After weeks of waiting, baby gets heart

Mechanical pump kept girl strong until donor organ was found

Lucile Packard Children's Hospital Serafina Akard

Serafina Akard, with parents Suzanne and Michael, about one week after her June 26 heart transplant.

Serafina Akard's wait is over. The 2-year-old from Modesto received a successful heart transplant on June 26, after surviving nearly eight weeks on the Berlin Heart device—an external pump that filled in for the job that her own heart couldn't do.

Serafina's new beginning marked another child's tragic end. Although the donor's identity is confidential, Serafina's mother will never forget the gift given to them by strangers.

"I can't wrap my mind around it," said Suzanne Akard the day after the transplant, who spoke of watching her daughter's chest move with each beat of her new heart. "It's such an overwhelming sacrifice. Words can't express my gratitude."

Serafina's father, Michael Akard, commented that earlier this year he and Suzanne had decided to donate Serafina's healthy organs to other children, should her condition prove to be fatal. "Now we find that we are the beneficiaries of another family having that same discussion," he said.

Serafina suffered from cardiomyopathy, which was first detected last November. She was admitted to Lucile Packard Children's Hospital's cardiovascular intensive care unit on April 28, and was placed on an artificial heart-lung machine that night. The Berlin Heart, a compact pump not approved for use in children in this country, was implanted on May 3 after Serafina's doctors, including pediatric cardiologist David Rosenthal, MD, petitioned the U.S. Food and Drug Administration for special approval to import the device for Serafina.

LPCH is the only pediatric hospital on the West Coast to have used the device, and Serafina is the hospital's second recipient. Five-month-old Miles Coulson was kept alive by a Berlin Heart for more than six weeks last fall until a transplanted organ became available. Such bridge-to-transplant, or ventricular-assist, devices are becoming more common for adults in this country, but small versions suitable for infants and toddlers are hard to come by. Although the Berlin Heart is widely used in Europe, the potential market here has not been large enough to spur the company to seek FDA approval.

"If Serafina's condition had manifested itself a year ago, she would probably not be here with us today," said her father.

But it's taken more than the latest technology to give Serafina another chance at life outside a hospital room. "The Berlin Heart is a marvelous tool," remarked Rosenthal, "but we still need the generosity of organ donors."