In first 5 years of heart program, Dell Children's has surprised even itself. Where it's headed.
Oliver Aleman, 8, isn't new to heart surgeries. He had one as a newborn and another at 6 months.
Even those surgeries, to improve hypoplastic left heart syndrome, a condition that happens when the left side of the heart is underdeveloped, wouldn't be enough. His parents were preparing themselves for the third surgery when they learned his heart was failing.
He was tired, and his skin, normally blue-tinged from a lack of oxygen, was a tad bluer, said his mom, Krystal Cantu. But she didn't expect to hear that he needed a heart transplant — and that it was suddenly his only option.
The family from New Braunfels was referred to Dr. Charles Fraser Jr. at Dell Children's Medical Center and its transplant program. Before Fraser came to Austin in 2018 to start the Texas Center for Pediatric and Congenital Heart Disease at Dell Children’s and UT Health Austin — the clinical practice of Dell Medical School at the University of Texas — Oliver would have had to travel to Houston or Dallas to receive a heart transplant.
Now finishing its fifth year, the center has performed 30 heart transplants, is one of a handful of sites in the U.S. to perform a partial heart transplant, and has done mechanical heart and heart valve operations.
"I never thought we would come this far this fast," Fraser said.
From yellow legal pad to real patients
When Fraser was hired, he sat down with then-Dell Children's President Chris Born and sketched out what the program would need and its timeline on a yellow legal pad.
They thought they would start a transplant program by year five.
"I misjudged how quickly we would start attracting sick patients from a broader area," Fraser said.
Patients now come to Dell Children's from across Texas, the United States, Europe, South America and Africa.
This year, Dell Children's will double its cardiac intensive care unit beds to 48 from 24 in a unit that didn't exist before 2019.
With each sick patient who arrived, Dell Children's kept stacking on firsts, including:
It has built a reputation for taking hard cases, some of which other centers have passed on.
"We are an aggressive program," Fraser said. "We are willing to take on things some programs won't. ... We'll be responsible ... but don't want to be limited by an external marketing tool and deny a child something that could be lifesaving."
The only thing missing from the list of firsts is a heart-lung transplant in the coming years.
Building on the adult cardiac care
As Fraser grew the pediatric side, he also has helped the adult cardiac side with the formation of the Institute for Cardiovascular Health, a joint project of Dell Medical School's UT Health Austin and the Ascension Texas hospital system, in 2022.
The institute, unique because adult and pediatric heart experts do not operate in silos, shares information and patients to increase clinical trials and research in Austin.
The institute expects to launch Austin's first lung transplant program and perform transplants within two years. Like the kidney transplant program, the lung program will start with adults before adding pediatric patients.
Fraser expects within two years to start a heart surgery fellowship program.
Expanding care: What's behind the growth in Central Texas health care? Here's what you need to know.
The impact of the University of Texas
A lure for coming to Dell Children's for Fraser, and the team he created, was to build a teaching program at a new medical school. Without the UT Dell Medical School, Fraser and all of his colleagues would not have come to Austin to build this program, he said.
The time spent at UT will lead to innovations, Fraser said. That could mean working on new heart valves with biomechanical engineering or using artificial intelligence to build new data platforms.
"There are some really exciting synergies," Fraser said. "That plays to the strengths of the University of Texas."
With Dell Children's elevating its profile nationally (its doctors have become featured speakers), there's room for more research, Fraser said. Dell Children's Dr. Carlos Mery is using data to improve medical procedures and clinical outcomes.
"The program is developing a reputation of being creative thinkers," Fraser said.
Inside the program: EXCLUSIVE: First heart transplant at Dell Children’s gives life to new program and a boy
Competition in pediatric care expands in Austin and Central Texas
Dell Children's strategic growth comes as other respected pediatric centers arrive in Austin.
Texas Children's Hospital from Houston will open its first Austin hospital in February. Texas Children's, where Fraser and many of his colleagues came from, is the leader in pediatric cardiac care. Texas Children's isn't planning a transplant program in Austin, but it will have more pediatric cardiac experts here.
"Making the lives of children better, making the lives of mothers better, that should be what the competition should be about," Fraser said.
Oliver finally receives a heart
Once Oliver Aleman's family learned a heart transplant was the only option, they met with Fraser.
"He was it for us," Cantu said.
Oliver was admitted to Dell Children's on Oct. 24 while waiting for a heart. By Nov. 10, he was listed for a transplant.
They expected to wait months, but at 2 a.m. Dec. 11, Cantu received the call that a heart had been located.
"I just stared at the ceiling," Cantu said. "Your thoughts go 100 miles an hour."
In a daylong surgery Dec. 13, Oliver received his new heart — Dell Children's 30th heart transplant.
When Cantu saw him, Oliver's fingers, toes and lips were pink for the first time in his life, she said. His new heart pumped oxygen throughout his body.
"It has meant everything for us," Cantu said of the transplant. "It totally changed our lives. It gave Oliver a second chance."
Oliver, now rocking green hair — a Christmas present from his Dell Children's nurse who also had green hair — is out of the hospital and staying with his family at the Ronald McDonald House across from the hospital. He's expected to be home soon.
Oliver hopes to soon play competitive sports, once inconceivable.
He plans on playing golf. "I love that for you," his mother told him.
"We are blessed," she said.
About this story
Statesman health reporter Nicole Villalpando has been covering the start of the cardiac program at Dell Children's since it began in 2018. She was in the operating room for the first heart transplant.
This article originally appeared on Austin American-Statesman: Dell Children's heart transplant program celebrates 5 years in Austin
