World’s First Partial Heart Transplant Proves Successful in First Year

• Owen Monroe was born with truncus arteriosus, a congenital heart defect in which his two main heart arteries were fused, and his one vessel was equipped with a leaky valve.
• The standard procedure to treat Owen would be implanting two preserved cadaver arteries with valves. However, the problem with the procedure is that the child would require several open heart surgeries as the implanted arteries would not grow with the heart. Larger valves would be needed time and again, which would decrease the life expectancy.
• To overcome this problem, Duke’s chief of pediatric cardiac surgery, Dr. Joseph W. Turek, M.D., Ph.D., used an innovative approach. In this novel partial heart transplant, living tissue and valves were used. The tissue was taken from a donor heart that had strong valves but could not be used for a full transplant due to weak muscle.
• Turek’s team at Duke included fellow pediatric heart surgeon Nicholas Andersen, M.D., a vast team of anesthesiologists, nurses, and support staff.
• Only 13 partial heart transplants have been performed, out of which nine were done at Duke Health, North Carolina, United States.
• This relatively new technique has several benefits, such as no need for multiple surgeries, as the donated tissue will grow with the child’s heart. The number of hearts available for transplant can be doubled with this technique, as one heart can save two lives (domino heart transplant).
• During a domino heart transplant, a patient who has healthy valves but needs stronger heart muscle receives a full heart transplant. Their healthy valves are then donated to another patient with defective valves, creating a domino effect.
• The amount of immunosuppressant medicines required after this heart transplant is one-fourth of what is generally needed after a full heart transplant.  
• The infant has shown remarkable growth and improvement since the surgery in 2022.
• Dr. Turek said his next step will be bringing this innovation to a clinical trial to help significantly increase the availability of hearts.

Source: Duke Health