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Girl, 4, Alberta's heart-lung transplant patient

December 15, 2011

EDMONTON — A four-year-old Calgary girl will be celebrating Christmas Day with family at Ronald McDonald House in Edmonton, two months after becoming the province’s youngest heart and lung transplant patient.

The nine-hour surgery — performed in October at Stollery Children’s Hospital by Dr. John Mullen, the surgical director of the lung transplant program — was complicated by the fact the donor organs are significantly larger than the damaged organs they replaced.

Cheyanne Mattern was discharged from hospital last month and is once again a playful and talkative little girl now living with her family at the Ronald McDonald House as they wait to move into their new Edmonton home. The family is moving here because the girl will require regular monitoring by the Stollery care team.

“This is a new chapter for heart-lung transplant in pediatrics to perform a transplant on a patient this small, this critically ill and a transplant that was this difficult,” says Dr. Jackson Wong, Director of the Pediatric Lung Transplant Program for Alberta Health Services (AHS).

Cheyanne is only the third pediatric patient in Alberta to receive a heart-lung transplant; the other two were five and 17 years old at the time of surgery.

“We’re very grateful for all the support and determination of the staff and physicians who’ve helped Cheyanne,” says Amanda Mattern, Cheyanne’s mother. “They make a great team.”

Cheyanne had appeared to be a perfectly healthy girl until this past July, when she experienced extreme shortness of breath and was admitted to the Alberta Children’s Hospital in Calgary.

She was diagnosed with pulmonary hypertension, a rare disease in which the blood pressure in the lungs’ arteries is elevated, putting pressure on the heart.

In August, Cheyanne was transferred to the Stollery for further testing. Despite hospital treatment, she went into cardiac arrest and was placed on a life support system, VA ECMO, which pushes oxygenated blood through the body, taking over the function of the heart and the lungs. With care provided by the Stollery pediatric intensive care unit team, she remained on VA ECMO but recovered enough to breathe, eat and drink on her own and to play with her family. She still needed a new heart and new lungs to survive long-term.

Cheyanne was referred to Dr. Wong and placed on the urgent transplant waiting list. In early October, a heart and two lungs from one donor became available – a rare occurrence. However the donor heart was much larger than Cheyanne’s and, in light of this, the pediatric lung transplant team had to carefully evaluate how to proceed.

Only 40 per cent of patients on VA ECMO are expected to survive a lung transplant due to an increased risk of hemorrhage and bleeding before and after transplant. Many medical centres will not perform lung transplants on patients who are on VA ECMO.
“We realized this was an opportunity that she might not otherwise get as we rarely have both organs available for very young patients,” says Dr. Wong. “On consultation with Dr. Mullen, we made the tough decision to proceed with transplant surgery.”

The surgery involved keeping Cheyanne’s chest open for five days. When the swelling in her chest due to surgery subsided, there was more room to accommodate the larger organs.

Cheyanne’s care team is currently monitoring her progress to make sure there are no rejection or infections issues.

Cheyanne’s story is tangible proof of the importance of organ and tissue donation.

“If we could say anything to the donor family, it would be thank you for giving Cheyanne a second chance at life,” says Shaun Hill, Cheyanne’s father.

Adds Dr. Wong: “Thanks to the decision made by a donor family, Cheyanne gets a second chance that she wouldn’t otherwise had.”

In Alberta, there are currently 14 pediatric patients awaiting a heart transplant and seven pediatric patients awaiting a lung transplants.

Albertans are encouraged to sign their organ and tissue donor card, located on the back of their Alberta Personal Health Card, and most importantly, to discuss their wishes with their family.

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than 3.7 million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

http://www.albertahealthservices.ca/6129.asp