Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
at Vanderbilt
2200 Children's Way
Nashville, TN 37232


(615) 936-1000

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The Heart Transplant Process

 

When a heart transplant is needed

There are three reasons for heart transplants in children:

  • Children born with normal hearts may develop weakness of the heart muscle (cardiomyopathy) following a viral infection or from other causes.
  • Some children are born with severe problems in their heart structure that are too complex for repair.
  • Children born with abnormal heart structure who have had heart surgery when they are very young can develop weakness of the heart muscle later in life.

Evaluation

The first step is confirming the diagnosis of uncorrectable heart disease. This evaluation may include repeat echocardiograms, cardiac catheterization, blood drawing, and other testing. Doctors then review the medical data to ensure your child has a good chance of surviving the operation and leading an active, independent life. If your child is thought to be a good transplant candidate, our heart team will explain the risks and benefits to you.

Family commitment

A successful heart transplant requires a team effort. You will become important members of the transplant team, along with doctors, nurses, social workers, pharmacists, and others. A heart transplant means a lifetime commitment to follow-up clinic visits, phone contact, and occasional hospital stays.

Our social workers will guide you through the transplant process to ensure your access to all available resources. If you do not live in the Nashville area, a family must relocate for six weeks following the surgery. The Ronald McDonald House frequently provides such accommodations.

Waiting for a donor

Your child is placed on a national waiting list when your family and the transplant team decide on transplantation. Blood type, age, severity of illness, and time on the waiting list all play a role in determining the length of time your child must wait for a donor heart. The average wait for a child at Children’s Hospital (status I at listing) is six weeks. The wait may be considerably longer for an older child who does not require intensive care.

Overall, 82 percent of children on the waiting list at Children’s Hospital have received new hearts and undergone transplantation.

The heart transplantation procedure

After surgery, your child will spend several days in the Pediatric Cardiac Intensive Care Unit. He or she will then move to a private room where we will begin teaching you how to care for your child. Our goal is to have your child ready for discharge 7 to10 days after the operation.

At Children’s Hospital, more than 90 percent of children have survived during, or immediately after, the operation. This is similar to the risk for other operations requiring heart-lung bypass to repair problems inside the heart. If your child is very sick at the time of the operation or has been sick for a very long time, the risk of death may be greater.

Between January 2000 and December 2014, our operative survival rate (from transplantation to 1 month) is 98 percent.

Post-transplant management

Transplantation requires a unique balance between preventing organ rejecting and allowing the body to recognize and fight off infections. Your child will take medicines to maintain this balance for the rest of his or her life. A key to success is frequent monitoring including

  • Examinations by parents at home and by doctors and nurses in clinic
  • Blood work to test medication levels 
  • Echocardiograms to evaluate heart function
  • Occasional biopsies, especially in older children, where special catheters are used to sample heart muscle to look at under the microscope 

The risk of infection and rejection are highest in the first six months, and lessen after one year. Extra medicines can prevent infections during the early months after transplantation. Children undergoing heart transplantation usually do not require steroids commonly used in adults to prevent rejection. They can interfere with normal growth and are avoided when possible.

After heart transplantation, most children grow and develop normally, attend school, and participate in normal childhood activities.


Last Edited: January 20, 2017
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