Health Information
For Patients, Families & Visitors
Return to Heart Transplantation Overview
More on Heart Transplantation
Organ Transplantation
Heart Transplantation
Our pediatric heart transplant program dates back to 1984, when the world's first successful pediatric heart transplant was performed at Columbia Presbyterian Medical Center on a four-year-old boy with complex congenital heart disease. Since then, our surgeons have performed over 265 heart transplants in children making NewYork-Presbyterian one of the largest pediatric heart transplant centers in North America and the world.
Our Pediatric Heart Transplant Program specializes in transplanting children with end-stage congestive heart failure due to cardiomyopathy and children with complex congenital heart disease who are not candidates for palliative or corrective surgery. We have also successfully pioneered transplantations in high-risk patients who are not offered heart transplants elsewhere, including patients with severe, elevated pulmonary resistance.
By applying new surgical techniques and expanding the donor pool, Morgan Stanley Children's Hospital continues to make strides in pediatric heart transplantation, and was the first hospital to perform heart transplants in an effective, single-lung physiology in children and also in adults.
Morgan Stanley Children's Hospital is also the first institution in the United States to perform ABO-incompatible heart transplants (donors and recipients have different blood types) in pediatric patients. By following a specific protocol, survival is the same as in children who receive ABO-compatible hearts.
An evolving area of surgery is the use of ventricular assistance devices (VADs) in pediatric pre-transplant patients to support the heart and stabilize the pre-transplant patient, a process called "bridging," until an appropriate heart that is located.
Center for Pediatric Cardiomyopathy, Heart Failure and TransplantationThe Center for Pediatric Cardiomyopathy, Heart Failure and Transplantation calls on the expertise of pediatric cardiologists, pediatric cardiac surgeons, and a wide range of health professionals with expertise in cardiology and heart transplant. Pediatric patients are cared for by a multidisciplinary team, with parents as key members. Parents help the team understand their child's particular medical issues, as well as emotional and practical needs, which guide the overall treatment plan.
This team approach has set the standard of care for children with end-stage heart failure-achieving 84 percent overall long-term survival after hospital discharge. Team members include:
- Pediatric cardiologists
- Pediatric cardiac surgeons
- Medical consultants, including pediatric electrophysiologists, neurologists, and endocrinologists
- Nurse specialists in cardiology and transplant
- Research nurses
- Genetic counselor
- Pediatric cardiology social workers
- Child psychiatrists
- Child life specialists
- Physical therapists
- Pharmacist
Since pediatric cardiomyopathy and heart failure can be progressive, the heart may deteriorate past the help of medication, mechanical treatments, or surgery. When a patient no longer responds to other treatments, has persistent severe symptoms of heart failure, or suffers severe disability, a heart transplant is offered as a procedure of last resort.
Cardiomyopathy is the leading reason for heart transplantation in children. Roughly 20 percent of infants and children with symptomatic cardiomyopathy require a transplant within the first year of diagnosis.
With the combined expertise of the members of our pediatric cardiology team, we help families learn whether they have looked at all possible treatment options before considering a heart transplant. As a research center, we may be able to offer treatments unavailable elsewhere.
Children who are considered candidates for transplant usually:
- Have hearts that are so weak or diseased that the flow of blood throughout the body is dangerously low. When the heart does not pump blood well, too little oxygen circulates to the child's body. Without oxygen, tissues and organs may be damaged;
- Have very complex congenital heart disease that is not correctable with surgery;
- Have dangerous heart rhythms that compromise the amount of blood entering and/or leaving the heart;
- Have little ability to enjoy or participate in ordinary childhood activities, including playing sports, visiting friends, or even attending school;
- Have trouble keeping up with their schoolmates or siblings. They are often much smaller than other children their age. Infants may exhibit developmental delays in sitting, crawling, and standing; they are often very poor feeders; or
- May have been well all their lives and only recently became severely ill with acute myocarditis or cardiomyopathy.
The process of transplantation for a child of any age has a profound impact on the entire family. The proper education, including age-appropriate activities such as play therapy, tours of the hospital, and talking with other parents and children prior to hospitalization, can turn this experience into a positive one. This education includes siblings of the recipient whose lives are very affected by everything their brother or sister is going through. We urge families to communicate openly with the transplant team and their own support systems. The transplant nurse, social worker, and child life specialist will provide more information about available resources and support groups.
ResearchIn addition to providing outstanding patient care, the Pediatric Heart Transplant Program stands at the forefront of pediatric heart failure research, including investigations of new strategies for post-transplant management. The Pediatric Heart Transplant Study Group, founded at Morgan Stanley Children's Hospital and comprised of 23 institutions across North America, is responsible for a significant proportion of today's published research related to pediatric heart transplantation.
