Dell Children’s begins heart transplant program
This story was originally published on Aug. 1, 2020.
Dell Children’s Medical Center of Central Texas officially launched its heart transplant program Friday after the United Network for Organ Sharing approved it July 22 to list children and adolescents in the network and to do transplants.
The program is a partnership between Dell Children’s, the University of Texas Dell Medical School and UT Health Austin, the clinical practice of Dell Medical School. Together, said Christopher M. Born, president of Dell Children’s, they are making “this next step in being able to fully care for all pediatric heart patients. The ability to do heart transplants is our next progression.”
Dell Children’s will be the third children’s hospital in Texas to do heart transplants. Texas Children’s Hospital in Houston and Children’s Health in Dallas perform about 150 pediatric heart transplants from 2015 to 2018. Born says a feasibility study showed that for its size, Texas should be doing about 179 heart transplants. Smaller states such as Missouri and Ohio already have three children’s hospitals doing transplants.
“Texas absolutely needs a third pediatric heart transplant center,” Born said.
Dell Children’s goal for this first year is to do two heart transplants. Within the next four years it expects to be doing 10 a year, Born said.
The transplant program is two years in the making and began when Dell Children’s, UT Health Austin and Dell Medical School brought pediatric cardiologist Dr. Charles Fraser Jr. to Austin from Texas Children’s to build the Texas Center for Pediatric and Congenital Heart Disease.
Fraser has since built a team, which includes Dr. Carlos Mery, the surgical director of the heart transplant program, and Dr. Chesney Castleberry, the medical director of the pediatric heart failure and transplant program and the first pediatric heart muscle disease specialist in Central Texas. Castleberry, who came from St. Louis Children’s Hospital, and Mery, who came from Texas Children’s, have experience with a combined 190 heart transplants.
“They have the expertise; they have the experience; they’ve done it before,” Born said.
Dell Children’s also has been building other specialized heart transplant staffing, including transplant coordinators, nurses, pharmacists, nutritionists, social workers and child life specialists, physical and occupational therapists, and anesthesiologists.
Fraser said in May, after Dell Children’s submitted the paperwork to start transplants here, that there’s been a “huge change.” “We’ve added large numbers of people that are needed and critical to the mission,” he said.
One of the beginning steps in the program was opening a specific cardiac care unit with specialized staffers and equipment inside the hospital. In June 2019, the 24-bed cardiac care unit opened, and it was already full on its first day. Overflow patients are cared for in other areas of the hospital.
The hospital also upgraded two operating rooms with specialized equipment for heart transplants and other cardiac procedures.
With the team and unit in place, the hospital was able to insert its first left ventricular assist device — a life-prolonging device for people with heart failure — in September and has since done a second of those procedures. That device can be considered a bridge between heart failure and a heart transplant.
Ascension, the parent company of Dell Children’s, is investing $700 million in the next five years in Dell Children’s for technology, facilities and medical teams.
The Dell Children’s Specialty Pavilion, a four-story, 161,000-square-foot building to the east of the hospital, is under construction and will house the medical offices for the Texas Center for Pediatric and Congenital Heart Disease, the Neurosciences Center of Excellence, and the Children’s Blood and Cancer Center of Excellence, as well as a new Fetal Center. That $113 million project is expected to open in April.
The hospital also has a $209 million expansion to build a fourth tower, which will add 72 beds and is expected to open in December 2023.
Dell Children’s plans to build a second hospital with 36 beds and a medical office building next door in November 2022. The $191.8 million project will be at the southeast corner of the 183-A tollway and Avery Ranch Boulevard.
Texas Children’s Hospital is also expanding its presence in Central Texas with a $450 million hospital being built at North Lake Creek Parkway and Texas 45. It will have 48 beds and is expected to open in the fourth quarter of 2023.
St. David’s HealthCare already has a 57-bed children’s hospital in North Austin that opened in 2014 and is attached to North Austin Medical Center.
The expansion from one children’s hospital to four in 10 years is part of the growth story of Central Texas.
More growth could be on the way. Both Texas Children’s and Dell Children’s are considering expanding with additional hospitals in South Austin or Hays County after the two North Austin hospitals are finished.
Dell Children’s is also building the kidney transplant team, and Born expects Dell Children’s will be performing those in a year. It also is working on a team to do bone marrow transplants in two years.
Since Born arrived from Texas Children’s in 2017, he has added 150 physicians to Dell Children’s and is able to recruit doctors to Austin because of the medical school. Doctors are looking for places that have opportunities in three areas: clinical care, research and academics, he said.
“These people will be the definers of excellent programs,” Born said. “They have the compassion to do it and the commitment.”
The goal for Dell Children’s, Fraser said, is “that no child in this part of the world would have to leave Austin for specialty care. There’s no reason why Austin should not be a destination hospital for the world.”