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"The standard of care, support, understanding and professionalism shown by you all was truly amazing. Throughout this difficult time there was always someone on hand to talk to and help us for which we will be forever grateful". Mr and Mrs RE

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Jargon buster

ECMO (extra corporeal membrane oxygenation)

Special technique of providing both cardiac and respiratory support oxygen to patients whose heart and lungs are so severely diseased that they can no longer serve their function.

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Cardiothoracic Services (Heart and Lung)

Transplant, ECMO and VAD

The Freeman Hospital is one of only two centres in the UK performing children’s heart and lung transplantations.

Our transplant programme began in 1985 with the first child's transplant in 1987. Over 1,800 patients have had transplants at the Freeman including more than 200 infants and children. The vast majority of children have an excellent quality of life, attend school and play sport. Many have gone onto college or university and are now in employment.

Specialist team

Transplant care - from referral through to transition to adult services - is supported and supervised by a large multi-disciplinary team with special expertise in transplantation. The team includes:

  • Transplant Cardiologists
  • Specialist Nurses
  • Transplant Surgeons
  • Microbiologists
  • Immunologists
  • Respiratory Paediatricians
  • Social Worker
  • Nursing Staff
  • Psychologist and many others.

Patients and other professionals involved in their care are supported in the community by the Specialist Nurses bridging the gap between hospital and home.

Patients need very close follow-up care after transplantation, and the introduction of a Young Person’s Transplant Clinic has helped us to meet the needs of children and young people until they are fully responsible for their own healthcare needs.

There is a large adult cardiopulmonary transplant service at the Freeman Hospital which allows working in partnership, sharing ideas, and seamless transition of care as children move through adolescence into adult life.

You can find more information about children’s heart and lung transplantation at


The Freeman is one of only three hospitals in England which provides a specialised service known as Extra Corporeal Membrane Oxygenation (ECMO).

The ECMO machine provides oxygen support for babies and children with severe heart and/or lung failure. The machine takes over the work of the heart/lungs allowing them time to recover.

Our unit was one of the first UK centres to provide neonatal respiratory ECMO, and we remain involved in developments, research and innovation in this area. We provide ECMO for children and babies who:

  • have severe lung disease and who have not responded to the usual treatment
  • have severe heart failure before or after heart surgery
  • need support while waiting for a transplant.

More information

We have developed an information leaflet for parents about ECMO.pdf.

You can get more information at the Extracorporeal Life Support Organization.


The Freeman leads the way in the UK in using the Berlin Heart Ventricular Assist Device (VAD). The VAD provides mechanical support for children in ‘end stage’ heart failure.

Children waiting for a heart transplant can be supported on this device for many months until a donor heart is found. In some cases, where it is felt the heart may recover, the VAD can be used for as long as it is needed.  

We have implanted 68 Berlin Hearts into children, with an 86% survival rate until heart transplant or recovery.

We are the only paediatric Berlin Heart training centre in the world (the only VAD suitable for use with children), and our surgeons have developed a modified Berlin Heart cannula design  that was subsequently developed commercially by the Berlin Heart Company.

Innovative techniques

There are a many examples of our innovation in this area such as being pioneers in the development of Hypoplastic left heart syndrome, and successfully undertaking single ventricle VAD support - we are the only UK unit offering such support. 

We are the only centre in the UK - and one of only three centres worldwide - with Berlin Heart Training Centre accreditation, and we are currently working with the units in Boston and Texas to share experience in this field.

We are the most experienced hospital in the world in the use of VADs for congenital (from birth) heart disease. We are also the only centre in the UK to support and carry out transplants for people of all ages with congenital heart disease. No other centre offers transplantation to adult cardiac congenital patients.

Added safety

Due to our expertise and experience on the Paediatric Intensive Care Unit, we are able to offer a wide range of high-risk procedures. We can perform these with the added ‘safety net’ of the mechanical support if necessary.

Data collection shows that our results are comparable with, and in some cases better than other centres across the world.

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