SAN FRANCISCO, Calif. (Ivanhoe Newswire) —About 500 heart transplants are performed each year in the U.S. on children aged 17 and under. But what is more troubling is the amount of time they have to spend on a donor waitlist. Now a new method is re-thinking how hospitals address donor matching with hearts.
The chords come effortlessly for Athena. The 15-year-old has been playing for as long as she can remember, before she even knew she was sick.
“I had symptoms since second grade,” Athena Tran recalled.
Athena was eventually diagnosed with cardiomyopathy. Blood wasn’t pumping through her heart efficiently. Athena needed a new one.
“I got on the list in fifth grade and then two years later in seventh grade, I had a stroke while I was sleeping,” Tran shared.
Athena recovered and after a two-year wait, finally received a new heart.
John Dykes, MD, a pediatric cardiologist with Stanford Children’s Health told Ivanhoe, “The thing that really limits us in pediatrics is that the number of pediatric donors is much smaller than the number of adult donors.”
But now that wait may be a lot less. Stanford is one of the few hospitals to match patients with donor hearts based on total cardiac volume.
Dr. Dykes explained, “Traditionally the way we thought of size matching, we’ve used what we call surrogate markers and that has to do with height and weight.”
But those markers don’t necessarily hold true with children in heart failure. Often they’ve stopped growing and have enlarged hearts.
“And so, if you had a 13-year-old that had a heart size that could accommodate a 25-year-old, it’s likely that that patient would wait much less on the list,” Dr. Dykes clarified.
Doctors are able to determine this by comparing chest images of a patient and a donor.
“What we’re doing is essentially performing, from a size standpoint, what would be called a virtual transplant,” Dr. Dykes stated.
A critical new step to finding a match sooner.
In addition to getting patients a heart faster, Dr. Dykes also aims to be able to use more donors. Currently, the U.S. utilizes only 60 percent of all pediatric heart donors. He says with this new method, that number can be much higher.
Contributors to this news report include: Cyndy McGrath, Executive Producer; Jennifer Winter, Field Producer; Rusty Reed, Videographer; Roque Correa, Editor.
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TOPIC: FASTER DONOR MATCHING SAVES ATHENA!
REPORT: MB #4738
BACKGROUND: Heart failure can be tricky to treat in pediatric patients for many reasons, mostly because the way that it presents can be very different from that of adults. Heart failure symptoms are often nonspecific in children and vastly less research has been done in the pediactic branch of cardiology. Heart failure occurs when there is an abnormality of the structure or function of the heart to deliver oxygen. In the U.S. approximately 10,000 children are hospitalized with heart failure every year.
DIAGNOSING: Pediatric heart transplantation is a small but significant portion of all organ transplants. Being diagnosed for transplantation is a last resort and often takes a long time to gather data and rule out other options. Patient selection is a crucial factor when it comes to overall patient outcomes. While there is an extensive criterion in place for these children and their hearts, doctors say a strong support system is necessary to ensure long-term recovery and families are often aided by psychologists to get through it.
NEW TECHNOLOGY: A new way of matching patients is evolving nationwide. 3D imaging such as CT scans and MRI have allowed doctors to closely evaluate the overall cardiac volume of a patient rather than basing it on surrogate markers like weight, height, and gender. Many patients have enlarged hearts in small bodies that are still growing. This essentially means that the new 3D imaging provides a way for many adults to be screened as potential pediatric donors and greatly expands the population of overall donors available to these kids.
(Source:John Dykes, MD, Stanford Children’s Health)
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