The world’s first partial heart transplant ,performed in spring of 2022 on an infant who needed a heart replacement, proved successful with functioning values and arteries. Prior to this innovative surgery, the procedure used non-living valves, which require frequent replacements, surgeries, and usually has a 50% mortality rate. The infant, Owen Monroe, had what is known as truncus arteriosus which links to the single valve’s dysfunction. Over half of all children with the rare heart condition die before they are 6 months old. Owen Monroe was only 18 days old when he received the surgery. Because his new values and blood vessels kept up with his growth, he might not need more risky heart surgeries in the future. Since Owen, there have been 12 more partial heart transplants.
This study was led by Duke Health physicians. Duke’s chief of pediatric cardiac surgery Dr. Joseph W. Turek said, “This publication is proof that this technology works, this idea works, and can be used to help other children.”
There are still many risks that come with this transplant. Medication is necessary to suppress the immune system so that the recipient will not reject the transplanted parts of the heart. A goal of the study is to refine Owen’s regimen of medicine because some of the drugs can be life-sustaining and leave people vulnerable to cancer and infections.
This innovative surgery is only the first step in advancing cardiac surgery. It could potentially lead to domino heart transplant where one heart can save two lives. In May 2023, the first-ever “domino” infant partial heart transplant was performed on a pediatric patient in New York. Although this surgery wasn’t the first partial heart transplant, a domino procedure had never been attempted. Pediatric cardiothoracic surgeon Dr. David Kalfa said “Having these living and growing valves is the Holy Grail in pediatric cardiac surgery because none of the current options to replace heart valves in children have a growth potential.” If someone with weak heart muscle but healthy values gets a full heart transplant and then therefore donate their healthy heart values to someone who needs it.
“This innovation adds a lot to the whole donation community,” Turek said, “because it’s treating more kids, while also honoring the wishes of selfless donor parents who’ve given the ultimate gift. It allows them to offer hope to another child in the process.”