Why the first partial heart transplant hailed as a success

The hearts and valves transplanted into an infant in 2022 are growing along with the child, leading the medical team at Duke Health to hail the first partial heart transplant a success. The pioneering surgery makes it unlikely the child, Owen Monroe, now 21 months old, will need further surgery, which was once the standard of care, since valves in previous transplants didn’t grow with the child and had to be replaced often.

Those valve replacement surgeries had a 50% mortality rate, according to a Duke news release . The valves in the new procedure are still living. WDTV in Durham, North Carolina, said that Owen was just 17 days old in the spring of 2022 when he became the first to receive a partial heart transplant. “He had a heart defect called truncus arteriosus, which basically is everybody’s got two arteries that come out of your heart.

And he just had one that came out of both sides,” his father, Nick Monroe, told the TV station. He explained that the surgical team took the pulmonary artery valves and aorta from a donor baby and replaced Owen’s valve and artery, “to make his heart 100%.” In a just published study in JAMA, the Journal of the American Medical Association, Duke Health doctors said the new way they used to retrieve the valves and transplant them means both valves and arteries work well and grow with a child as if they were always his or hers.

The release said the procedure also requires only about a fourth as much medicine to suppress the immune system compared to a full heart transplant, which could reduce side effects that “compound over decades.” Additionally, the lead surgeon on the transplant, Dr. Joseph W. Turek, chief of pediatric cardiac surgery at Duke, said the innovative approach could make it possible for one heart to save two lives, called a domino heart transplant.

“During a domino heart transplant, a patient who has healthy valves but is in need of stronger heart muscle receives a full heart transplant; their healthy valves are then donated to another patient in need, creating a domino effect,” per the release. “You could potentially double the number of hearts that are used for the benefit of children with heart disease,” Turek said.

“Of all the hearts that are donated, roughly half meet the criteria to go on to be used for full transplant, but we believe there’s an equal number of hearts that could be used for valves.” Since that pioneering transplant, a partial heart transplant has been performed 13 times at four centers worldwide, including nine at Duke, which said several of those have been domino heart transplants.

The next step, according to researchers, is testing the innovation in a clinical trial — “the next step to achieving the volume in procedures that would change the availability of hearts by a large amount.”.