Partial Heart Transplantation Promotes Organ Stewardship: Domino Hearts and Split Roots

Annals of thoracic surgery short reports Pub Date : 2025-03-01 DOI:10.1016/j.atssr.2024.07.033

Berk Aykut MD , Douglas M. Overbey MD, MPH , Cathlyn K. Medina BA , Tariq M. Omer MS , T. Konrad Rajab MD , Smith M. Ngeve BA , Ziv Beckerman MD , Joseph W. Turek MD, PhD

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Abstract

Background

Partial heart transplantation (PHT) has emerged as a pioneering approach for treating infants with irreparable heart valve dysfunction. However, the scarcity of suitable donors presents a significant bottleneck to its widespread application. This study introduces and evaluates the novel use of domino and split-root procedures within PHT.

Methods

We describe 6 pediatric cardiac patients who underwent either domino or split-root PHT at our institution.

Results

From May to August 2023, our team successfully executed 3 domino and 3 split-root PHTs, including 1 procedure that involved interinstitutional collaboration. These cases highlight the procedural feasibility and the potential for broader application.

Conclusions

The implementation of PHT represents a significant advance in pediatric heart care. Domino and split-root techniques within the PHT framework have the potential to substantially increase both donor availability and recipient capacity. These strategies usher in a new era of organ stewardship through addressing the challenge of donor organ shortage.

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