The Royal Children’s Hospital (RCH) today celebrated 25 years of providing heart transplants to children and young people across Australia.

Young transplant recipients wore their hearts on their sleeves at the hospital this morning to thank the RCH clinicians past and present who gave them another chance at life.

Since its establishment in 1988, the RCH Heart Transplant Service has performed transplants for 116 patients, enhancing the lives of neonates through to young adults suffering end stage heart failure.

The first transplant was performed on a 14-year-old boy on 5 October 1988. The operation required the collaboration of a large and dedicated team of clinicians, including then Director of Cardiology Jim Wilkinson and Director of Cardiac Surgery Roger Mee, both of whom attended this morning’s celebration.

At that time, heart transplantation was regarded as pioneering treatment. There was no local adult heart transplant service with which to share experience, knowledge about how to handle rejection was limited, and there were fewer medications available to prevent and manage complications.

Today, the team is no smaller and just as dedicated. Each heart transplant patient will receive care from cardiologists, cardiac surgeons, perfusionists, theatre nurses, theatre technicians, cardiac anaesthetists, transplant coordinators, intensive care nurses, ward nurses, pharmacists, physiotherapists and many other supporting services.

The RCH is the Nationally Funded Centre for paediatric heart transplantation – a status granted in 1991 by the Commonwealth Government – and patients come from all Australian states and territories. The RCH is also a Nationally Funded Centre for lung and liver transplantation in children, and for the surgical treatment of hypoplastic left heart syndrome.

Dr Robert Weintraub, cardiologist who manages the RCH Heart Transplant Service, said the service remains at the forefront of care among international transplant centres.

“Our survival rates equal those of the world’s largest heart transplant centres and that’s a testament to the skill, commitment and enthusiasm of our entire team,” Dr Weintraub said.

“We also collaborate with the Murdoch Childrens Research Institute and transplant centres across the United States on research programs to better understand diseases that might one day require transplantation and to improve outcomes for patients globally,” he said.

Over the years, the service has embraced new technologies and procedures to improve patient eligibility for heart transplantation and achieve better clinical results.

In 1988 the RCH performed Australia’s first heart-lung transplant. This program has evolved into the Nationally Funded Centre lung transplant service shared with the Alfred Hospital in Melbourne.

In 2005, RCH cardiac surgeon Dr Yves d’Udekem began placing eligible patients on ventricular assist devices (VADs). This mechanical pump replaces the function of a patient’s failing heart while they wait for transplantation. The VAD can extend a patient’s life long enough for transplantation to be viable or, in very rare cases, allow the heart to recover from a severe viral infection to the point where transplantation might no longer be necessary.

In 2009, the RCH performed Australia’s first paediatric ABO incompatible heart transplant. After being diagnosed with dilated cardiomyopathy, baby Scarlett McGowan was placed on the waiting list for an urgent heart transplant. To increase the chance of a suitable donor becoming available in time, Scarlett was listed for transplant with a heart from an incompatible blood type.

Today, Scarlett is a healthy, lively four year old and her mother Sam cannot thank the RCH enough.

“We are forever grateful to the donor and their family for giving our daughter such a selfless gift. We have so much love and gratitude for all the team at the hospital and we will encourage Scarlett to live her best life to honor her donor, and her doctors and nurses,” Sam said.

Another development allows patients who would otherwise not have been considered for transplantation, to become eligible. When a patient develops antibodies that might increase the chance of organ rejection after transplantation due to previous heart surgery, a suitable treatment plan can be devised, which may include treatment to purify the blood plasma of antibodies thereby reducing the risk of organ rejection.

Dr d’Udekem said the future of heart transplantation looked bright.

“We will soon start using implantable forms of circulatory support which will allow more comfort and mobility for children awaiting transplantation, as well as lower rates of complications,” he said.

Amidst the celebrations, Dr Weintraub stopped to acknowledge that for every success his team witnessed, a family was hurting.

“Without the courage and generosity of organ donors and their families, none of these transplants would be possible. Despite this, our organ donor rates are significantly below those of comparable countries in Europe and North America.

“Organ donation is a selfless gift and I urge Australians to consider registering themselves as organ donors,” he said.

To register as an organ donor, visit www.donatelife.gov.au