When Tmya Harris was only 4 months pregnant with Ma’Kyrie, an ultrasound showed a severe form of congenital heart disease. Her doctors informed her that three surgeries are usually needed for babies with his condition to survive.
At just eight months pregnant, Tmya was admitted to the hospital with complications. Unfortunately, Ma’Kyrie’s heart rate was dangerously low, and a caesarean section (c-section) was performed.
Ma’Kyrie was transferred into the Neonatal Intensive Care Unit (NICU) at Atrium Health Levine Children’s Hospital where he was diagnosed with hypoplastic left heart syndrome, a congenital heart defect where the left side of the heart never fully develops, leaving the right side to do all the work of a normal functioning heart. Ma’Kyrie had evidence of significant heart failure already, resulting in needing a heart transplant, instead of the typical three staged surgeries.
While he waited for a new heart, Ma’Kyrie underwent a cutting-edge cardiac catheterization procedure, giving a more stable blood flow to his lungs. Unfortunately, his single ventricle heart continued to fail prompting his cardiac team to implant a mechanical heart pump.
Heart transplant donor shortage
“Sadly, there aren’t enough donor hearts available for all the patients who need them,” explained Gonzalo Wallis, MD, one of Ma’Kyrie’s pediatric cardiologists. “For our youngest patients, time is of the essence as we simply cannot afford to wait several months for an appropriately sized heart as children are often extremely sick awaiting heart transplant. The development of an ABO incompatible heart use doubles the number of organs available to infants with Ma’Kyrie’s blood type.”
Alternative heart transplant strategy
To expand the heart donor pool for infants, research has developed an algorithm to successfully transplant blood type-incompatible organs. “This technique involves transplanting a donor heart of one blood type into a recipient with a different blood type,” said Dr. Wallis.
“Your body naturally makes antibodies against anything that is not your own,” Dr. Wallis explained. “Babies, however, do not begin to develop these antibodies until 6 to 12 months of age. If the antibodies have not been fully formed, we can successfully transplant a heart into the blood type-incompatible recipient. The recipient will adapt to the new organ without creating new antibodies.”
Support from a multidisciplinary team
According to Dr. Wallis, a multidisciplinary team is essential to perform an ABO-incompatible heart transplant. Our specialists work together during the following stages:
Before surgery: Pre-transplant antibodies are checked to confirm donor heart acceptance.
During Surgery: Once the donor heart is accepted, the blood products are washed to decrease the risk of developing antibodies. The levels are checked frequently. If the antibody levels increase, the team can filter the baby’s blood in the operating room to improve acceptance of the donor heart.
Surgical success
Ma’Kyrie’s pediatric cardiac team provided outstanding support as soon as he arrived at Levine Children’s. “Not only were we able to successfully support a single ventricle patient on a mechanical heart pump for months, but we ensured the antibodies remained low during this critical time period,” said Dr. Wallis.
After a 4-month wait, Levine Children’s transplant doctors successfully performed Ma’Kyrie’s ABO-incompatible heart transplant. Levine Children’s is one of the few centers in the country and the only hospital in the Charlotte region to offer this type of transplant.
Follow-up care
After spending the first six months of his life in a hospital, Ma’Kyrie’s family was looking forward to bringing him home. “Ma’Kyrie is doing excellent since the transplant,” his mom said. “He smiles a lot and is such a sweetheart. Now that he finally has his new heart, I just cannot wait to see him grow up and become a little boy, run around and play sports – all that good stuff.”
Tmya has been overwhelmed by the ongoing support shown by her son’s care team. She especially appreciated the support of his pediatric cardiologists, Drs. Wallis and Morrison, the transplant team, as well as his nurses in NICU and CVICU.
“In the pediatric cardiovascular intensive care unit, his care team just fell in love with him,” explained Tmya. “They would check on him during the day before they went back to their own patients. There were so many wonderful, supportive staff members – I just can't name them all!”
When asked what advice she would give to other families coping with similar circumstances, Tmya emphasized the importance of being patient and trusting the physicians. “It’s a long journey, so you have to put God first and be patient,” she said. “The doctors at Levine Children’s are amazing. They know what they are doing. They will do everything in their power to help you bring your child home safely.”
To learn more about innovative treatments at Levine Children’s, visit the pediatric heart surgery and cardiology page.
