Heart transplant process

From evaluation to aftercare, the heart transplant process involves a long-term partnership between Children’s and your family. Our exceptional pediatric heart transplant team provides all the support and services you and your child will need, every step of the way.

Transplant team

Our transplant team members include a pediatric heart transplant cardiologist, cardiovascular surgeon, heart transplant coordinator, pulmonologist, infectious disease specialist, rehabilitation specialist, child psychologist, social worker, child life specialist, pharmacist, nutritionist and financial counselor. You’ll have a transplant coordinator to guide you through the whole process.

Evaluation

It’s essential that we carefully and thoroughly assess whether heart transplantation is a good fit for your child. As part of the evaluation for heart transplant, our team of experts will also consider alternatives to transplant and help you decide the approach that is best for your child and your family. This may include the use of mechanical circulatory support (MCS), such as ventricular assist devices (VADs), to help your child feel healthier and function more normally while waiting for a heart. Our team will perform all the diagnostic tests required – including blood and urine tests, echocardiogram, ECG, EKG and, if necessary, heart biopsy. In addition, our social worker and child life specialist will help make sure your entire family is prepared and able to participate in your child’s recovery.

Placement on UNOS list

Once Children’s has determined that heart transplant is a good fit for your child, he or she is placed on a waiting list with the United Network for Organ Sharing (UNOS) for a donor heart. Your child is prioritized based on medical urgency and the wait can vary from a matter of days to several months.

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Pre-transplant education

Education and communication are central to how Children’s partners with families. There is a lot of information to digest before your child’s transplant – and you may have a lot of questions. We create an open dialogue, providing you with a detailed transplant manual, and arrange meetings with key members of your child’s transplant team.

Heart availability

As mentioned above, the time it takes for a heart to become available for your child varies widely. Once a suitable heart is available, things move very quickly. Your transplant coordinator will help you navigate the process. You will be notified immediately and, if your child is not already at Children’s, will be instructed to arrive as soon as possible. We then make sure the heart we receive is a healthy match for your child. Learn more about heart transplant innovations through the Herma Heart Institute that help increase match options, potentially decreasing wait times.

Heart transplant

The heart transplant surgery itself takes between four and six hours. During transplantation, Children’s team of experts places your child on heart bypass to supply oxygen to the organs. With your child safely on heart and lung support and under the watch of a pediatric cardiac anesthesiologist, we remove the damaged organ and attach the new heart. Once everything is connected, we remove your child from bypass. Our team will keep you updated on your child’s progress throughout the procedure.

Aftercare

Post-surgery, your child will be moved to the Cardiac Intensive Care Unit (CICU) or the neonatal intensive care unit (NICU). Our team carefully monitors him or her, watching for signs of infection or rejection. During this time, we also prescribe and manage any medications your child needs. When he or she is ready, your child is moved to our intermediate/cardiac care unit for continued recovery.

Follow-up care

Caring for your child after a heart transplant is a long-term proposition and there’s a lot to consider. Before your child is discharged, a Children’s transplant coordinator will work with you and our transplant team to make sure you know everything you need to in order to obtain the best follow-up care. We’ll provide you with a detailed follow-up care plan for the months and years ahead. Our team is available 24/7 to answer your questions.

If your child's heart transplant occurs when he or she is younger than 3 years old, our Developmental Follow-up Program is an essential resource. The first of its kind in the country, our program will help you monitor and support your child's healthy neurodevelopment so he or she can live life to the fullest. As children get older, they work closely with a Herma Heart Center's pediatric psychologist to transition to grade school life and beyond. We recommend that children have a neurodevelopmental assessment annually throughout their adolescent years. Even into adulthood, you and your child can access the professionals at Children's to answer questions and connect your family with the resources you need.