Norton Children’s Heart Institute now 100 transplants strong

Looking back: In 1986, Norton Children’s Hospital was the second facility in country to save a neonate with a heart transplant.

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The transplant nurse clinician at Norton Children’s Hospital got the call on Sunday, Oct. 15, 2023. It was one that got her heart racing — in a good way. A heart was available for a young patient at Norton Children’s Hospital who had been waiting for nearly a year for a transplant.

This news sent the team at Norton Children’s Heart Institute, affiliated with the UofL School of Medicine, into action, including with notifications to the transplant doctors: Bahaaldin Alsoufi, M.D., chief of pediatric cardiothoracic surgery at Norton Children’s Heart Institute, and Deborah J. Kozik, D.O., pediatric cardiothoracic surgeon. Dr. Alsoufi is also holds the Erle H. Austin III, M.D. endowed chair in pediatric cardiac surgery and is co-director of Norton Children’s Heart Institute.

While Dr. Kozik flew with a team to retrieve the donor heart, the team remaining in Louisville prepared for what would be a nine-hour surgery on Oct. 16.

While this would be Norton Children’s 100th heart transplant, nothing about the procedure is ever “normal” or the same. It’s a complex undertaking that relies on a team approach with a high level of expertise. Before Drs. Alsoufi and Kozik, Erle H. Austin III, M.D., spent 32 years at Norton Children’s Hospital helping build the transplant program that started in 1986. That was when Constantine Mavroudis, M.D., performed the first pediatric heart transplant in Louisville. In fact, Norton Children’s Hospital was the second hospital in the country to successfully perform a neonatal heart transplant.

‘Baby Calvin’ gets a heart

Norton Children’s Hospital’s first heart transplant, an infant initially known to the world as “Baby Calvin,” was born in May 1986 with hypoplastic left heart syndrome, a condition in which the part of the heart that pumps blood to most of the body is severely undeveloped.

While outcomes of surgical treatment of hypoplastic left heart syndrome are currently much improved, that was not the case in 1986.

“Ninety-five percent of these patients die within the first few months of life, and the rest die shortly thereafter,” Dr. Mavroudis, the heart surgeon at what is now Norton Children’s Hospital, told reporters after the surgery. “Until recently there has been no effective surgical treatment for these children.”

On June 13, 1986, a surgical team led by Dr. Mavroudis removed a tiny donor heart from an infant and then in a lifesaving, six-hour procedure, implanted it into 23-day-old Robert Dean Cardin, who had been given the “Baby Calvin” pseudonym to protect his identity at the time.

It was the first pediatric heart transplant in Kentucky, and it was thought to be the sixth or seventh successful such transplant in the world.

Robbie went home with his parents to Glendale, Kentucky, after seven weeks in the hospital. After his heart transplant, Robbie led a fairly active boyhood — playing baseball, riding his bike, engaging in water fights, chasing a calf with his baseball bat. Unfortunately, he experienced rejection of his heart at age 9 and passed away at Norton Children’s Hospital.

“We had 9½ years of borrowed time,” his mother, Trish Cardin, told The Courier-Journal the following day. “He touched so many people’s lives, and he made so many people aware of what organ donation can do.  For a 9-year-old, he left quite a legacy.”

Fortunately, with improved immunosuppression and other advances in the field of heart transplantation, the outlook of these children in the current era is much improved.

The heart transplant program at Norton Children’s Hospital continued in December 1986 when “Baby Rose” (Natasha Rose Hatfield) received a new heart. She went home a month later.

100 hearts strong

“It’s exciting to reach this milestone,” Dr. Alsoufi said of reaching 100 transplants. “We are the only pediatric program in Kentucky capable of doing heart transplants. And we are doing that with outcomes that match those of the best programs in the United States.” Since Robbie’s groundbreaking surgery nearly 40 years ago, Norton Children’s Heart Institute has grown into a full-service program featuring a specialized team of cardiovascular and transplant surgeons, cardiologists, fetal heart specialists and other caregivers dedicated to heart patients and their families. Norton Children’s is among the top 50 pediatric heart programs in the country, according to U.S. News & World Report.