Our Summary

This study looked at how children with severe kidney problems fare after a heart transplant. They compared children who were listed to receive both a heart and a kidney transplant with children who were only listed for a heart transplant. They found that children who were listed for both transplants had a better chance of surviving and had better outcomes after the transplant. However, if a child’s kidney function improved significantly, it was just as effective to only give them a heart transplant.

FAQs

  1. What was the main focus of the study on heart transplants in children with severe kidney problems?
  2. How do the survival outcomes compare between children listed for both heart and kidney transplants versus those only listed for a heart transplant?
  3. Does an improvement in kidney function affect the need for a kidney transplant in addition to a heart transplant?

Doctor’s Tip

It is important to follow your doctor’s instructions closely after a heart transplant. This may include taking immunosuppressant medications as prescribed, attending regular follow-up appointments, maintaining a healthy lifestyle, and avoiding potential risks to your heart health. It is also important to communicate any concerns or changes in symptoms to your healthcare team promptly. By taking these steps, you can help ensure the success of your heart transplant and improve your overall quality of life.

Suitable For

Patients who are typically recommended for a heart transplant are those with end-stage heart failure, which is a condition where the heart is severely weakened and unable to pump enough blood to meet the body’s needs. Other criteria for heart transplant candidacy may include:

  • Severe coronary artery disease
  • Cardiomyopathy (disease of the heart muscle)
  • Inoperable congenital heart defects
  • Severe valvular heart disease
  • Severe arrhythmias
  • Failure of previous treatments such as medications, lifestyle changes, or other surgical interventions

Evaluation for a heart transplant typically involves a thorough assessment of the patient’s overall health, including their heart function, lung function, kidney function, liver function, and mental health. Patients must also meet specific criteria for age, overall health, and ability to comply with post-transplant care and medications. The decision for a heart transplant is made by a multidisciplinary team of healthcare providers, including cardiologists, transplant surgeons, social workers, psychologists, and other specialists.

Timeline

Before heart transplant:

  1. Patient is evaluated by a medical team to determine if they are a suitable candidate for a heart transplant.
  2. Patient undergoes extensive medical tests and assessments to assess their overall health and determine the severity of their heart condition.
  3. Patient is placed on the transplant waiting list and waits for a suitable donor organ to become available.
  4. Patient may experience symptoms such as fatigue, shortness of breath, chest pain, and swelling in the legs and abdomen.

After heart transplant:

  1. Patient undergoes the heart transplant surgery, which involves removing the diseased heart and replacing it with a healthy donor heart.
  2. Patient is closely monitored in the intensive care unit for several days following the surgery to ensure that the new heart is functioning properly.
  3. Patient takes immunosuppressant medications to prevent rejection of the donor heart and must adhere to a strict medication regimen for the rest of their life.
  4. Patient undergoes regular follow-up appointments with their medical team to monitor their heart function, adjust medications, and address any complications that may arise.
  5. Patient may experience improvements in their overall health and quality of life, with reduced symptoms and increased energy levels.

What to Ask Your Doctor

  1. Am I a candidate for a heart transplant?
  2. What is the success rate for heart transplants in patients with my condition?
  3. What are the risks and potential complications of a heart transplant?
  4. What is the recovery process like after a heart transplant?
  5. How long will I need to be on immunosuppressant medication after the transplant?
  6. What kind of lifestyle changes will I need to make post-transplant?
  7. How often will I need to follow up with you after the transplant?
  8. Are there any support groups or resources available for heart transplant patients?
  9. How will a heart transplant affect my overall quality of life?
  10. Are there any alternative treatments or options I should consider before proceeding with a heart transplant?

Reference

Authors: Dani A, Price N, Thangappan K, Ryan TD, Hooper DK, Cooper DS, Lehenbauer DG, Chin C, Zafar F, Morales DLS. Journal: J Thorac Cardiovasc Surg. 2022 Dec;164(6):2019-2031. doi: 10.1016/j.jtcvs.2021.10.082. Epub 2022 Mar 1. PMID: 35331555