Origins of neonatal heart transplantation: an historical perspective

Clinical heart transplantation was first accomplished by Christiaan Barnard in 1967. Infant heart transplantation was first attempted by Adrian Kantrowitz just 3 days later in New York. Sixteen years lapsed before neonatal transplantation was again attempted, first in London and then in Loma Linda, California in the summer and fall of 1984, respectively. The latter infant became known as "Baby Fae." Neither infant survived a month, but both produced an important impact through media exposure on the public consciousness. The idea of infant organ donation slowly developed traction. The first successful neonatal heart transplant occurred in Loma Linda on November 15, 1985. That recipient, born with hypoplastic left heart syndrome, is now 25 years old. Thereafter, the incidence of infant and pediatric heart transplantation gradually increased. Today, 350 to 450 transplants are reported annually to the Registry of the International Society for Heart and Lung Transplantation, 25% of which are in young infants. Norwood's staged-reconstruction for complex univentricular heart disease has markedly reduced the need for primary transplantation in very early life. Still, many potential young infant recipients are best treated in no other way.