In 1984, Elizabeth “Lizzy” Craze, then 2, underwent a heart transplant at Stanford Medicine, making her among the youngest recipients on record at that time. Now, as Stanford Medicine celebrates 50 years of pediatric heart transplants at the institution, Craze is marking 40 years of life with the same heart, far beyond the expected five to 10 years.

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The five research projects, which began July 1, 2024, and will continue through three years, include:

Elucidation of the Mechanisms Underlying the Development and Progression of Fontan Associated Liver Disease (FALD) – Led by Christopher Breuer, M.D., director of the Center for Regenerative Medicine at Nationwide Children's Hospital.

• PULSE-SVA Network: Personalized Understanding from Linked Simulations & Electrophysiology in Single Ventricle Arrhythmia – Led by Isabelle Deschênes, Ph.D., professor and chair of physiology and cell biology at The Ohio State University College of Medicine.

• Correcting Latent Mechanisms that Underlie Neurodevelopmental Disorders Associated with Congenital Heart Disease – Led by Casey Gifford, Ph.D., assistant professor of pediatrics cardiology and genetics at the Stanford University School of Medicine.

• The DEFEND Trial: Dapagliflozin or Empagliflozin for Fontan Exercise, QOL and MitochoNDrial function – Led by Shelley Miyamoto, M.D., FAHA, a professor of pediatrics (cardiology) at the University of Colorado School of Medicine.

• Consequences of Impaired T Cell Homeostasis in Single Ventricle Congenital Heart Disease – Led by Stephanie Nakano, M.D., a pediatric cardiologist at Children’s Hospital Colorado.

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The method used across the United States to wait-list children for heart transplants does not consistently rank the sickest patients first, according to a new study led by Stanford Medicine experts.

The study published online Aug. 5 in the Journal of the American College of Cardiology.

Adding nuance to the wait-list system by accounting for more health factors could reduce children’s risk of dying while they await donor hearts, according to the study’s authors. A revision to the way donor hearts are assigned is already in process. The study adds evidence for why it is needed, they said.

“Wait-list mortality, which is the chance that a child will die while awaiting transplant, is higher in pediatric heart transplant than for virtually any other organ or age group,” said the study’s senior author, Christopher Almond, MD, professor of pediatrics. Almond cares for children before and after heart transplantation at Stanford Medicine Children’s Health.

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“All along, doctors talked about an eventual heart-lung transplant, so it was always on my radar,” ToneeRose says.

That day came when she was 17 years old, a senior in high school in 2008. She remembers the day she learned that a transplant was imminent—she had gone in to Stanford Children’s for a checkup and was sitting doing her homework in a hospital room when she fell asleep. She woke up to providers looking at her with concern. They told her that she was in heart failure, and she had to stay at Stanford Children’s until she could get her transplant.

Six weeks later, a donor heart-lung were located, and her transplant took place. ToneeRose recalls her doctor Jeffrey Feinstein, MD, director of Pulmonary Vascular Disease at the Betty Irene Moore Children’s Heart Center, coming to the operating room the day of the transplant to hold her hand.

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In 1974, the first pediatric heart transplant at Stanford was performed for a teenager. Since then, the Stanford heart transplant program has completed more than 560 pediatric heart transplants—a higher volume than at many pediatric heart centers in the United States and the highest volume in the Western U.S. One of the more recent advances by the Stanford Children’s team includes the heart transplant size-matching program. A Stanford Children’s pediatric cardiologist pioneered the use of 3-D imaging software to better match donor hearts with children awaiting heart transplant to help expand the donor pool and reduce wait times.

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A small, implantable cardiac pump that could help children await heart transplants at home, not in the hospital, has performed well in the first stage of human testing.

The pump, a new type of ventricular assist device, or VAD, is surgically attached to the heart to augment its blood-pumping action in individuals with heart failure, allowing time to find a donor heart. The new pump could close an important gap in heart transplant care for children.

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Pediatric doctors tend to find their calling by following their passion for medicine and then choosing to treat children. But pediatric cardiologist Lynn Peng, MD, came about it from the reverse. When she went to Harvard as an undergrad, she didn’t think she’d go into medicine. She adored kids, so she volunteered at Boston Children’s Hospital in order to spend time with them. “I fell in love with taking care of kids in that setting,” she says. She’d always been good at science and was majoring in chemistry, and it clicked.

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Over a four-year period, patients’ medical records mentioned “Apple Watch” 145 times. Among patients whose medical records mentioned the smartwatch, 41 had abnormal heart rhythms confirmed by traditional diagnostic methods; of these, 29 children had their arrhythmias diagnosed for the first time.

“I was surprised by how often our standard monitoring didn’t pick up arryhthmias and the watch did,” said senior study author Scott Ceresnak, MD, professor of pediatrics. Ceresnak is a pediatric cardiologist who treats patients at Stanford Medicine. “It’s awesome to see that newer technology can really make a difference in how we’re able to care for patients.”

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Pediatric cardiologist Charitha Reddy, MD, teamed up with engineers and computer scientists to develop a model that automatically estimates the left ventricle’s function in children with accuracy and reliability. Medical decisions for children that rely on a doctor’s assessment of the heart’s ability to pump, such as determining safe chemotherapy doses, can benefit from models tailored to children, she said.

Reddy, a clinical assistant professor of pediatrics, helped collect heart ultrasound videos and annotate images from 1,958 pediatric patients seen at Lucile Packard Children’s Hospital Stanford. The model she helped develop analyzed more than 4,000 video clips of hearts and generated estimates of the left ventricle’s function with high accuracy. Its assessments of heart-pumping ability were speedier and more consistent than doctors’, said Reddy, the lead author of a study of the model published in February 2023 in the Journal of the American Society of Echocardiography.

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