We aimed to summarize the nursing experiences in a pediatric patient who developed right ventricular failure, diaphragmatic paralysis, and hepatic injury during the critical phase following heart transplantation after implantation of a left ventricular assist device. Key nursing interventions included: establishing multidisciplinary collaboration and rapid response mechanisms to facilitate precise decision-making and prompt interventions; pathophysiology-based precise maintenance of right ventricular function and early intervention for acute heart failure; utilising diaphragmatic ultrasound visualization combined with stepwise respiratory training to enhance respiratory function; introducing gastric ultrasound for dynamic monitoring of nutritional tolerance, alongside individualised enteral nutritional support and hepatic function protection. Through implementation of the "Collaborate-Protect-Support" tripartite nursing model and refined multidisciplinary team management, the pediatric patient recovered sufficiently for discharge. Two-month postoperative follow-up demonstrated favorable recovery.