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Heart transplant on an infant——s​ave life before Children's Day

Time:Jun 3, 2021

A cross-disciplinary team led by Cardiovascular Surgery Dept. of our hospital performed a heart transplant for a 9-month-old baby girl called Hanhan from Hangzhou on May 31. The operation lasted two and a half hours, and Hanhan regained a healthy heart on the eve of Children's Day. According to Cardiovascular Surgery Dept., Hanhan is showing stable vital signs today and healing quickly after removal of air tube and cannula.

In August 2020, Hanhan was born in Hangzhou. Starting from the seventh month, however, her head was always down and leaning on her parents' shoulders, and she had no appetite and was losing weight. Seeing his daughter getting worse, Mr. Sun took her to a local hospital and it was found that Hanhan's heart was double the size before, combined with interventricular septal defect and pulmonary artery hypertension. The doctor suggested them to go to a better hospital. 

In April, the family went to Shanghai for treatment. Hanhan was in a bad situation then. After further examinations, Hanhan was diagnosed with dilated cardiomyopathy combined with severe heart failure, and need to be put into PICU (Pediatric Intensive Care Unit) for treatment. The only way to save her life would be a heart transplant.

"During those days, we felt we were waiting in the ICU for her life to come to an end helplessly." Mr. Sun was desperate but didn't want to give up. After making some inquiries, he learnt that Director Dong is a top expert in pediatric heart transplantation, and they set off for Wuhan immediately.

Hanhan's heart is almost as big as adult's

Knowing Hanhan's conditions, Director DONG Nianguo told him, "the kid still has hopes. We will do everything we can to save her life."

Dr. LI Geng of Cardiovascular Surgery Dept. escorted Hanhan from Shanghai to Wuhan via an ambulance at 9 a.m. on May 7.

The ambulance arrives at Union Hospital

At about 7 p.m. on the same day, the ambulance arrived at Union Hospital.

Thanks to attentive care by Prof. SHI Jiawei from Cardiovascular Surgery Dept. for three days, Hanhan recovered from fever, the respirator was removed and she was transferred to a regular ward.

The team of Prof. DONG Nianguo, Director of Cardiovascular Surgery Dept., and Prof. XIA Jiahong performs heart transplant on Hanhan

After the operation, Hanhan was moved to the Telemetry Unit. The heart-care team at Union Hospital can provide the best possible nursing and care. She would face infection, rejection and pulmonary artery hypertension, among other difficulties.

"We are doing our best to offer a China's solution to children at the final stage of heart diseases", Prof. XIA Jiahong, Vice President of Union Hospital and professor of Cardiovascular Surgery Dept., said that heart transplantation is a main approach to treat heart diseases at the final stage. It started late and developed slowly in China, not to mention pediatric heart transplantation. Nowadays, Union Hospital has become advanced in pediatric heart transplantation, especially for infants.

Union Hospital has completed more than one hundred cases of pediatric heart transplants and topped the country in terms of the number of cases for many years in a row. From three-month Tianyou who weighed 4.25 kg in 2014, to 66-day Ruirui who weighed 3 kg in 2019, Cardiovascular Surgery Dept. at Union Hospital has kept pushing the boundaries and rewriting the record of pediatric heart transplantation with younger age and lower weight.

Led by Prof. DONG Nianguo over these years, Cardiovascular Surgery Dept. of Union Hospital innovated the "marginal donor heart" theory, improved the donor heart protection methodology and lengthened the international standard cold ischemia time from 4 hours to 6-8 hours, which has eased the shortage of donor hearts to some extent, a bottleneck in the development of transplantation. A set of heart transplantation techniques well suited to the conditions in China have been developed to not only optimize receptor evaluation, mechanical assistance and anti-rejection policy, but also to design surgical methods individually, considering the characteristics of pediatric heart transplantation, and to improve the success rate. For example, the donor heart rotation surgical method was applied to dextrocardia heart transplant at the final stage of congenital heart diseases, and combined with side branch closure, the world's first hybrid heart transplant at the final stage of congenital heart diseases was implemented. By enlarging cavum pericardii and improving anastomosis of cavity, a heart transplant on the smallest patient of the lowest weight (66 days, 3 kg) in Asia was successfully performed. These achievements are believed to have advanced heart transplantation in China and in particular taken pediatric heart transplantation in China to world-class level.