flu. Some such viruses can lead to heart problems for a minuscule few--”a fraction of a fraction of a fraction of patients,” the physician said.

A biopsy of the internal lining of the heart confirmed the diagnosis that Leonard had a dilated heart and cardiomyopathy that failed to respond to medication: “The damage to the heart was permanent,” Marcus said.

Doctors recommended a heart transplant. “A transplant was his last chance for a functionally normal existence,” Marcus said.

Since heart transplants are not performed at Childrens Hospital, Earline Carr chose to take her son to Stanford University Medical Center, where Leonard became the 392nd heart transplant recipient and the third of four child patients to undergo such surgeries there this year. She praised Dr. Vaughn Starnes, chief of transplant service and a cardiovascular surgeon at Stanford Children’s Hospital, as “a quite human” person for his care of Leonard, as well as the nursing staff in the heart care unit.

Shy, Retiring Child

But she will be glad to have Leonard back under the care of Marcus and the cardiac nurses at Childrens of Los Angeles. A shy, retiring child (“He doesn’t talk until he gets to know people,” Carr said), Leonard is more comfortable among those he knows, and the cardiology staff at Childrens have become his friends.

Barry Marcus, too, said he’ll be delighted to see Leonard again.

“He is a very mature young man for his age, kind of shy,” Marcus said. “But our nursing staff was phenomenal with him, an example of how nursing care is just that, nursing care. Two nurses especially, Lori Stern and Wendy Morse, became his special friends and took him to the zoo on their afternoons off and went to his birthday party (for which he was allowed to go home briefly) when he turned 11.”

Much of the Leonard Pattnett story centers around the team effort to save his life.

Obvious, of course, are the medically skilled cardiologists, surgeons and nurses who labored desperately to diagnose and treat him.

But others are deeply concerned, notably Beverly Daley, a Childrens Hospital social worker who helped Carr with the gamut of problems that arise when a family member becomes seriously ill and who has stayed in touch with her during Leonard’s months at Stanford.

Daley explained that Leonard’s family includes Heidi, 18, and Houston Carr, 15, his mother’s children by a previous marriage, and a sister, Denise Pattnett, 8. Carr’s father, the children’s grandfather, also is especially close to Leonard. They are a loving and supportive family, a key element, Marcus said, in the decision for a heart transplant.

Emotional Interaction

“The network of family support is superb,” Marcus said. “That is important. All patients have an emotional response that interacts with the physical.”

While Earline Carr, a single mother in South-Central Los Angeles, found her children an emotional bolster, they at the same time posed problems. They needed care and supervision while she worked as a medical assistant for a product group in Inglewood and during the time she spent with Leonard, whom she visited daily at Childrens Hospital.

When Leonard went to Stanford for surgery, she had to quit her job to be with her son, compounding an already difficult financial situation. As medical expenses increased, so did costs--transportation to Palo Alto, living expenses there (kept to a minimum by staying at the Ronald McDonald House near Stanford Children’s Hospital) for Carr and for Houston and Denise, who joined her during the summer.

With the help of Daley, Carr has been able to get financial aid for Leonard’s medical costs through California Children’s Services, Medi-Cal and the American Heart Assn.

Support Group

Between $2,500 and $3,000 in contributions to Leonard have been forwarded by the Parents Heart Assn., a support group for families of children with heart problems that is composed largely of parents of Childrens Hospital patients, to assist Carr with living expenses, according to David Michels, president of the parents’ group.

Michels also put Carr in touch with people in the Bay Area who contacted her and offered their help during Leonard’s surgery and recovery. Those who wish to assist through donations should earmark them for Leonard Pattnett and send them to the Parents Heart Assn., P. O. Box 54700, Los Angeles, Calif. 90054-0700, Michels said.

Money remains a problem for Carr, who cannot return to work yet and who has had troubles with her car. She is working, however, with the Los Angeles District Attorney’s office to obtain child support from Leonard’s father.

But Carr is a mother determined to do everything possible to restore her son to health.

“It is tough financially,” she said, “but so far we’re surviving. I have no choice. It’s kind of scary. . . . But we have a lot to be thankful for.”