Heart Transplant

What to expect

When you seek care with us for your child, you will be at the center of a multidisciplinary, integrated team of pediatric heart experts. We consider heart transplantation when your child becomes more ill despite treatment, or when he or she is experiencing significant symptoms of heart failure. We work closely with your child’s referring doctor to determine if heart transplantation is needed.

Evaluation

To start, our team of specialists meets with you to discuss transplantation and help you understand what transplant means for your child. We will explore all medical, interventional, and surgical options available to your child, welcoming your input and questions. Our evaluation may result in placing your child on the waitlist or continuing conventional treatments, depending upon what is best for your child.

To aid decisions on transplant, we conduct a complete evaluation of your child’s medications, alternative therapies, and considerations of transplantation from our multidisciplinary heart transplant team, as well as reviewing tests, including an echocardiography stress test, cardiac catheterization, blood tests, and more. Ideally we evaluate your child for transplant before it’s urgently needed.

Transplant preparation and waitlist

If we determine that transplant is needed, we place your child on the transplant waitlist and assign you a transplant coordinator who keeps you informed and helps you at every step of your child’s transplant journey. The national waitlist, maintained by United Network for Organ Sharing (UNOS), ensures that donor hearts go where they are needed most and are prioritized by a child’s level of illness. In other words, your wait depends on your child’s condition. Wait times for transplant can be between 30 and 60 days for extremely ill children and up to one to two years for children with milder symptoms. We’ve worked hard to shorten transplant wait times at our Betty Irene Moore Children’s Heart Center, and results are encouraging. For example, we pioneered a computerized tomography (CT) scanning protocol to determine the compatibility between the size of your child’s heart and the size of the donor’s heart. This innovative approach shortens wait times by opening up the pool of donors and ensures a good match.

Sometimes, your child can await transplant at home, but if your child is very ill, he or she may receive care in our hospital, including in our Cardiovascular Intensive Care Unit (CVICU), where we can keep your child stable with intravenous heart failure therapies or with a ventricular assist device (VAD). While waiting, our specialized team works together closely to help prevent complications for other organs in the body.

During this waiting period, our team focuses on maintaining your child’s best possible health, addressing any problems so that when a donor heart becomes available, your child is well prepared for transplant both physically and emotionally. We like you to stay near the hospital to be ready when a heart becomes available, and our social workers and transplant coordinators can assist you with logistics and resources, including helping you secure lodging or housing.

Heart transplantation

Once a donor heart comes available, our team—available 24 hours a day, 7 days a week—determines whether it is medically appropriate for your child. If it’s a viable donor heart, we ask you to come to the hospital for the transplant surgery.

Heart transplant requires open-heart surgery and a several-week stay in the hospital. The surgery is similar in many ways to heart surgeries your child may have had in the past. Cardiovascular surgeons, cardiac anesthesiologists, and cardiologists are present to perform and guide the transplant. Because heart failure can affect every aspect of your child’s life, the Pediatric Advanced Cardiac Therapies (PACT) team is a holistic team of physicians and providers that includes cardiologists, surgeons, dietitians, physical therapists, and a dedicated group of transplant nurses and coordinators. To support your family’s emotional and social needs, you can also access social workers, child life specialists, and cardiac psychologists. Our collective team is among the most experienced teams nationwide.

After heart transplantation surgery, your child recovers in our CVICU. Once stable, he or she is transferred to a regular hospital room and from there to the Ronald McDonald House, where your family stays until your child is ready to return home. It may take several months after transplant surgery for your child to achieve full recovery, when she or he can expect to experience very minimal symptoms and a full return to daily life and schooling.

Living well with heart transplantation

At Stanford Children’s Health, we provide lifelong care to our transplant patients. Our multidisciplinary team partners with you and your child’s local physicians to support your child as he or she grows through the years. Heart transplant often resolves heart failure, but it requires ongoing care. In return, your child can expect an excellent quality of life.

Children who receive a heart transplant require permanent immunosuppressant medicines and ongoing monitoring to prevent potential complications. Occasionally, multiorgan transplantation is needed, or a second heart transplant is called for under very rare circumstances. We’re known nationwide as experts in heart-lung and heart-kidney transplants, having completed 85 since our first in 1988 and performing the most pediatric heart-liver transplants in the United States.

Our pediatric heart failure and heart transplantation highlights

  • At Stanford Children’s Health, we’ve performed 500+ pediatric heart transplants since completing our first one more than 35 years ago. As one of the nation’s highest-volume programs, we perform an average of 15 to 25 transplants each year. We lead in the Western United States for pediatric heart transplants, having performed the most in California for nine consecutive years.
  • We welcome a high number of referrals from across the country and nation to provide lifesaving transplants to children with the most complex needs, including an extraordinary number of babies younger than 1 year old, with 15 days old as our youngest. We also collaborate on babies with fetal heart defects, in partnership with our hospital’s exceptional fetal cardiologists and maternal-fetal medicine specialists.
  • We work in conjunction with our Pediatric Transplant Center, which is No.1 in the Western United States in organ transplant volume in children and No. 3 nationwide. Our transplant teams have deep expertise not only in single organ transplants but also in multi-organ transplants. To date, we have performed more than 85 multi-organ transplants since our first in 1988, and so far we have completed the most pediatric heart-liver transplants in the United States.

For more information, call us at (844) 393-4474. We are happy to discuss any questions you may have.