A heart transplant improves the length and quality of life of children whose own hearts have failed. At the University of Michigan Pediatric Heart Transplant Program, we have performed more than 200 pediatric heart transplants since the program's beginning in 1984, and report low organ rejection and high patient survival rates that rank among the world's best. Our dedicated, multidisciplinary team of pediatric cardiac transplant surgeons and transplant cardiologists provides coordinated and comprehensive evaluation, treatment and follow-up for children from newborn to 18 years old and our active research program means our patients have access to the newest treatments available.
The two most common reasons a child may require a heart transplant are:
- Congenital heart defect (existed at birth)
- Cardiomyopathy (acquired heart muscle disease)
We specialize in treating complex congenital heart disease, so kids can avoid heart transplants whenever possible. Our center also offers many unique treatment options for children with heart disease that can delay the need for a heart transplant and/or prolong life while waiting for a donor heart:
- Oral heart failure medications
- Intravenous inotropes – medical therapy to make the heart beat more strongly
- Assist device – a blood pump, which assists the heart with pumping blood to the body. In some cases, the device is portable and can be operated on batteries, so children can live at home.
Nutrition therapy is a key component of the Pediatric Heart Transplant Program, getting children nutritionally stable so they are ready for transplant sooner and to avoid complications following transplant. Formulas, vitamins and feeding tubes are some of the options our dedicated nutritionists use to get kids the nutrition they require.
Education and family involvement are very important to the success of our program. Education and support are provided before, during and after the transplant for children and their families, utilizing our Child Life services and Pediatric Transplant Psychologists, to ease anxiety, answer questions and help kids feel in control of their treatment plan. We also view each child and family as collaborating members of our team, which includes social workers, dieticians, transplant coordinators, nurse practitioners, physicians, surgeons, living donor advocates, financial coordinators, pharmacists and the clinical research team.
We Transplant People Other Centers Can’t
To be considered for a heart transplant, a child’s heart must be unresponsive to other forms of treatment and all other vital organs must be in excellent health. Many centers will turn down a child whose kidneys aren’t working optimally or who has liver disease. Our center, however, offers multiple transplant listings, and can perform combination transplants such as heart/kidney or heart/liver.
The Transplant Process
Candidates for heart transplant require a comprehensive evaluation. The process includes patient education, medical records review, patient examination and often additional medical testing. The case is then reviewed by our multidisciplinary transplant team and a decision about the child’s suitability for an organ is made.
Since routine medical care must be up-to-date prior to transplantation, it’s recommended that children are current with their routine health care prior to their evaluations. Examples of routine health care include dental exams and cleaning, immunizations (including PPD, pneumovax, and influenza vaccine).
At the follow-up evaluation, the child and family meets with several members of the pediatric transplant team, including a transplant coordinator, cardiologists, transplant surgeon, social worker and a nurse educator. The evaluation appointment involves a variety of tests, such as blood tests and a chest x-ray. Each child and/or family must attend the patient education class on transplantation.
Children who are eligible for a heart transplant are placed on a waiting list for a donor heart. This waiting list is part of a national allocation system for donor organs run by the Organ Procurement and Transplantation Network. For the transplant surgery, a bypass machine is hooked up to the arteries and veins of the heart. The machine does the work of the child’s heart and lungs, while the diseased heart is removed and the donor heart is sewn into place.
Our Pediatric Heart Failure Transplant Team cares for children during their inpatient stay, which usually lasts 10 days to two weeks after transplant. Once they are discharged, our Post-Transplant Coordinators take care of all the post-transplant management, including scheduling follow-up biopsies and blood work and any other needs the child or family might have.
We also follow pediatric heart transplant patients who have relocated to Michigan, managing all their post-transplant care. Currently we follow more than 300 adult and pediatric patients.
Our team is dedicated to helping children become healthy, functioning adults. To ensure they are able to care for themselves as they get older and go on to live independent lives, we access each child carefully to determine their ability for self-care. We begin that transition process very early – before they are teenagers – so they can administer their own medications, call for their own prescriptions and more. It takes a lot of supervised transition education before most kids can provide their own self-care, so the earlier we start the process, the better their chances for success.
- Children can typically return to school 6-8 weeks after transplantation.
- A dedicated social worker will help kids with home schooling until they can go back to school full time.
- Our Transplant Specialty Pharmacy has pharmacists and customer service staff specialized in transplant medications; dedicated solely to assisting our patients through their treatment process.
- Each summer we provide children 7-15 years of age, who have had an organ transplant, an exciting camping experience called Camp Michitanki.
Transplant Research Studies
Research is an important component of the University of Michigan Transplant Center, where we are committed to cutting-edge studies that will benefit today's patient and patients of the future. We participated in the testing of the only currently available pediatric device, the Berlin Heart, and are currently involved with designing the trials for the newest pediatric assist device through the National Institutes of Health Our patients have access to the newest heart pumps before they are available in other centers across the U.S. due to our role in their development. We also participate in a multi-center Pediatric Heart Transplant Study Group, dedicated to advancing the treatment of children once they are listed for heart transplant all the way through post transplant.