World’s First Partial Heart Transplant Completed in Newborn With Truncus Arteriosus; Donor Valve Tissues Grow Along With the Patient’s Body

One year after a heart transplant procedure was carried out on a newborn, doctors consider it a success. It has shown an outcome that has never been seen before in humans, a key measure of success in the procedure that could pave the way for future advancements.

Groundbreaking Medical Procedure

While Tayler Monroe was pregnant, she and her husband Nick learned that their son Owen showed signs of a rare congenital heart defect called truncus arteriosus. In this cardiovascular anomaly, a large blood vessel emerges from the right and left ventricles instead of the two normal smaller ones.

The couple was told that their child would require several major heart surgeries before reaching puberty. Shortly after Owen was born, doctors also found out that the valve on the top of his heart was significantly leaking. This means that the infant either needed new heart valves or a heart transplant right away.

Unfortunately, it would normally take six months for a child his age to get a heart, and doctors did not have that time. Although Owen had been listed for a normal heart transplant, experts suspected that they were going to make it that far.

Dr. Joseph Turek, Chief of Pediatric Cardiac Surgery at Duke University Hospital, offered a new option. He suggested conducting a living-tissue partial heart transplant, a technique of salvaging native heart tissue by replacing defective parts with living donor tissue.

This method has only been done in pigs and has never been trialed in humans. However, doctors believe this revolutionary surgery would solve two problems simultaneously. First, it could reduce the time spent waiting on a donor tissue. Second, the living tissue would grow with the body, so the patients would not need follow-up operations to replace the tissue once it becomes too small.

In April 2022, Owen underwent the first-of-its-kind procedure when he was just 17 days old, weighing only five pounds (2.3 kilograms). He recovered well and was able to leave the hospital after seven weeks.

Within several months, Tayler and Nick reported that it was hard to notice much difference between Owen and other babies his age. His check-ups showed that his heart was functioning well with no more leaking heart valves.

Growing Neonatal Heart Valve Implants

After a year, doctors reported that Owen's heart had grown from the size of a strawberry to the size of an apricot, with the donor tissue growing with it. His heart function is described as "excellent," and he has shown developmental milestones such as crawling, standing, and playing. More importantly, Owen's patched-up heart is expected to last a lifetime.

According to Dr. Turek, this success proves that this technology works and can be used to help other children. Duke experts believe a similar approach may be viable for other patients with pediatric congenital heart defects.

In addition, the method can open the door to domino heart transplant surgery, which could effectively provide 'pre-conditioned' donor hearts to infants who urgently need heart transplantation. In this procedure, a patient with healthy valves and in need of a stronger heart muscle receives a full transplant. Then, the healthy valves are donated to a second patient in need.

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