Heart Transplants

What is a heart transplant?

A heart transplant is surgery done to remove a heart that is not working properly, in order to replace it with a healthy donor heart. A successful heart transplant in a child will extend the child's life and help him grow and develop more normally.

The first human heart transplant was done in 1967.

Heart transplantation is not a cure. It is a very complex process that includes lots of medications, tests, procedures, and an intensive follow-up. As a parent, it can seem overwhelming. Just remember that you will have the ongoing support of the transplant team from start to finish. Team members will teach you what you need to know to help your child.

When are heart transplants needed?

Heart transplants are usually done in children with very complex types of congenital heart defects that cannot be effectively treated with drugs or corrective surgery, such as some cases of hypoplastic left heart syndrome. Also, children with decreased heart function for any reason can sometimes need a heart transplant. Generally, a heart transplant is needed when a child's heart is simply unable to pump blood effectively to the body.

There are some age differences; transplants in younger children tend to be more for congenital heart disease, while in older children they tend to be done for decreased heart function.

Why does your child need a heart transplant?

The goal of a heart transplant is to make the quality of your child's life better by giving your child a new heart. Getting a new heart will not cure your child. Heart transplantation may be offered to your child as an option to other medical or surgical treatments or when other treatments are no longer available or effective.

Can a child have a heart transplant at any age?

Several hospitals offer heart transplantation to suitable patients from infancy through to 18 years of age. In some cases, heart transplantation is an option prior to a baby being delivered if the heart disease is diagnosed before birth and there are no other problems with the baby.

Who is part of the transplant team?

Members of the transplant team typically include:

  • transplant cardiologists
  • cardiovascular surgeons
  • advanced practice nurses
  • transplant nurses
  • social workers
  • psychiatrists
  • clinical dietitians
  • occupational therapists
  • physiotherapists
  • pharmacists
  • adolescent medicine physicians
  • information coordinators
  • cardiology, transplant, and cardiovascular surgery fellows (physicians in training)

What happens before the transplant?

If your child’s cardiologist or doctor feels that your child may need a heart transplant, he will refer you to the heart transplant team. If you and your family decide that you are interested in pursuing heart transplantation, the initial step is an assessment phase to identify all factors that will be important at the time of and after a heart transplant.

The assessment for a heart transplant includes being seen by all members of the transplant team. Some of the evaluations are medical and others relate to your child and your family’s psychosocial, financial, and emotional wellbeing. All of these aspects are important to make sure that the transplant team can support you throughout the entire process, before, during, and after transplantation.

Medical tests are done to confirm the extent of your child's illness, and to identify other medical factors that may be important either while waiting for a transplant, during the transplant, or after the transplant. The tests ordered depend on your individual child’s medical condition at the time that she is referred for transplant. They will be fully explained to you before you come to the hospital for assessment

Once the assessment is complete, the team will review and summarize all of the information and discuss your child’s case at a cardiosurgical meeting. The team will then meet with you to share the information and make a recommendation about whether or not your child is a candidate for transplantation. The team will inform you of the risks and benefits for your child and help you with your decision-making around whether to pursue transplantation.

Anne Dipchand, MD, FRCPC