Three significant studies published in 2025 highlight the expertise of Riley Children’s Health in pediatric heart transplant and the management of complex care for children and young adults with heart failure. Cardiovascular specialists at Riley Children’s presented the studies at the International Society for Heart and Lung Transplantation annual meeting in April 2025.
Fontan Heart Transplant with Cirrhosis: Give the Liver to Someone That Needs It
A retrospective review since January 2010 revealed that liver transplant is not universally needed in failing Fontan patients undergoing orthotopic heart transplant (OHT). In the cohort at Riley Children’s, no patients with a diagnosis of liver cirrhosis had a combined heart-liver transplant. The one-year and three-year OHT survival in the biopsy-proven cirrhosis group is 100%. For the cirrhosis group proven by imaging, the one- and three-year survival rates are 100% and 91%, respectively.
Switch to Success: Heart Transplant After the Mustard Operation
Since 2005, patients who had OHT after Mustard operation at Riley Children’s had exceptional early postoperative outcomes: average postop length of stay of two weeks, low incidence of acute rejection in the first year and 100% survival at one year. Three-year survival was 82%, and five-year survival was 73%—both consistent with reported outcomes of adult heart transplant recipients with congenital heart disease.
Cardiovascular surgeons at Riley Children’s have transplanted two patients with severe cardiac and skeletal disease, allowing both patients with neonatal Marfan syndrome to discontinue enteral tube feedings and independently complete activities of daily living.
Surgical expertise and surveillance are key to success
In the latest report released by the Scientific Registry of Transplant Recipients (SRTR) in July 2025, Riley Children’s performed at or above benchmark in one-year and three-year patient survival following pediatric heart transplant. Survival at 30 days is 100% compared to benchmark of 98.36%.
“Riley’s longstanding record of success in pediatric heart transplant is attributable to a unique combination of intraoperative expertise and proactive post-transplant surveillance,” said pediatric cardiologist John J. Parent, MD, MSCR, who shares leadership of the Riley Children’s heart transplant program with cardiovascular surgeon Mark W. Turrentine, MD. “Our experienced cardiothoracic surgeons are highly skilled technically, particularly when transplanting to patients with congenital heart disease which requires much more extensive reconstruction. This is particularly true for patients with Fontan completions.”
Following transplant, a team of three seasoned transplant coordinators provides 24/7 support to heart transplant patients and their families. The program maintains a low coordinator-to-patient ratio with each coordinator assigned to just 25 to 30 patients to ensure more personalized care. Patients stay with the same transplant cardiologist and coordinator who see them throughout their time in the program.
Riley Children’s is home to one of the few Pediatric Heart Failure/Transplant Programs in the Midwest–and the only program in Indiana. In addition to skilled, experienced pediatric heart surgeons and cardiologists, Riley Children’s offers a proven home monitoring program for single ventricle patients and patients on VAD.
