Researchers at Children’s Hospital of Wisconsin, led by pediatric heart surgeon Dr. Michael Mitchell, are pioneering a new way to provide less invasive and more cost-effective care for children with heart transplants. Dr. Mitchell hopes to establish a new standard of care for heart patients.
Children’s Hospital of Wisconsin has one of the lowest mortality rates for pediatric heart transplant surgery in the country. Patients who undergo a heart transplant must also endure between eight and 12 biopsies per year to monitor for potential transplant rejections.
Rejections occur in approximately 15 percent of patients.
According to Mitchell, the biopsies are invasive and cost thousands of dollars to perform, not to mention the challenge for the child involved.
Mitchell is the chief investigator on a new study that could help identify early signs of transplant rejection by testing a blood sample from the patient.
Testing the blood sample can help determine the level of donor DNA, which serves as a barometer of heart health. Higher levels of donor DNA in the child’s blood stream indicate the donor heart is being rejected, Mitchell said.
In a recent pilot study, the new method was proven to be 100 percent accurate in identifying early signs of transplant rejection days before a child displays any symptoms. This allows the patient to be treated with oral steroids at home for about $6.22 per day, compared to the thousands it would cost for multiple biopsies.
“We’re very excited,” Mitchell said. “This is the holy grail of the field and its potential, if proven as sensitive as we think it is, will literally get us to the next level in terms of outcomes in the industry.”
Mitchell, with fellow investigator Dr. Mats Hidestrand at Children’s Hospital of Wisconsin Research Institute, is conducting a 480-patient clinical study of the new approach with both adults and children at six transplant centers across the country. A $3.3 million, five-year grant from the National Heart, Lung, and Blood Institute funds the study.
If proven successful, the routine could replace most biopsies in two to four years.
