Tissue Used for Baby's Partial Heart Transplant Has Grown

The tissue used in the first ever partial heart transplant has grown more than a year after surgery, according to a new study.

A newborn made history in 2022 when he became the first known person to receive a partial heart transplant. A study published in the JAMA journal Tuesday revealed that the tissue used in the surgery has successfully grown with him more than a year later — accomplishing the goal of the ambitious procedure.

A team at Duke Health, led by Joseph W. Turek, M.D., Ph.D., performed the landmark surgery on an infant when he was just 18 days-old. The baby was diagnosed with persistent truncus arteriosus and severe truncal valve dysfunction, heart defects that would typically require him to undergo numerous invasive heart surgeries and greatly shorten his life expectancy.

"The treatment of neonates with irreparable heart valve dysfunction remains an unsolved problem because there are no heart valve implants that grow," the surgical team reported in JAMA. "Therefore, neonates with heart valve implants are committed to recurrent implant exchanges until an adult-sized valve can fit."

Turek and his team at Duke Health, therefore, developed a new approach. The surgeons fused the arteries and valves from a donor — a 2-day-old female whose delivery had been complicated by hypoxic-ischemic brain injury — with the infant’s own heart, and gave him low levels of anti-rejection medications. The goal was to allow the valves to grow with him to prevent the need for future surgeries and extend his life expectancy. The effects of the procedure are expected to last a lifetime, according to the study.

When surgeons followed up with the child at 14 months-old, the results were optimistic. Tests showed that the valves had grown with the child and showed no obstruction or insufficiency of the transplanted valves. Study authors reported that the child had also achieved many healthy developmental milestones, including playing, looking for objects, crawling, standing, and making different sounds.

"This is the first demonstration of growing valve implants in humans," Turek told Healthnews. "This signifies the creation and viability of a whole new field within cardiac surgery and should be able to help countless children in the future."

While longer-term follow-ups and more patients are needed to determine whether this approach can truly result in improved long-term survival and reduced death for infants with these heart defects, the results so far suggest that this new procedure may just represent a major improvement in treatment for newborns with irreparable heart valve dysfunction.

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