In a Texas first, surgeons at Dell Children’s Medical Center this week announced they completed a partial heart transplant on a child.
On June 23, 11-month-old Elias Robinson-Rodriquez became the seventh patient in the world to undergo the groundbreaking surgery, which transfers a valve from a donor heart to a patient whose valves are not properly functioning.
Elias was born with a heart defect. Even after two open-heart surgeries, he continued to have problems with his aortic valve, which didn’t open fully and limited blood flow.
“It was clear that valve needed to be changed,” Dr. Carlos Mery, surgical director of the Heart Transplant Program at Dell Children’s, said.
There are more challenges and fewer options for valve replacement with young children. Adults can often get a mechanical valve or one sourced from pig hearts. However, these are often too big for small children.
Adults can also receive a donor valve that is deceased tissue. This is possible for children, but is not an ideal option as they quickly outgrow the tissue and the valve degenerates over time, leading to repeated surgeries and valve replacements.
With partial heart transplants, however, surgeons use valves sourced from donor hearts that aren't suitable for a total transplant. This method provides children with living tissue that will ideally grow along with them and extend their life expectancy.
“I’m cautiously optimistic that the children who’ve had these [surgeries] to date, including Elias, will be able to have a single operation rather than having to have multiple ones,” Dr. Chesney Castleberry, medical director of the Pediatric Heart Failure and Transplant Program, said.
So far, Elias’ doctors say, his condition has improved and his outlook is strong.
Dr. Charles Fraser, who leads the Texas Center for Pediatric and Congenital Heart Disease at Dell Children’s, said the surgery is an example of what the program can offer the Central Texas region.
“Our ability to perform this surgery is a major step in Dell Children’s’ effort to provide innovative, life-changing care for the most complex cardiac cases in the region,” he said. “This groundbreaking surgery provides hope for thousands of babies with congenital heart defects and amplifies the way we can use the gift of organ donation to save more lives.”
Pediatric partial transplants have been performed at only three other U.S. institutions — Duke University, Columbia University and the Medical University of South Carolina.
Mery noted that Dell Children’s has ramped up its heart transplant capabilities in a few short years, bringing new care options to Austin-area residents.
“There was no ability to actually offer any heart transplant, period, in Central Texas. There were two heart transplant programs in the state, in Houston and Dallas,” Mery said. “Now, we have a busy heart transplant program that's taking on patients that other transplant programs don't take on.”
