Rules Relaxed on Giving Babies New Hearts
Inspired by the death of a 6-week-old girl, the nation’s transplant network voted Thursday to ease its rules on giving new hearts to infants.
The new policy by the United Network of Organ Sharing will let babies younger than 1 year old get hearts that don’t match their blood types.
The change, which will be implemented as soon as possible, came after a Colorado baby, Arionna Harris, died at 6 weeks old while awaiting a heart.
“This is her gift back to society,” said Dr. Mark Boucek, director of the pediatric heart transplant program at Children’s Hospital in Denver, who campaigned for the change.
The Richmond, Va.-based organ network maintains the nation’s waiting list for organ transplants.
Under the policy, donor hearts will be offered first to recipients with compatible blood types and then to those younger than 12 months with other blood types, network spokeswoman Anne Paschke said.
Doctors say there is evidence that infants can tolerate hearts from incompatible donors. Critics have questioned whether the risks are too great and whether the policy change would deprive babies with matching blood of heart donations.
Dr. Frederick Grover, chairman of the organ network’s thoracic committee, said that the proposal is crafted so that there will not be a disadvantage to babies listed for a specific blood type.
“If anything, it will allow more organs to be utilized and get to the recipient centers so there is a shorter waiting list. For the children who need hearts, the clock is ticking,” said Grover, head of cardiothoracic surgery at the University of Colorado Health Sciences Center.
About 1 in every 5,000 newborns suffers from congenital heart disease and can be a candidate for a heart transplant. Type O recipients are compatible only with type O donors, but recipients with A, B and AB blood can be matched with other types.
In a March study reported in the New England Journal of Medicine, Canadian doctors said they transplanted hearts of incompatible blood type into 10 children. The recipients, as old as 14 months, were almost all type O. In most, immune systems had not yet produced antibodies against incompatible blood types.
Dr. Lori West and her colleagues at the Hospital for Sick Children in Toronto reported a survival rate of 80% among such patients, as good as the rate with compatible donors.
Arionna, daughter of 19-year-old Tiffany Ray of Rockvale, died Sept. 23 at Children’s Hospital. She had been on the waiting list for a heart because her left ventricle wasn’t developing properly.
