Multidisciplinary Evaluation of Heart Transplantation and Ventricular Assist Device Implantation in a Child with Autism Spectrum Disorder.

Abstract

Organ transplantation practices have witnessed tremendous advances all over the world and in Türkiye in recent years, and the pre-transplantation preparation, operation and postoperative follow-up procedures are being meticulously handled. However, there is very limited information about follow-up processes of pediatric patients with autism spectrum disorder (ASD) undergoing organ transplantation. Furthermore, it is difficult to manage the arduous and long-term care and follow-up processes in ASD cases undergoing organ transplantation. In this case report, an 11-year-old male patient with a diagnosis of ASD and attention deficit-hyperactivity disorder (ADHD) was reviewed psychiatrically for the suitability of ventricular assist device (VAD) implantation and heart transplantation, and the multidisciplinary council process was evaluated. The council decided that the case was suitable for heart transplantation but not suitable for long-term intracorporeal device implantation due to behaviors such as plucking wounds, playing with vascular access, and being nervous about vascular access. The council stated that due to sensory hypersensitivity of the case, implantation of such a device may further increase anxiety, and involuntary damage to the device may result in personal harm. We hope that this case report will guide future endeavors to develop devices suitable for cases with ASD or other behavioral problems.