“Happy, Scared and Anxious”: Duke Performs First Pediatric DCD Heart Transplant

A Duke medical team successfully made the first donation after a circulatory death heart transplant (DCD) in a pediatric patient last month, expanding the potential pool of heart donors.

The pediatric patient was Jaynzra “Nae” Rice, 14 years old. Rice was hospitalized in Duke earlier this year with difficulty breathing and received a left ventricular assist device that helps the heart pump, according to a Duke Health Press release.

About three months after discharge from the hospital, the family learned that Rice was eligible for the first DCD pediatric heart transplant. Rice’s mother, Brandaline Rice, said she felt elated.

“I felt blessed that she could receive a new heart and be the first to experience it so that many children could have the opportunity to have it available to them,” said Brandaline Rice.

Andersen hopes this first transplant will launch this technology in pediatrics and motivate others to pursue it. This technique could increase the number of heart transplants performed by 50%, said Andersen, “which would help more children get heart transplants and get them sooner.”

Nae Rice’s existing heart pump made the operation more difficult, Andersen said. However, being with the same medical team he worked with for previous transplants took the pressure off.

During this time, Brandaline Rice felt a roller coaster of emotions.

“I was happy, scared and anxious until I knew the surgery was over,” said Brandaline Rice.

Although Nae Rice has a bit of trouble breathing after the operation, she is strong and will continue to recover, Brandaline Rice said.

“She just rolls with the punches, so she’s ready to get back to some normalcy,” she said. “She loves school and she loves taking the bus; she is ready to get back on the school bus.

Turek and Assistant Professor of Surgery Benjamin Bryner recovered the donor’s heart. Assistant professors of surgery Nick Andersen and Jacob Schroder were the lead surgeons for the procedure, which took place on August 31.

How the transplant works

The main difference between traditional heart transplants – known as donation after brain death transplant – and DCD is getting the donor’s heart.

Previously, DCD cores could not be used due to damage sustained during provisioning.

Now, thanks to organ preservation technology approved by the Food and Drug Administration of the company TransMedics, the heart is recovered from a deceased donor with no cardio-respiratory function and circulates warm, oxygenated blood to maintain the action of pumping.

Duke was a pioneer in DCD surgeries, having played more than 50 DCD adult heart transplants since the first December 2019. However, the first procedure on a pediatric patient was particularly exciting because it was “very difficult to get pediatric patients involved in trials,” according to associate professor of surgery Joseph Turek.

“It’s just a limitation of pediatrics, so it’s very exciting to be a part of something that can help kids down the road,” Turek said.

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