Health Information
Organ Transplantation
Specialty Centers
Center for Pediatric Cardiomyopathy, Heart Failure and Transplantation
The Center for Pediatric Cardiomyopathy, Heart Failure and Transplantation calls on the expertise of pediatric cardiologists, pediatric cardiac surgeons, and a wide range of health professionals with expertise in cardiology and heart transplant. Pediatric patients are cared for by a multidisciplinary team, with parents as key members. Parents help the team understand their child's particular medical issues, as well as emotional and practical needs, which guide the overall treatment plan.
This team approach has set the standard of care for children with end-stage heart failure-achieving 84 percent overall long-term survival after hospital discharge. Team members include:
- Pediatric cardiologists
- Pediatric cardiac surgeons
- Medical consultants, including pediatric electrophysiologists, neurologists, and endocrinologists
- Nurse specialists in cardiology and transplant
- Research nurses
- Genetic counselor
- Pediatric cardiology social workers
- Child psychiatrists
- Child life specialists
- Physical therapists
- Pharmacist
Since pediatric cardiomyopathy and heart failure can be progressive, the heart may deteriorate past the help of medication, mechanical treatments, or surgery. When a patient no longer responds to other treatments, has persistent severe symptoms of heart failure, or suffers severe disability, a heart transplant is offered as a procedure of last resort.
Cardiomyopathy is the leading reason for heart transplantation in children. Roughly 20 percent of infants and children with symptomatic cardiomyopathy require a transplant within the first year of diagnosis.
With the combined expertise of the members of our pediatric cardiology team, we help families learn whether they have looked at all possible treatment options before considering a heart transplant. As a research center, we may be able to offer treatments unavailable elsewhere.
Children who are considered candidates for transplant usually:
- Have hearts that are so weak or diseased that the flow of blood throughout the body is dangerously low. When the heart does not pump blood well, too little oxygen circulates to the child's body. Without oxygen, tissues and organs may be damaged;
- Have very complex congenital heart disease that is not correctable with surgery;
- Have dangerous heart rhythms that compromise the amount of blood entering and/or leaving the heart;
- Have little ability to enjoy or participate in ordinary childhood activities, including playing sports, visiting friends, or even attending school;
- Have trouble keeping up with their schoolmates or siblings. They are often much smaller than other children their age. Infants may exhibit developmental delays in sitting, crawling, and standing; they are often very poor feeders; or
- May have been well all their lives and only recently became severely ill with acute myocarditis or cardiomyopathy.
The process of transplantation for a child of any age has a profound impact on the entire family. The proper education, including age-appropriate activities such as play therapy, tours of the hospital, and talking with other parents and children prior to hospitalization, can turn this experience into a positive one. This education includes siblings of the recipient whose lives are very affected by everything their brother or sister is going through. We urge families to communicate openly with the transplant team and their own support systems. The transplant nurse, social worker, and child life specialist will provide more information about available resources and support groups.
ResearchIn addition to providing outstanding patient care, the Pediatric Heart Transplant Program stands at the forefront of pediatric heart failure research, including investigations of new strategies for post-transplant management. The Pediatric Heart Transplant Study Group, founded at NewYork-Presbyterian Morgan Stanley Children's Hospital and comprised of 23 institutions across North America, is responsible for a significant proportion of today's published research related to pediatric heart transplantation.
Liver Disease and Transplantation Center
The Liver Disease and Transplantation Center is a comprehensive program dedicated to treating all forms and stages of liver disease in children and adults. When treatments are unable to save a damaged liver and transplantation becomes necessary, our program offers surgical and postoperative care that reflects the great progress achieved in liver transplantation. While patients await transplantation, our team provides the medical intervention necessary to improve the success of the transplant postoperatively.
Our hepatologists take care of patients with mild liver disease to major illnesses requiring transplantation. Among the conditions we treat that could lead to the need for transplantation are:
- Acute liver failure
- Alagille syndrome
- Alpha 1 antitrypsin deficiency
- Ascites
- Biliary atresia
- Cholestasis
- Cirrhosis
- Hepatitis
- Hepatoblastoma
- Hepatomegaly
- Jaundice
- Liver disease
- Liver injury
- Liver tumor
- Neonatal hepatitis
- Portal hypertension
- Portal vein thrombosis
- Splenomegaly
- Tyrosinemia
- Variceal bleeding
- Wilson's disease
The Center cares for patients from the pre-operative phase through post-transplant recovery. As a medical-surgical service, our surgeons and hepatologists are readily available to answer any parent and patient concerns. The Center also includes a social worker, nurse practitioners, and a financial assistant who helps families with insurance.
Our pediatric patients have access to clinical trials that address the latest therapies in immunosuppression, including novel adult therapies that may be appropriate for older teenagers.
Many of our pediatric liver transplants are performed in children with biliary atresia, whose care is maximized by the collaboration of general pediatric surgeons and transplant surgeons.
Living DonorsNewYork-Presbyterian Hospital is a world leader for living donor transplantation, which involves the removal of a portion of the donor's healthy liver into a recipient. This is possible because of the unique ability of the liver to regenerate. A living donor offers the possibility of earlier transplantation to those in need before their health deteriorates to life-threatening status. Very often a family member or parent is a suitable donor for the child. In addition, we can split donor livers - making a liver available to two children at one time.
