A study carried out in the US in 2004 discovered that majority of the pediatric patients that go through heart transplant enjoyed proper adulthood and lived a good life. Pediatric heart transplantation is a beneficial intervention as it helps patients to live long active years after the surgery. Sometimes the heart transplantation can take up to 12 to 16 hours of operation depending on the nature of the surgical operation that the individual has undergone before. In children that have never been operated on, the procedure may take about four hours, but if the child had undergone numerous procedures, the transplant might even take double of that period, sometimes six to eight hours.
The concept of retransplantation is real, and it occurs in about two to four percent of the entirety of cardiac transplants carried out. This could be immediately after the heart transplant, as in acute failure or the future. But when these retransplantations are done it is just like in the initial procedure, every protocol is followed as before, and the clock practically reset.
How Much Does a Heart Transplant Cost with Insurance?
A heart transplant can be very expensive only medications can be in the upwards of $30, 000 and the entire heart transplant can be up to a Million US dollars. There is no reason to panic or worry, the cost of a million is without the consideration of insurance, and it is not the final representation of the patients end up paying. Moreover, there are other expenses that one has to make that are not directly related to the surgery such as feeding, tutoring, and traveling among a few others. Medical Costs include Insurance deductibles, Doctor fees, Insurance co-pays, complication treatment, treatment for 30 days before transplant, treatment by the doctors during transplantation, in the case where there is no donor – procuring the heart, hospital admission for the operation, immunosuppressant medication, evaluations and testing, treatment for the first 180 days aftercare, follow-up care, rehabilitation, surgical procedures.
Do Heart Transplant Patients Live Long?
The rates of survival of the patients who go on the table and under the knives of the surgeon have immensely improved. This feat was achievable as a result of the improvement in the techniques of performing the Fontan surgical operation that has been developed over the past four decades. Training of surgeons and the healthcare professionals involved in the procedures have entirely been enhanced, and become sophisticated with the help of simulators, and the boost that antisepsis and antibiotics preparation has brought into the practice.
However, the incidence of having Protein-Losing Enteropathy (PLE), which is losing protein through the gut affects about one-fifth of the Fontan patients. Furthermore, the occurrence of arrhythmic attacks, which is having an irregular heartbeat, is still not been effectively dealt with by the surgeons. Also, alongside the requirement for the operations to be done again when the long-term checkups are done, is still significantly not reducing and managing of the patients in these situations have been quite demanding.
But the assessment of the patients after the heart transplant has also been remarkably improved upon to ensure that prompt intervention is implemented in cases of rejection. Although it is an expensive and invasive procedure, the endomyocardial biopsy is the gold standard for monitoring heart allograft health currently after surgery making the noninvasive method of diagnosis based on the screening of circulating cell-free donor-derived DNA (cfdDNA), a relatively efficient and preferable option as well.
The strength of using the cfdDNA is that is not invasive. The noninvasive DNA transplant dynamic approach of the cfdDNA is a very elaborative and efficacious method for regular assessment of the allograft health without having to worry about the risk and financial implication of an invasive biopsy to monitor the success of the procedure. Both are used to ensure the safety of the health of the person that has undergone the heart transplant.
Pediatric Heart Transplants
A heart transplant is rarely done in a pediatric patient unless it is of utmost importance and it is only carried out as the final course of action in saving the life of the pediatric patient. The whole idea of heart failure in a child is relatively complicated. Most often heart failures may basically be as a result of systolic dysfunction which further leads to low cardiac output, but it can also be as a result of diastolic dysfunction that could be seen in restrictive cardiomyopathy. The growing or developing child may even be suffering from a congenital disease of the heart making the entire much more complex both in diagnosing and as regards the intervention. The rate of survival has dramatically risen in the pediatric population subjected to this procedure with almost eight to nine out of every ten heart transplant surviving and going on to lead and live a good life.
How Long Does a Heart Transplant Last in a Child?
A study carried out in the US in 2004 discovered that majority of the pediatric patients that go through heart transplant enjoyed proper adulthood and lived a good life. The research was done by Seth A. Hollander and his team. He was the clinical assistant Professor of Pediatrics (Cardiology) and associate section Chief of Pediatric Heart failure and transplantation, Department of Pediatrics (Cardiology), Stanford University Medical Center, Palo Alto, California, USA.
The experiment went further to test the quality of life (QOL) and the capacity for achievement in the lives of the survivors of the pediatric heart transplant in their adult years. The test was done with 20 individuals who were operated on as children and had lived for a minimum of ten years after the transplant. They also had to have been older than 18 years to be part of the study. So the Quality of Life Index (QLI) was utilized and even the Metrics of life achievement questionnaire that took into consideration their salaries, education, social status, accommodation and their level of health care.
The result of the overall QLI score was averagely satisfactory in domains such as that of health and socioeconomic, and the scores were exceptionally good in the family section with the lowest performance recorded in the psychological and spiritual domain. Which shows that all these people have now grown mature and healthy, capable of pursuing careers in the academic field, work, and live life independently. Most of them were even able to raise a family and take care of both their immediate family as well as the new one they have started.
Pundi, K. N., Johnson, J. N., Dearani, J. A., Pundi, K. N., Li, Z., Hinck, C. A., … & Cetta, F. (2015). 40-year follow-up after the Fontan operation: long-term outcomes of 1,052 patients. Journal of the American College of Cardiology, 66(15), 1700-1710.
De Vlaminck, I., Valantine, H. A., Snyder, T. M., Strehl, C., Cohen, G., Luikart, H., … & Quake, S. R. (2014). Circulating cell-free DNA enables noninvasive diagnosis of heart transplant rejection. Science translational medicine, 6(241), 241ra77-241ra77.
Hollander, S. A., Chen, S., Luikart, H., Burge, M., Hollander, A. M., Rosenthal, D. N., … & Bernstein, D. (2015). Quality of life and metrics of achievement in long‐term adult survivors of pediatric heart transplant. Pediatric transplantation, 19(1), 76-81.
Ryan, T. D., & Chin, C. (2017, August). Pediatric cardiac transplantation. In Seminars in pediatric surgery (Vol. 26, No. 4, pp. 206-212). Elsevier.
Roessner, B. (2014). How Much Does A Heart Transplant Cost? – smallbeats. smallbeats. Retrieved 27 February 2018, from http://smallbeats.childrensomaha.org/much-heart-transplant-cost/
Zidwick, V. (2017). Heart Transplant in Children: Surgery and Quality of Life Afterwards | Johns Hopkins Comprehensive Transplant Center. Hopkinsmedicine.org. Retrieved 27 February 2018, from https://www.hopkinsmedicine.org/transplant/news_events/media/transcripts/heart/heart_children_surgery.html