Stories of Getting Better at Children's Hospital Colorado

2 Heart Transplants, 1 Great Story

Samantha, pictured at age 3 in 1995, listens to her first new heart.

Samantha Remington is looking for travel recommendations. California, a cruise, and anywhere with a beach are all under consideration. After her second heart transplant almost a year ago, Samantha, 18, will soon have the travel nod from her doctors at Children’s Hospital Colorado's Heart Institute.

“I have a goal… road trip!” Samantha said as she glanced at her cell phone covered with a picture of the Golden Gate Bridge.

The trip is part of what Samantha hopes will be a more eventful summer than last year, when she spent the majority of time recovering at home after her second heart transplant.

“I couldn’t even go to the mountains,” she said. “All I could do was swim.” After a transplant, most patients must stay within an hour’s drive of the hospital for a year or more.

A heart transplant at four months old

Although she doesn’t remember, Samantha had her first heart transplant at just four months old. That heart carried her through 17 years of school, basketball and family trips to CU football games. But unfortunately, most heart transplants don’t last a normal lifetime.

In fourth grade, Samantha’s doctors discovered she had transplant coronary vasculopathy, a form of organ rejection that makes the coronary artery become dangerously narrow. This disease, which one can acquire when the body begins rejecting a transplanted heart, made it difficult for the transplanted heart to get blood.

Transplant coronary disease is the most common and most severe long-term heart transplant issue. It likely develops as the immune system takes its toll on a donated organ over time, according to Dr. Bill Pietra, Samantha’s cardiologist at Children’s Hospital Colorado's Heart Institute.

The transplant field has seen remarkable progress in fighting short-term or “acute” organ rejection that occurs in the weeks and early years after a transplant. But while great strides have been made in preventing rejection in the short-term, transplant coronary vasculopathy is still a problem in the long-term (even decades after transplant).

After 17 years, Samantha needed another new heart

Samantha, pictured at age 18 in 2011, after her second heart transplant.

Samantha managed her transplant coronary disease with medication from fourth grade until her junior year of high school. But by May of 2010, 17 years after her first transplant, Samantha’s coronary artery was so dangerously narrowed that she decided to go back on the transplant list for a second heart. Five days later, she underwent a second successful transplant at Children’s.

Dr. Pietra predicts that as technology and medicine improve, more and more teenagers will find themselves in Samantha’s shoes – coming back for a second heart transplant to propel them into the next phase of life.

“She’s clearly a pioneer. Just imagine what it’s like to have congenital heart disease, two heart transplants, and still come out of that with a bubbly personality and life goals. That’s an achievement in itself,” Pietra said.

Samantha has big plans for her future

Samantha will graduate from Monarch High School in May of 2011. She plans to attend Front Range Community College, but not before having a lot of fun this summer.

“I’ll go anywhere. Just buy me a ticket,” Samantha said.

Read more about Samantha in the Boulder Daily Camera.

Researching new ways to prevent transplant coronary disease

In his laboratory at University of Colorado Health Sciences Center, Dr. Pietra and his research team are creating a model of transplant coronary disease in mice. By identifying the way the immune system causes the coronary arteries to narrow, they hope to find new ways to stop it. Dr. Pietra’s goal is to control the immune system’s long-term response to a transplanted heart and extend the length of the new heart to last a lifetime.

“In the future we’re going to have even more tools. People think I’m crazy, but I think someday we’re going to be able to do a transplant and tell patients, ‘Have a nice life.’ I think it’s going to happen in my lifetime,” Pietra said.

Learn more about our world-class Heart Transplant Program.