Owen’s parents Tayler and Nick Monroe spend time with him after he underwent the world’s first partial heart transplant in April 2022 just 17 days after he was born. — Photos: TNS
In 2022, Duke Health surgeons in North Carolina, United States, made history when they successfully performed the world’s first partial heart transplant on a newborn.
Doctors thought the groundbreaking, eight-hour surgery – which fused living arteries and valves from a donor’s heart to a newborn’s heart – could create a new field of cardiac surgery that would spare young patients from numerous risky procedures later in their lives.
But the surgery’s initial success came with a big caveat: Doctors didn’t know how the transplant would hold up over time.
A study published recently in the Journal of the American Medical Association, found that the transplanted arteries and valves were growing along with the patient’s heart, as hoped.
“This publication is proof that this technology works, this idea works, and can be used to help other children,” said Duke Health paediatric cardiac surgery chief Dr Joseph Turek, who led the surgery.
Since the first partial heart transplant surgery on then-newborn Owen Monroe, the procedure has been performed 13 times at four centres worldwide, including nine at Duke Health.
Until recently, newborns with severe heart valve problems had two options.
The first was to replace the entire heart, which could require waiting up to six months for a donor organ, with many dying while waiting.
The second was to use tissue from a cadaver to repair the heart – an extremely risky procedure for babies with valve leaks.
Even if that succeeded, dead tissue wouldn’t grow with the rest of the heart – the child would have to undergo several more heart operations throughout their life, each riskier than the last.
The partial heart transplant appears to have melded the benefits from both approaches.
Compared to patients with an entirely new heart, Owen has a small amount of donor tissue.
Owen at home four months after his partial heart transplant. He was born with an extremely rare condition that fuses the two main arteries of the heart together.
That means the one-year-old takes a fourth of the amount of anti-rejection drugs he would have had to take to prevent his body from rejecting an entire donated heart.
And with the donated valves appearing to have grown along with Owen’s heart, the need for future surgeries is hopefully eliminated.
Partial transplants have also allowed doctors to tap into a supply of donor hearts that go unused due to deficiencies.
About half of donated hearts are deemed unfit.
The heart used in Owen’s procedure, for example, had been cast aside because the muscle was too weak.
The valves were in great condition though.
This could have a large impact on the nearly one in four babies on heart donor wait lists who die before they’re given an organ.
At Duke Health, the partial heart transplant has already given way to the “domino heart transplant”, in which a patient who receives a full heart transplant can donate their original healthy valves to another patient who could benefit from a partial heart transplant.
“You could potentially double the number of hearts that are used for the benefit of children with heart disease,” Dr Turek said. – By Teddy Rosenbluth/The News & Observer/Tribune News Service
