Children's Hospital Colorado (Children's Colorado) has achieved a remarkable milestone by successfully completing its inaugural dual heart and liver transplant. This significant event is a testament to the dedication and teamwork of numerous specialists operating across 25 multidisciplinary care teams, all working together to nurture the health of young patients.

In the United States, only 38 pediatric patients have previously undergone the dual transplant of both a heart and liver, making this accomplishment even more noteworthy. "Performing Children's Colorado's first-ever heart and liver dual organ transplant is an amazing accomplishment for our Pediatric Transplant Program," expressed Dr. Megan Adams, the surgical director of the Pediatric Liver Transplant and Kidney Transplant Programs. She emphasized the hospital's commitment to being a trusted leader in pediatric transplant care across a seven-state region, highlighting the joy of being able to offer such advanced treatment to children facing life-threatening illnesses.

Years of dedicated preparation paved the way for this life-saving procedure. The care teams at Children's Colorado had been readying themselves for the possibility of a dual transplant, fostering close collaboration among experts in surgery, cardiology, hepatology, and more. Their hard work and the unwavering support from hospital leadership were crucial when 11-year-old Gracie Greenlaw and her family turned to them for help.

Gracie bravely faced a challenging journey from birth due to hypoplastic left heart syndrome (HLHS), a condition in which her heart developed with only one functioning pumping chamber. Before her third birthday, she had undergone three major surgeries—Norwood, Glenn, and Fontan—to help her heart circulate blood effectively. While many children with HLHS now thrive into adulthood, the journey often brings long-term complications, including liver damage.

To meet these ongoing challenges, Children's Colorado established the Fontan Multidisciplinary Clinic in 2016, focusing on holistic care for patients like Gracie who have HLHS and other single ventricle conditions. This innovative clinic has provided Gracie with continuous monitoring and treatment for her heart and liver, thanks to the collaborative efforts of her care team, which included cardiologist Dr. Kathleen Simpson and hepatologist Dr. Dania Brigham. Together, they ensured Gracie remained as healthy as possible before deciding that a dual organ transplant was the best path forward.

Gracie's journey included grappling with plastic bronchitis, a condition that caused her airways to become blocked. As her symptoms intensified over the past year, signs of liver failure prompted her medical team to place her on the transplant waitlist in April. The months of meticulous preparation paid off as specialists met regularly to strategize for the complex surgery, accounting for the unique challenges presented by transplanting two organs simultaneously.

In an exciting turn of events, just under a month after being placed on the waitlist, compatible donor organs became available, thanks to the selfless decision of another family to donate. With time being of the essence, the surgical team began with the heart transplant. Dr. Matthew Stone, the surgical director of the Pediatric Heart Transplant Program, and congenital heart surgeon Dr. Emily Downs led the nine-hour procedure while ensuring the donor liver was preserved using a TransMedics Organ Care System, which maintains normal liver function.

Following the heart transplant, Dr. Adams and transplant surgeon Dr. Kendra Conzen performed the liver transplant, which took an additional seven hours. Throughout this intricate process, seamless coordination with anesthesiology teams was paramount to safeguarding Gracie's health.

The outcome was successful, and Gracie was able to leave the cardiac progress care unit just over a month later. Now, seven months post-transplant, she regularly attends follow-up visits while joyfully returning to school and enjoying life at home with her beloved dogs.

While Gracie will eventually need another heart transplant, her new liver is expected to support her for a lifetime, bringing hope and happiness to her future. "This procedure showcases the expertise, talent, and level of care Children's Colorado provides to our patients, including those with complex medical needs," remarked Dr. Duncan Wilcox, Surgeon in Chief. He expressed pride in the hospital's leading-edge transplant care and excitement for the opportunity to assist more patients requiring dual organ transplants in the future.