Frequently Asked Questions About Pediatric Heart Transplants

We consider the option of a heart transplant when neither medication nor surgery will make the heart work well enough for your child to keep growing and gaining weight.

To help ensure your child will benefit from a heart transplant, our team will perform a thorough heart transplant evaluation. We work closely with a multidisciplinary team of experts in the Heart Institute and the hospital to complete this process.

We support your family before and after transplant by working with pediatric experts including child life specialists, psychiatrists, cardiac nurses and transplant coordinators.

Joining the UNOS waiting list

If you and the transplant team decide that a heart transplant is what’s best for your child, we will place them on the national transplant waiting list. Children's Colorado coordinates all transplant operations with the help of the United Network for Organ Sharing (UNOS) and Donor Alliance. 

You will meet many people and pediatric caregivers throughout this process. A transplant coordinator will help make the process easier for your family.

Because of the complex nature of the heart transplant process, an entire team of pediatric heart experts is dedicated to your child before, during and after their transplant. Specialists including transplant surgeons and cardiologists, pharmacists and social workers are on-call and available every single day, 24/7.

A multidisciplinary team of psychologists, dietitians, pathologists, exercise physiologists and others will also support your child.

Medical criteria 

The transplant cardiologists will thoroughly review your child's information and may recommend additional testing before approving your child for possible transplant. During the medical evaluation, we will draw blood to determine your child's blood type, infection status and to see if their other organs are functioning properly. We will do an echocardiogram to look at the heart function and structure. We may also do a diagnostic cardiac catheterization to measure the pressures inside the heart.

Psychosocial criteria 

All families will have a psychosocial evaluation by a social worker to help anticipate any problems that may develop during the waiting period or after transplant. The social worker will provide resources to help your family understand the psychosocial and financial stresses related to transplant. Children 10 years and older will have a psychological evaluation by a psychiatrist to assess any mental health problems.

Financial criteria 

After all of your child's medical history and transplant information is sent to your insurance company, Children's Hospital Colorado will wait for approval from your insurance company before your child can be listed as a possible transplant recipient. Insurance companies sometimes require further information or testing before they approve a transplant.

The approval process 

The heart transplant team meets on a weekly basis to discuss potential candidates. The full approval process can take days to weeks, depending on each individual child. 

Patients with the following symptoms or conditions will not be considered transplant candidates and will not qualify for transplant:

• Active sepsis unresponsive to treatment 
• Irreversible renal or hepatic failure 
• Severe immunodeficiency 
• Active malignancy 
• Inability to undergo cardiopulmonary bypass (i.e. small size, vascular access, etc.) 
• Metabolic instability not likely to be corrected by transplantation 
• Irreversible lung disease

Any child who has a heart transplant at Children's Colorado must live within 1 hour of our hospital on Anschutz Medical Campus for at least three months after heart transplant.

Why do we have to live near the hospital?

The chance of a body rejecting a new organ is highest during the first three months, and we monitor your child closely during this time. If, at the end of three months, your child has not experienced an episode of rejection, then you may return to your hometown. With any episode of rejection your child may be required to stay in the Denver area until they are medically stable.

Rejection and infection are the most common complications during heart transplant recovery. The first 24 to 48 hours after transplant can be difficult. Most complications can be taken care of medically, but a trip back to the operating room is a possibility and would be fully discussed with you at that time.

What are the signs of organ rejection during heart transplant recovery?

• Low-grade fever
• Tiredness
• Irritability/fussiness
• Poor appetite
• Vomiting
• Difficulty breathing
• Puffiness in the hands, face, and/or feet 
• Chest pain or palpitations (racing or skipped heartbeat) 

Please call us at 720-777-3218.

You can also call the Heart Institute at 720-777-6820 and ask for the transplant team.