In patients with some forms of CHD, such as hypoplastic left heart syndrome (HLHS), heart transplant surgery may be necessary. A heart transplant involves replacing the baby’s defective heart with a donated healthy heart (a relatively new procedure in newborns). The baby’s eligibility for a transplant is determined by the results of blood tests and other specific factors relating to the baby’s health and potential for survival. Once that determination is made, he or she is entered into a computerized national waiting list.

There is a shortage of heart donors, especially within the newborn population. Therefore, transplantation usually involves a long waiting period with no guarantees in which the infant is on “standby” for a suitable heart. Some patients’ hearts give out before a suitable donor heart can be found.

Even if a donor heart match is made, transplantation carries a risk of rejection and the early development of conditions such as coronary artery disease or lymphoma – cancer of the lymph nodes. Lifelong use of medication to prevent rejection and infection must be taken, and these drugs tend to weaken the immune system. Lifelong medical management will be necessary, and the long–term results for newborn transplantations are not yet known.