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Updated: May 21, 2025

Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems
Published on: August 2, 2024
Partial Heart Transplantation Promotes Organ Stewardship: Domino Hearts and Split Roots
Berk Aykut1,2, Douglas M Overbey1,2,3, Cathlyn K Medina1,3
1Duke Congenital Heart Surgery Research and Training Laboratory, Durham, North Carolina.
Background:
Partial heart transplantation (PHT) has emerged as a pioneering approach for treating infants with irreparable heart valve dysfunction. However, the scarcity of suitable donors presents a significant bottleneck to its widespread application. This study introduces and evaluates the novel use of domino and split-root procedures within PHT.
Methods:
We describe 6 pediatric cardiac patients who underwent either domino or split-root PHT at our institution.
Results:
From May to August 2023, our team successfully executed 3 domino and 3 split-root PHTs, including 1 procedure that involved interinstitutional collaboration. These cases highlight the procedural feasibility and the potential for broader application.
Conclusions:
The implementation of PHT represents a significant advance in pediatric heart care. Domino and split-root techniques within the PHT framework have the potential to substantially increase both donor availability and recipient capacity. These strategies usher in a new era of organ stewardship through addressing the challenge of donor organ shortage.

