Partial Heart Transplant Update: Where Are We In 2025?
| Title: | Partial Heart Transplant Update: Where Are We In 2025? |
|---|---|
| Authors: | Wolf SEM; Department of Surgery, Duke Congenital Heart Surgery Research and Training Lab, Durham, North Carolina.; Aykut B; Department of Surgery, Duke Congenital Heart Surgery Research and Training Lab, Durham, North Carolina; Department of Surgery, Duke University Medical Center, Durham, North Carolina.; Medina CK; Department of Surgery, Duke Congenital Heart Surgery Research and Training Lab, Durham, North Carolina; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina.; Kucera JA; Department of Surgery, Duke Congenital Heart Surgery Research and Training Lab, Durham, North Carolina.; Ghandour HZ; Department of Surgery, Duke Congenital Heart Surgery Research and Training Lab, Durham, North Carolina; Department of Surgery, Duke University Medical Center, Durham, North Carolina.; Turek JW; Department of Surgery, Duke Congenital Heart Surgery Research and Training Lab, Durham, North Carolina; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina; Department of Surgery, Duke University Medical Center, Durham, North Carolina. Electronic address: joseph.turek@duke.edu.; Overbey DM; Department of Surgery, Duke Congenital Heart Surgery Research and Training Lab, Durham, North Carolina; Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina; Department of Surgery, Duke University Medical Center, Durham, North Carolina. |
| Source: | Seminars in thoracic and cardiovascular surgery [Semin Thorac Cardiovasc Surg] 2025 Summer; Vol. 37 (2), pp. 174-179. Date of Electronic Publication: 2025 Mar 19. |
| Publication Type: | Journal Article; Review; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: W.B. Saunders Country of Publication: United States NLM ID: 8917640 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-9488 (Electronic) Linking ISSN: 10430679 NLM ISO Abbreviation: Semin Thorac Cardiovasc Surg Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Philadelphia, PA] : W.B. Saunders, [c1989- |
| MeSH Terms: | Heart Transplantation*/adverse effects ; Heart Transplantation*/methods ; Heart Transplantation*/trends ; Heart Defects, Congenital*/surgery ; Heart Defects, Congenital*/physiopathology ; Heart Defects, Congenital*/diagnostic imaging ; Heart Valves*/surgery ; Heart Valves*/growth & development ; Heart Valves*/physiopathology ; Heart Valve Prosthesis Implantation*/adverse effects ; Heart Valve Prosthesis Implantation*/trends; Immunosuppressive Agents/administration & dosage ; Humans ; Treatment Outcome ; Risk Factors ; Recovery of Function |
| Abstract: | Partial heart transplantation (PHT) creates a new and innovative approach to allow for patient and disease tailored intervention with the ability to treat a larger patient base. It offers the growth capacity of a heart transplantation without the need for high dose immunosuppression. The importance of a valve replacement with the potential of growth is imperative in the pediatric population as these patients will otherwise outgrow their new valves requiring repeat and high-risk interventions. Adaptive valve growth has been observed prior to PHT, in the case of orthotopic heart transplantation and Ross pulmonary autografts. The first human PHT was performed in April of 2022 at Duke. The recipient was a 17-day old infant with truncus arteriosus and severe truncal valve regurgitation. The operation was a success and the transplanted PHT conduit showed appropriate adaptive valve growth. Due to the low immunogenicity and recipient endothelialization of the transplanted PHT graft, the immunosuppressive requirements for PHT patients are low. One of the benefits of PHT is that it utilizes hearts which would otherwise not be suitable for orthotopic heart transplantation. Furthermore, the prospect of domino and split root PHT increases the potential of ethical and efficient organ stewardship. Currently PHT is regulated by the Food and Drug Administration, a ruling which was released in early 2024 as human cells, tissues, or cellular or tissue-based products (HCT/Ps). This means it does not compete with hearts suitable for orthotopic heart transplantation which are regulated as organs under the Organ Procurement and Transplantation Network (OPTN).; (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: adaptive valve growth; immunosuppression; partial heart transplantation; regulatory authority |
| Substance Nomenclature: | 0 (Immunosuppressive Agents) |
| Entry Date(s): | Date Created: 20250321 Date Completed: 20250616 Latest Revision: 20260319 |
| Update Code: | 20260320 |
| DOI: | 10.1053/j.semtcvs.2025.03.002 |
| PMID: | 40118236 |
| Database: | MEDLINE |
Journal Article; Review; Research Support, Non-U.S. Gov't