MEMPHIS, Tenn. – Over the last five years, Le Bonheur Children’s Hospital and University of Tennessee Health Science Center Radiologist Jignesh Shah, MD, who leads Le Bonheur’s heart transplant imaging program, has pioneered a novel imaging technique to match pediatric heart transplant recipients with donors. Using computed tomography (CT) volumetric analysis, Shah developed a methodology to improve donor weight selection in recipient patients awaiting complex pediatric heart transplantation. Shah measured the volumes of the chest cavities of recipients. He then measured the heart volumes of hundreds of patients who underwent CT scans for non-cardiac reasons and created a database of correlation of total cardiac volume and the child’s weight. He utilized this information to choose appropriate donor weight for a recipient’s chest cavity volume.
This technique has been utilized for successful heart size matching in 25 complex pediatric heart transplant surgeries at Le Bonheur. In all cases, the donor hearts were perfectly compatible with the recipient’s chest cavity and inflow/outflow vascular connections.
Le Bonheur was one of the first hospitals in the world to use this technique and is now leading the way to establish this methodology as a standard of care for complex pediatric heart transplants.
Surgical director of Heart Transplant Program, Dr. Umar Boston, was in search of a more scientific way to evaluate patients on the heart transplant waiting list,” says Shah. “In the last five years, we’ve been able to develop this method into a standard of care in our heart transplant program.”
The new methodology can be most valuable in young infants with complex heart anatomy, such as dextrocardia (right-sided heart) where an accurate donor size is critical to avoid compression issues. Shah worked with Boston to develop a more accurate methodology that better predicts the appropriate size of donor best suited for Le Bonheur’s heart transplant recipients.
“This is a key indicator for donor selection,” says Shah. “It’s important to have accurate information for the surgeons, and it helps families to understand the care with which we match their child to a donor heart."
Heart size matching has been helpful for the heart transplant to go smoothly and for postoperative success. Of the 25 patients matched using this technique, none have had instances of open chest immediately after surgery due to size mismatch. In partnership with heart transplant surgeons, Shah has been able to refine his technique and establish a methodology for heart transplant recipients.
Currently, Shah is representing Le Bonheur in the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) size-matching project – a multi-institutional effort to help standardize the size matching methodology for heart transplantation.
About Le Bonheur Children’s:
Le Bonheur Children’s Hospital in Memphis, Tenn., treats children through community programs, regional clinics and a 255-bed state-of-the-art hospital. Le Bonheur serves as a primary teaching affiliate for the University Tennessee Health Science Center and trains more than 350 pediatricians and specialists each year. Nationally recognized, Le Bonheur is ranked by U.S. News & World Report as a Best Children’s Hospital.
About University of Tennessee Health Science Center:
As Tennessee’s only public, statewide, academic health system, the mission of the University of Tennessee Health Science Center is to bring the benefits of the health sciences to the achievement and maintenance of human health through education, research, clinical care, and public service, with a focus on the citizens of Tennessee and the region. The main campus in Memphis includes six colleges: Dentistry, Graduate Health Sciences, Health Professions, Medicine, Nursing and Pharmacy. UTHSC also educates and trains medicine, pharmacy, and/or health professions students, as well as medical residents and fellows, at major sites in Knoxville, Chattanooga and Nashville. For more information, visit www.uthsc.edu. Find us on Facebook: facebook.com/uthsc, on Twitter: twitter.com/uthsc and on Instagram: instagram.com/uthsc.
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