The normal heart has four chambers, two at the top and two at the bottom. The top two chambers are called the atria and the bottom two are the ventricles. Oxygenated blood flows from the left ventricle to the body. Deoxygenated blood flows from the right ventricle to the lungs, where carbon dioxide is released and fresh oxygen is absorbed.

Each year, about 35,000 babies are born with a congenital heart defect. One of those conditions is hypoplastic right heart - development of an abnormally small, weak right ventricle. The valves that control blood flow through the right side of the heart may also be malformed or absent. The body has a hard time getting deoxygenated blood back to the lungs, causing a back up of blood in the heart and circulatory system. Several operations may be needed to correctly route "blue" deoxygenated blood back to the lungs and provide enough freshly oxygenated blood for the body.

Heart-Liver Organ Transplants

Lawrence Czer, M.D., a Heart Transplant Surgeon at Cedars-Sinai Medical Center, says even with surgical correction, children with hypoplastic right heart may eventually face problems with heart function as they get older. In addition, as the circulatory pressure behind the heart builds, it can lead to damage to other organs as well, like the liver and kidneys.

Czer has a 23-year-old patient who has had several surgeries to correct a hypoplastic right heart defect. Her condition has now progressed to the point where she needs a heart transplant. In addition, the patient has serious liver problems and will eventually need a new liver. So, doctors have placed her on the organ transplant list for two organs - a heart and liver.

The solution is not as simple as it would seem. There is a serious shortage of donor organs. As of January 3, 2006, there were 94,645 on the transplant waiting list. According to the organization, Donate Life America, an average of 18 people die every day because of the shortage of donor organs. Needing two organs at once may make it even more difficult to get the life-saving transplants.

If suitable organs are found, they will come from the same donor and both transplants will be performed the same day. Steven Colquhoun, M.D., a Liver Transplant Surgeon at Cedars-Sinai Medical Center, says the heart transplant will be performed first. Then, after surgeons are satisfied that the new heart is working reasonably well, the liver transplant team will come into the operating room and perform the second transplant.

Colquhoun says double transplants are not nearly as common as single organ transplants. And they are considerably more technically difficult to coordinate and perform. However, surgical advances and better techniques in immunosuppression are keeping transplant patients alive for longer periods of time - even among those who receive two organs.

Health experts urge everyone to consider becoming an organ donor. Many people don't think about the possibility until they are faced with the death of a loved one and asked to consider organ donation. Family members should make their intentions about organ donation clear to their next-of-kin and carry a donor card to express their wishes. For information about becoming an organ donor, log onto Donate Life America's website at Donate Life America.

For information on organ transplants:

Organ Donor

Donate Life America

UNOS

For information about congenital heart defects: American Heart Association, or contact your local chapter