Healthy Kids Summer 2022

Nineteen hundred. That’s the number of children on the national organ transplant waiting list. More than 500 of them are between 1 and 5 years old . The need is great, but so is the effort of the multi-organ transplant team at Rady Children’s, which has been recognized as one of the nation’s best hospitals for pediatric organ transplants.

The Rady Children’s Heart Transplant Center Under the direction of John Nigro, MD, cardiothoracic and heart transplant surgeon, chief of cardiac surgery, director of cardiac transplantation and the mechanical assist program, and director of Rady Children’s Heart Institute, the Rady Children’s Heart Transplant Center is a leading referral center for all of Southern California, as well as parts of Arizona, Hawaii and the South Pacific. The Hospital has developed a program that can provide heart transplants for every patient with congenital heart disease, from infancy through adulthood, under the care of a multidisciplinary team that consists of Dr. Nigro and a transplant cardiologist, transplant nurse or nurse practitioner, pharmacist, social worker, financial coordinator, dietitian, child life specialist, pathologist, physical therapist, occupational therapist, psychiatrist, psychologist and spiritual care worker. With incidence of pediatric heart failure on the rise, there’s never been a greater need for the work this team is doing to save the lives of children with serious heart disease. “We’re seeing an increase in serious heart failure in children, resulting in more patients being candidates to benefit from heart transplant or advanced heart therapy, like left ventricular assist devices, or LVAD,” explains Dr. Nigro. “The number of patients at risk has increased, and at the same time, the technology has advanced to help stabilize their condition and get them

to transplant. Additionally, there’s been an increased recognition about the benefits of transplant—especially for children. Now we have more substantial data that show that pediatric patients can appreciate long-term survival after transplant, which is a little different from the adult world. Some patients have been able to survive for decades, while being able to do all normal activity.” While Dr. Nigro explains that these are heart trends that exist nationally, the growth of the Rady Children’s Heart Transplant Center locally is due to increased recognition of these factors and increased effort to create a world-class program to help pediatric patients in critical need. “We have recognized all those factors and tried to aggressively understand and interpret these trends in the context of our patients,” he says. “We’ve been actively working to provide access to more heart transplantation. “We’ve expanded our team of transplant surgeons, our overall program and our collaborative relationship with UC San Diego. We’ve expanded criteria and donor selection so our patients will get transplanted sooner and not languish on the list. We’ve been innovative in the technical aspects of the surgery and the way we use mechanical support, like extracorporeal membrane oxygenation and LVAD. And we’ve made changes internally to identify patients early on and start following them closely. Finally, we have a very advanced patient transport program. All these things have allowed us to have a broader referral network and increase the number of patients we’ve seen.”

JOHN NIGRO, MD Cardiothoracic and Heart Transplant Surgeon, Chief of Cardiac Surgery, and Director of Cardiac Transplantation

SUMMER 2022 HEALTHY KIDS MAGAZINE 17

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