Gabrielle "Gabbi" Smith, UMMC's youngest heart transplant patient, holds her sonographer's hand.
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Thriving after heart transplant, tragic fire, Gabbi Smith turns 1

Published on Thursday, January 17, 2019

By: Annie Oeth, aoeth@umc.edu

Gabrielle Smith looks, smiles and plays like a strong, healthy year-old baby, but that wasn’t always the case.

The youngest patient ever to undergo a heart transplant at the University of Mississippi Medical Center, Gabbi celebrated her first birthday Dec. 26, due in no small part to the love and dedication of her great aunt, Cindy Thompson of Bassfield.

While awaiting a new heart, Gabbi stayed in her patient room in Batson Children’s Hospital. Her family split their time between Jackson and their home in Bassfield.

Cindy Thompson holds Gabbi as Dr. Brian Kogon checks her out months after surgery while Dr. Avichal Aggarwal, pediatric cardiologist, observes.

On the night of March 3, 2018, Gabbi’s parents, Latoyia and Carlos Smith, and 1-year-old sister Ivory, were spending the night at their home when tragedy struck. A fire consumed the house, killing all of its occupants. Because she was away from home as a hospital patient, Gabbi and her adult sister, Jada, who is in the military and was spending the night with Thompson, were the only surviving family members.

“It was awful,” Thompson said, “losing them all on the same day. We have a close family.”

The family, Thompson said, was worried over Gabbi’s condition, “but she gave us hope, too.”

The demands of follow-up care following a heart transplant are such that doctors had to be certain that Gabbi had a caregiver willing to take on those responsibilities, said Dr. Avichal Aggarwal, Gabbi’s pediatric cardiologist at the Children’s Heart Center at Batson Children’s Hospital and medical director of UMMC’s pediatric heart transplant program.

“Some of her medications have to be given every four hours around the clock,” Aggarwal said. “Missing a dose, for these patients, could be life-threatening.”

Thompson knew what she had to do.

“I didn’t think about it,” said Thompson, 53, of the decision to become Gabbi’s guardian. “I just did it because it needed to be done.”

Kayla Mills, sonographer, and Aggarwal look at Gabbi's heart while Thompson observes.

Born with an extraordinarily small right ventricle and abnormal coronary arteries, Gabbi’s congenital heart condition left her with a high risk of sudden death, Aggarwal said.

Shortly after her birth, Gabbi underwent surgery aimed at stabilizing her condition, said Dr. Brian Kogon, chief of pediatric cardiothoracic surgery at Batson Children’s Hospital, but the risk of sudden death remained.

“After surgery, she remained on the heart-lung machine for several days after. Ultimately, she recovered, but she needed a new heart,” said Kogon, “and she was added to the national transplant waiting list.”

A requirement for receiving a heart transplant, said Kogon, is to have a stable support system for the care needs that will follow. Thompson, who has no biological children, stepped forward to raise her great niece, paving the way for Gabbi to receive the heart that became available to her not long after. She got a new heart March 27, 2018.

“The transplant went well and was without major complications,” Kogon said. “Her hospital stay was prolonged, only because of her young age, small size and her being so sick and debilitated at the time of transplant.”

Children with congenital heart disease can become weakened over time due to their condition.

Thompson, said Kogon, “is doing a wonderful job. Gabbi looks terrific!”

Gabbi smiles at her great aunt.

Gabbi’s heart transplant in 2018 followed four pediatric heart transplants performed at Batson in 2017. Among those patients was Jharad Faust of Meadville, who was a few days older than Gabbi when she received her life-saving heart.

Gabbi was slightly younger than Jharad when she had her heart transplant, making her the Medical Center’s youngest heart recipient at 3 months and a day.

The five children who had heart transplants at Batson Children’s Hospital since 2017 are all in good condition, Kogon said.

“Offering a pediatric heart transplant program in Mississippi provides the complex care some children need to survive,” said Dr. William Moskowitz, chief of Pediatric Cardiology at UMMC. “Providing world-class cardiac critical care close to home is part of our mission at Batson Children’s Hospital and Children’s of Mississippi.”

The Children’s Heart Center at UMMC, in fall 2020, will be getting a new home. A seven-story pediatric expansion now under construction will include additional space for surgery, pediatric and neonatal critical care and imaging as well as clinic space for specialty care, including pediatric cardiology.

According to the registry of the International Society for Heart and Lung Transplantation, about 500 to 600 pediatric heart transplants are performed each year, representing about 12 percent of the total number of heart transplants.

According to the U.S. Centers for Disease Control and Prevention, about one in every 7,700 babies born in the United States each year are born with pulmonary atresia, Gabbi’s congenital condition. About one in 100 babies is born with congenital heart disease.

Since her transplant, Gabbi has been growing stronger. Fond of bright colors and musical toys, she is no longer using an oxygen tank, giving her more freedom to play, Aggarwal said. “She was on oxygen for more than six months after surgery.”

Gabbi’s next medical challenge, he said, is in swallowing. Because of her condition at birth, she required a feeding tube to get adequate nutrition. She will soon undergo tests of her swallowing ability, with the goal of one day having the feeding tube removed.

“We have high hopes for Gabbi,” said Aggarwal. “She’s doing very well, and much of that is because of the care she is getting at home.”