Ventricular Assist Device Offers Long-Term Use in Children Waiting for Donor Heart

Children with severe heart failure often face long and dangerous waits for a donor heart, with limited options to keep them stable during this period. For patients between the ages of one and 11, there are currently no heart pumps approved for long-term use, leaving a critical treatment gap. This lack of suitable mechanical support contributes to high hospitalization and mortality rates among pediatric patients awaiting transplant. Researchers are now developing a purpose-built heart pump to provide long-term circulatory support for this vulnerable group.

Researchers at Penn State College of Medicine (Hershey, PA, USA) are focusing on creating a ventricular assist device (VAD) tailored to the anatomy and physiological needs of young children. The goal is to deliver reliable, long-term mechanical support while children wait for a heart transplant.

The pediatric heart pump, known as the PSU Child VAD, is designed to fit children weighing 10 to 35 kilograms while still generating sufficient blood flow for older children within that range. Earlier pediatric pump designs struggled to balance size and power and often caused blood damage or clotting. This new design optimizes internal geometry and materials to reduce blood trauma while remaining compact enough for implantation in small patients.

In preclinical testing, the prototype demonstrated strong biocompatibility in a large-animal model over 26 days, with no signs of organ failure or red blood cell damage. These findings support the feasibility of a continuous-flow pediatric heart pump that is both small and powerful. The researchers have shown that the device can maintain stable circulation without the complications seen in earlier designs.

Using a new USD 3.2 million grant from the NIH, the team will conduct multiple 30-day animal studies, refine the mechanical and external design, and develop a controller that introduces pulsatility to better mimic natural heart rhythms. Adding pulsatile flow may reduce risks such as bleeding, stroke, and organ dysfunction associated with continuous-flow pumps. Future plans include longer-term animal studies, FDA approval, and first-in-human trials, with the long-term vision of a fully implantable system that allows children to leave the hospital while awaiting transplant.

“The combination of age-specific sizing, high-flow capability, improved material and design that’s compatible with the body and a clear path toward a fully implantable system sets this project apart from previous attempts to develop a pediatric pump,” said associate professor Choon-Sik Jhun, who will lead the research team.

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