Unborn Baby Waits for Heart Transplant
Doctors in Denver are planning to deliver a baby by C-section just as soon as a heart donor can be found. The unborn child has a rare heart disorder and will undergo a transplant procedure that's never been tried in the United States--almost immediately after she enters the world.
The surgery is the first of its kind in this country in that the heart will not be matched to the baby's blood type, making the chances of finding a heart quickly that much better.
Before she is even born, Baby Arionna is fighting a rare heart defect called hypoplastic left heart syndrome. The defect occurs when the left side of the heart does not grow enough while a baby is in the mother's womb. It affects one in 5,000 babies born each year. The cause is not known. Treatment is risky and consists of either a heart transplant or a series of three heart operations.
Arionna's 19-year-old mother, Tiffany Ray, has opted for the transplant. She will wear a pager to notify her when a heart has been found. Arionna will then be delivered by Caesarean section in Colorado Springs and airlifted to Children's Hospital of Denver to have the transplant.
The baby's mother and her doctor, cardiologist Dr. David Boucek of Children's Memorial Hospital in Denver, spoke with the Early Show about the situation.
The operation is a daunting prospect, but Tiffany remains strong and is keeping a very positive attitude with the help of her family, co-workers, and neighbors. She felt overwhelmed to begin with but thinks that Arionna can feel everything she feels, and she doesn't want her unborn baby to have any doubts.
Although Medicaid will pay for the costs, Tiffany estimates housing and loss of wages will cost her $4,000 during her 3-month stay in Denver. They are not well off and have started a fund to pay for the expenses. People in the area have helped a lot already, if not with money then with prayers.
In the meantime, Tiffany is trying to keep her mind off the heart issue and focus on what most expectant mothers do--gathering baby items and decorating Arionna's nursery.
Since Arionna will probably be born a little smaller than other babies because her oxygen level is lower, she has a nickname picked out already--"Smurf"--because she'll be bluish when she is born due to the oxygen levels. Arionna will turn more of a reddish color after she gets her new heart.
Dr. Boucek says while it is common for a newborn to have a heart transplant, it is unusual for one to occur right at birth. Only one or two babies have had a heart transplant right after being delivered specifically for the purpose of a heart transplant.
The technique is trying to take advantage of the "immune privilege" that a baby has while in the womb--that is, its immune system doesn't fight back against the mother, who more than likely has a different blood type. The theory is that this privilege lasts for a period of time once the baby is born, and that's why thtransplant will be done as soon as possible after the Caesarean section delivery.
The only alternative to the transplant is a surgical technique to alleviate rather than cure the problem, says Boucek. It allows the baby to survive, but in a debilitated way. The odds for survival are not good for the baby in the three-part surgery.
The other benefit from this new transplant technique is that the baby waits in the protective custody of the womb for as long as possible. Her heart condition is not as severe before birth because she is supported by the mother. Babies that are born and wait for a heart get sicker and sicker as time goes on and their chances for survival are less. If she doesn't find a heart before she's born then she will revert back to that scenario--needing to match the blood type and having less of a chance of finding a heart.
Twice as many newborn transplants could be done using this new technique, because when it comes to shortages of donors, a lot of te times it's the blood type matching that makes the donor incompatible.
Transplantation always carries the risk of rejection, and it's a continuous risk for a long time after the surgery. Arionna will still take the immunosuppressive drugs to avoid that chance, but a limited regimen compared to adult transplants.
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