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A Successful Infant Heart Transplant Highlights the Need for Reform to Nation’s Heart Allocation System

Posted on 15 January 2015

By Caroline Song

A story recently published by ABC News focuses on the Knickerbockers, a young family from Huntley, Illinois. Their son, Noah Knickerbocker, was born with an aortic valve stenosis and needed a heart transplant to survive. Since coming into the world five months ago, Noah has received care from the Wisconsin Children’s Hospital. During an attempt to raise money for the procedure, Noah’s parents fell victim to a GoFundMe fraud: the money that was raised on the GoFundMe site to help pay for Noah’s care never reached the Knickerbockers. Despite the Knickerbocker’s financial troubles, Noah received a suitable heart transplant. Although Noah’s surgery went well, he is still recovering. It will take months to determine whether or not the transplant was a success. According to the Organ Procurement and Transplantation Network (OPTN), between 200 and 300 children younger than one year receive heart transplants annually. In 2014, 24,383 heart transplant were performed nationwide.

The Knickerbocker’s story highlights the need for reforms to the current heart allocation system, a problem the Scripps Research Institute also recently addressed. Their article details changes that are recommended by leading cardiac specialists in the United States; these changes are intended to increase the survival rates of patients on waiting lists. The current allocation system was introduced in 1988 and is three-tiered; it takes under consideration factors such as urgency, time on a waiting list, geography and blood type. The proposed changes would add more tiers as a way of including more relevant information about patients, such as the severity of the patient’s illness, estimates of post transplant survival, estimates of waiting list mortality, geographic considerations of heart allocation, and patient ability to survive with ventricular-assisting devices, among other factors. This new push for a more comprehensive allocation system has come about due to technological improvements as well as an increased demand for hearts and a stagnant supply. The proposal will eventually be presented to the United Network for Organ Sharing (UNOS).

Read more about the Knickerbockers here.

To learn more about proposed changes to the heart allocation system, see Medical Xpress.

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