Combining intraoperative expertise with proactive post-transplant surveillance, Riley Children’s Health is among the nation’s leaders in pediatric heart transplant outcomes.
The latest metrics, reported by the Scientific Registry of Transplant Recipients (SRTR) in July 2024, show Riley Children’s has achieved:
- 100% 90-day pediatric patient survival (benchmark: 96.1%)
- 100% one-year pediatric patient survival (benchmark: 93.1%)
- 100% three-year pediatric patient survival (benchmark: 85.1%)
In addition, Riley Children’s has the eighth-lowest hazard ratio for pediatric heart transplant (0.68) in the country. These stellar outcomes are attributed to a variety of distinguishing factors, according to pediatric cardiologist John J. Parent, MD, MSCR, medical director of pediatric heart transplant at Riley Children’s. Dr. Parent, who shares leadership of the program with Riley cardiovascular surgeon Mark W. Turrentine, MD, answers questions about the hospital’s record in pediatric heart transplant.
Q: How does Riley’s surgical expertise in pediatric heart transplant impact patient outcomes?
Dr. Parent: Our experienced cardiothoracic surgeons are highly skilled technically, particularly when transplanting to patients with congenital heart disease. In these cases, the reconstruction is much more extensive, requiring our surgeons to perform at the highest level. This is especially true for patients with Fontan completions. In effectively managing bleeding, our surgeons are able to reduce ischemic time—a factor that’s critical to success.
Q: What’s significant about Riley’s intraoperative methods for procuring and transplanting donor hearts?
Dr. Parent: To optimize the preservation process, Riley Children’s intraoperative surgical team always includes both a procuring surgeon and an implanting surgeon. Because our congenital heart surgeons are involved in every case, they know how much donor vessel they need to bring back to effectively complete the necessary reconstruction. This significantly decreases post-transplant complications. Additionally, our outcomes for patients who’ve had Fontan completions are above average, and that’s largely attributable to how we procure the hearts and how our surgeons implant them.
Q: How does Riley Children’s help ensure heart transplant patients thrive following surgery?
Dr. Parent: We have a team of three very experienced transplant coordinators who provide 24/7 support to heart transplant patients and their families. Following transplant, the coordinators check in regularly with their patients to help identify and address any signs of rejection, infection or issues with medication adherence. We maintain a low patient-to-coordinator ratio with each coordinator assigned to 25 to 30 patients to ensure more personalized care. Patients stay with the same transplant cardiologist and coordinator who see them throughout their time in our program. Our team’s commitment to post-transplant surveillance and continuity of care are vital for our patients to do well long term and contribute to our outcomes.
Q: How is the HeartMate 3 making a difference for Fontan patients?
Dr. Parent: We are one of the few centers nationally that has expanded the use of the HeartMate 3 in our Fontan population. All our patients who’ve received the implant have survived at least one year. While it wasn’t initially known how Fontan patients would fare on the HeartMate 3, we’ve had good success getting patients with end-stage failing Fontan rehabbed and ready for transplant.
Riley Children’s is home to one of the few Pediatric Heart Failure/Transplant Programs in the Midwest–and the only program in Indiana. In addition to skilled, experienced pediatric heart surgeons and cardiologists, Riley Children’s offers a proven home monitoring program for single ventricle patients and patients on VAD.
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