Team approach to transplant care saves patient’s life

November 04, 2010

Quaneisha "NeNe" Driver, 15, knew she would be given presents this past Christmas, but she never expected to receive the gift of life.

An undiagnosed coronary artery anomaly caused the Everman High School freshman athlete to suffer a heart attack back in August. Surgeons at another area hospital attempted to repair the anomaly on Nov. 29, but NeNe's heart function continued to deteriorate, and she was placed on extracorporeal membrane oxygenation, or ECMO, to sustain her life. ECMO is a special procedure that uses an artificial heart-lung machine similar to the bypass equipment used during open-heart surgery to take over the work of the heart and lungs.

When NeNe's heart failed to recover following two weeks of life support, doctors at the other hospital determined a transplant was her only hope. Children's was the obvious choice, the only hospital in North Texas with a sustained history of performing pediatric heart transplants. Since pioneering the operation in the area in 1988, Children's has performed more than 70 pediatric heart transplants for patients as young as newborns and continues to be the only center in North Texas to offer pediatric heart transplants for neonates to young adults.

Critical expertise

ECMO transport is dangerous because of the delicate state of the patient and the size and weight of the equipment.

"From the time we got the call from Transport, we were told we had 45 minutes to build a special ramp 34 inches high on one end and adjustable from 30 to 33 inches high at the other end to meet the height of the ambulance bay floor," said Craig Williams, director of Engineering. "During the same time frame, housekeeping cleaned and sanitized the receiving bay in preparation for the critically ill patient's arrival."

Once NeNe arrived at Children's, she was taken to the 17-bed cardiovascular ICU, the first and largest dedicated pediatric cardiovascular intensive care unit in North Texas, where she was monitored by a specialized team of cardiac intensivists, nurses, nurse practitioners and respiratory therapists.

Upon arrival, Susan Daneman, heart transplant coordinator in the hospital's Solid Organ Transplant Program, and the transplant team began the extensive evaluation and a search for an appropriate match for the heart. After determining she was a suitable candidate for transplant, they placed her on the United Network for Organ Sharing list. By Dec. 23, NeNe had been on ECMO for more than three weeks, and the danger of infection and internal bleeding increased exponentially with each passing day. She was running out of time.

Finally, late in the evening on Christmas Eve, Children's received a call that a heart had been donated. Once tests determined the heart was compatible, the transplant was scheduled for Dec. 25.

A Christmas wish comes true

"I wished for a Christmas miracle, and that's just what we got," said Angela Driver, NeNe's mother. "We're so thankful for Children's."

Dr. Steven Leonard, a cardiac surgeon on the medical staff at Children's, and Dr. Dan Meyer, Sarah M. and Charles E. Seay Distinguished Chair in Thoracic Surgery at UT Southwestern, began the transplant on Christmas evening, and just before midnight, NeNe was removed from ECMO support for the first time in nearly a month, her body sustained by her new, functioning heart.

"Seeing NeNe off life support following the surgery was the best gift I could have received," Angela said. "I'm blessed that she's at Children's."

Dr. Leonard credits NeNe's success story to the team approach to care she received at Children's. "When you have multiple facets of a talented organization working in concert to provide care, it's amazing what can be accomplished," he said. "A lot of people had a hand in this success story."