If your child is getting a heart transplant, their new heart comes from a heart donor. This page explains how your child will be matched with a donor heart.
How is listing for heart transplantation done?
Once it is decided that a patient is a candidate for heart transplantation, she is placed on a waiting list for all of the patients in Ontario who need a heart transplant. Candidates are listed by weight, blood group, and how sick they are: for example, at home, in the hospital, in the intensive care unit.
Who decides who gets a donor heart?
This will depend on the province or state where you live. In Ontario, organ retrieval is managed by an organization called the Trillium Gift of Life Network. Once this organization is informed of a potential donor organ, the coordinator informs the transplant cardiologist, who will make a decision about accepting the donor heart for a specific patient.
If more than one child is eligible for the same donor heart, the decision about who gets the donor heart is based on multiple things, including how sick each child is and how long each child has been waiting.
Does your child's blood need to match the donor's blood group?
Usually, children get hearts from donors whose blood group matches their own. This is called ABO-compatible transplantation.
If your child is a young baby, the transplant cardiologist will talk to you about the possibility of receiving a heart from a donor with a different blood group that does not match your baby's. This is called ABO-incompatible transplantation.
Babies do not seem to have the same problems with different blood groups that older children do, since their immune systems are not mature and are not yet equipped to reject a new organ. It can be a wonderful option in cases where waiting lists are long and organs are few.
Where will the donor heart come from?
Heart donors can be newborn babies, older babies, children, or adults who have had an injury to their brain. They may have been injured in a car crash or fall, or by drowning, or in some other accidental way. Their brain injuries cannot be treated with medicines or operations.
These donors are not alive. They are what is called "brain dead," but their hearts and other organs can be kept alive for a short time with medicines and machines.
The heart donors' families have kindly donated their injured family member's heart and other organs for patients, like your child, who need them. The donor families see their donation as giving the gift of life to another person. It is a way for them to know that their loved one keeps living.
By provincial law, all information about your child's heart donor is kept private, for example where the donor is from, how old the donor is, and what caused the donor's death. This will depend on the province or state where you live.
What happens to the donor heart before transplant?
A number of things are important in determining the suitability of a donor heart for your child, including weight and the results of the heart tests on the organ donor. It does not matter if the donor is the same sex or ethnic background as the recipient.
A team of surgeons at the donor hospital assesses the donor heart and surgically removes it for transfer back to the hospital. At the donor hospital, the heart (also called the graft) will be stopped with a fluid in a process called cardioplegia. It is then put in salt water and transported in an ice cooler to the hospital where the transplant patient is waiting.