The Children's Heart Center at Phoenix Children's Hospital is proud to provide the Valley’s only pediatric heart transplant program. Pediatric heart transplants are among the most complicated procedures and patients require a lifetime of care. A heart transplant is recommended for children who have serious heart dysfunction and cannot be managed with medications or other surgeries.
The program at Phoenix Children's Hospital is multidisciplinary and involves both medical and surgical components. The program provides many services, including:
- Rigorous ambulatory program for pre and post-operative care
- Pediatric heart failure clinic
- Full service cardiac catheterization laboratory
- Echocardiography laboratory for diagnosis and monitoring studies
- Devoted cardiac nursing staff for day-to-day transplant care
- Social service support
- Psychiatric support
- Other ancillary support programs, such as the Infectious Disease Team
There are certain conditions/indications that must be considered individually after an appropriate assessment/evaluation by the physician team caring for your child. See conditions.
Benefits and risks of pediatric heart transplant surgery
The most important benefit of a heart transplant is that a successful heart transplant will prolong your child’s survival and improve the symptoms associated either with heart failure or with end-stage chronic heart disease.
After successful heart transplantation, patients require medications and careful follow-up, but most typically have normal or near-normal quality of life. At this point, it is not possible to predict how long children who undergo successful heart transplants will live, since the surgical techniques, medications and other medical care continue to improve. Heart transplants using modern immunosuppression were first done in the early 1980’s, and there are many children who were transplanted 20 years ago who remain healthy.
There are many risks associated with a heart transplant, both pre, during, and post surgery.
1. Perioperative: What happens before the operation?
Prior to being considered for a heart transplant, your child will be seen as an outpatient or possibly be admitted to Phoenix Children's Hospital for an evaluation. The purpose of our evaluation is to determine whether heart transplantation would be your child’s best option.
During your child’s evaluation, he or she will meet a number of doctors and specialists and have many blood and skin tests, x-rays, and other diagnostic procedures. These tests will help us to determine if transplantation is the right choice.
You and your child will be introduced to:
- Transplant Coordinator
- Transplant Surgeon
- Social Worker
- Financial Coordinator
The evaluation period is designed not only for the team to learn about your child, but also for you and your family to meet us, learn about heart transplant surgery and what our program has to offer you and your family. Your physician will go over any risks involved during and after the procedure.
After undergoing an evaluation, each patient's case is discussed at a multidisciplinary conference. If the patient is determined to be an appropriate candidate for heart transplantation, they are placed on the heart transplant wait list with the United Network for Organ Sharing.
3.Heart Transplant Operation
The heart transplant operation will be performed by a cardiac surgeon here at Phoenix Children’s Hospital. The operation will consist of placing your child on a heart/lung bypass machine, removing the old heart and reconnecting the new heart to your child’s body. Some patients with complex anatomy will require additional steps in the surgery to provide adequate connection to the new heart. These additional steps will be discussed with you by the cardiac surgeon prior to the surgery.
During the heart transplant operation, your child will receive blood and blood product transfusions, antibiotics, and other medications. A breathing tube is placed and a breathing machine (ventilator) will be used to assist breathing. Catheters and drains will be placed to drain blood and body fluids, monitor intracardiac pressures and administer medications. These special catheters and tubes are placed after your child has been given general anesthesia. The specifics of the type general anesthesia to be used and the risk involved will be discussed by the anesthesiologist prior to the surgery.
4. Postoperative: What happens after the operation and what are the risks?
After the surgery, your child will be taken to the cardiothoracic intensive care unit to recover. The cardiothoracic intensive care staff, in consultation with the heart transplant team, will monitor your child’s response to the surgery and to the transplanted organ, direct and manage medical/surgical needs, and consult with additional specialists as needed. Care is individualized based on each patient’s needs. Your child will remain in the cardiothoracic intensive care unit until fully recovered and ready for discharge.
Immunosuppressive medications will be necessary for the survival of the transplanted organ. It will be necessary for your child to take two or more immunosuppressive medications forever. Several other medications are given after the heart transplant. Each of these medications will be discussed individually with you. You will be given additional information about these medications, including how to take them properly, how they are monitored, and their side effects.
In advance of the procedure, your physician will go over any risks involved during and after the procedure.
Physicians and Clinical Staff
Stephen Pophal, MD – Division Chief, PCMG / Heart Failure and Transplant
Roy Jedeikin, MD
Robert Puntel, MD
John Nigro, MD - Surgical Staff Division and Section Chief
Daniel A. Velez, MD
April Colón, CPNP – Coordinator, Heart Failure and Transplant
Susan Park, NP - Coordinator, Heart Transplant Program
Sharon Pfeifer, CPNP - Coordinator, Heart Transplant Program
Cardiology / Cardiothoracic Surgery (602) 888-0788