[ISPHLT-KL3] Pediatric heart transplantation: from the beginning
Pediatric heart transplantation at Loma Linda University began in 1985 with the transplant of a 4 day old infant born with hypoplastic left heart syndrome. The success of this transplant made it necessary to establish a reliable infant donor identification process to match future potential recipients and donors. It also necessitated designing treatment protocols for the clinical management of infants after transplant. As well, it was necessary to identify dedicated nurse clinicians, so called transplant coordinators, to carefully oversee each step of the transplant process.
The first step in the transplant process begins with the referral of any potential recipient. This first call sets in motion a cascade of activity that gives definition to the transplant coordinator's role as communicator and family advocate. As a first priority, the transplant coordinator facilitates the rapid transfer of information from the transplant center to the referral facility regarding management techniques for the potential recipient while awaiting diagnostic data that supports the need for heart transplantation. Communication with the family may begin at this time. It is important to provide the family with information about their options and the serious, lifelong commitment involved if the choice for transplant is made.
The second important call is the donor call, which necessitates a rapid but thorough assessment of the donor, especially in regard to cardiac function. The transplant coordinator's responsibilities include organizing the pre-operative orders for the recipient, making flight and logistical arrangements for the donor recovery process, including notification of all team members. In the case of Loma Linda, the transplant coordinator accompanies the surgeon on procurement, functioning as a "circulating" nurse in the operating room.
Success in heart transplantation requires a dynamic interdisciplinary team whose members are dedicated to improving the quality of life of the children they serve. The pediatric heart transplant team includes cardiac surgeons, general pediatricians, pediatric cardiologists, neonatologists, immunologists, infectious disease specialists, ethicists and transplant nurse coordinators. At Loma Linda, all primary long-term care is provided by a group of pediatricians, supported by transplant coordinators.
The first step in the transplant process begins with the referral of any potential recipient. This first call sets in motion a cascade of activity that gives definition to the transplant coordinator's role as communicator and family advocate. As a first priority, the transplant coordinator facilitates the rapid transfer of information from the transplant center to the referral facility regarding management techniques for the potential recipient while awaiting diagnostic data that supports the need for heart transplantation. Communication with the family may begin at this time. It is important to provide the family with information about their options and the serious, lifelong commitment involved if the choice for transplant is made.
The second important call is the donor call, which necessitates a rapid but thorough assessment of the donor, especially in regard to cardiac function. The transplant coordinator's responsibilities include organizing the pre-operative orders for the recipient, making flight and logistical arrangements for the donor recovery process, including notification of all team members. In the case of Loma Linda, the transplant coordinator accompanies the surgeon on procurement, functioning as a "circulating" nurse in the operating room.
Success in heart transplantation requires a dynamic interdisciplinary team whose members are dedicated to improving the quality of life of the children they serve. The pediatric heart transplant team includes cardiac surgeons, general pediatricians, pediatric cardiologists, neonatologists, immunologists, infectious disease specialists, ethicists and transplant nurse coordinators. At Loma Linda, all primary long-term care is provided by a group of pediatricians, supported by transplant coordinators.