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As Darrin Hall ended his high school sophomore year, life was good. He had a new driver’s license, enjoyed motocross competitions on local dirt tracks, and pitched in with chores on his family’s 42-acre cattle farm in Reedy, W.Va.
By the time he began junior year 10 weeks later, he had been transported by medical air transport to Children’s Hospital of Pittsburgh of UPMC, attached to ventricular assist devices (VADs), given a heart transplant, and returned home. It was, most definitely, an out-of-the-ordinary summer vacation.
When Darrin’s mother, Angela, noticed her son’s coughing and fatigue the first week of June 2010, she suspected nothing more than a sinus infection. After a few doses of over-the-counter medicine, he seemed to improve. But as the weekend approached, a blood test showed some abnormalities. By Saturday, he was doubled over with stomach cramps, pleading to go to the hospital.
"His liver was shutting down. He was in severe pain,” Angela recalls. After a transfer from a small community hospital to a larger medical center in Charleston W. Va., he was given a diagnosis of cardiomyopathy, a condition in which the muscles of the heart’s main pumping chamber – the left ventricle – become weak and flabby, so that the heart can’t do its job of pumping blood to the body.
His enlarged heart was failing rapidly, affecting other organs. Recognized that his case required tertiary care, the team immediately contacted Children’s Hospital to dispatch a helicopter. Children’s long experience in transporting patients in heart failure is a unique complement to its expertise in cardiac care. As a thunderstorm raged, Darrin was lifted aboard a midnight flight to Pittsburgh.
Five days later Darrin’s condition was stabilized with the use of two VADs to keep the upper chambers of his heart functioning. A VAD is a special type of blood pump that can help the heart to rest and heal. In about a third of pediatric VAD cases, patients recover without the need for a transplant.
“For kids in sudden heart failure, it’s a big shock to their families,” said Darrin’s surgeon, Peter Wearden, MD, PhD, director of Children’s Mechanical Cardiopulmonary Support Program. Dr. Wearden said. “Adults in heart failure go downhill over months or years. A child can be perfectly fine one day, and the next day, they’re in big trouble.” The cause of the infection that attacked Darrin’s heart remains a mystery. “We suspect a virus, but we don’t know,” said Dr. Wearden.
With a national reputation for both VAD use and transplantation, Children’s was well equipped to help Darrin. And his size – nearly 6-foot-3 and 155 pounds – qualified him for the Thoratec VAD approved by the Food and Drug Administration for use in adults. Dr. Wearden’s team has also achieved remarkable results with smaller experimental VADs for smaller children.
Over the next 10 days, Darrin and his family coped with pain and uncertainty.
“I was pretty sore, Darrin said. “I could hardly do anything.”
“I could get up and walk, but four or five people had to carry all the stuff,” he said referring to the VAD and related monitoring equipment attached to him.
When Dr. Wearden determined that Darrin’s heart wasn’t healing on its own, he was listed as a candidate for a heart transplant.
Remarkably, a heart was found almost immediately. On June 26, the surgeons came to talk to Darrin and his parents. “If five of seven different things matched up” between the donor heart and Darrin’s system, his mother remembered, “they could do the transplant the next day. We were up all night, worrying.”
The day after transplantation, Darrin was sitting up. By late July, Darrin was back home in West Virginia and was well enough to start school with his classmates in mid-August.
While the progress of his case was unusually fast, the outcome was routine. Since performing the first pediatric heart transplant in 1982, Children’s has completed more than 200. About 85 to 90 percent of Children’s heart transplant patients survive at least three years following surgery, a rate significantly higher than the 80 percent national average. At the time of Darrin’s surgery, Children’s was one of only two high-volume pediatric cardiovascular programs in the country with a surgical mortality rate of less than 1 percent, according to the Society for Thoracic Surgery. That compared to a national average mortality rate for high-volume pediatric cardiovascular programs of 3.4 percent.
Two years after surgery, Darrin had regained his strength and returned to nearly all his regular chores on the family farm. “The only difference is, he can’t put up hay, because of the mold,” says his mother. “He gets lucky!”
Darrin takes anti-rejection medication and continues to visit Children’s for follow up, but less and less frequently. He says simply,” I can do everything now.”
Children's Hospital's main campus is located in the Lawrenceville neighborhood. Our main hospital address is:
Children’s Hospital of Pittsburgh of UPMC
One Children’s Hospital Way
4401 Penn Ave.
Pittsburgh, PA 15224
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