Partial Heart Transplant Update: Where Are We In 2025?

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Transplantation Medicine

Background:

• Partial heart transplantation (PHT) presents an innovative surgical option for a wider patient demographic.
• Pediatric patients require valve replacements with growth potential to avoid repeat interventions.
• Existing transplantation methods have limitations regarding immunosuppression and organ suitability.

Purpose of the Study:

• To introduce and evaluate the initial outcomes of partial heart transplantation (PHT) as a viable treatment.
• To assess the feasibility of adaptive valve growth in PHT recipients.
• To highlight the benefits of PHT in terms of immunosuppression and organ utilization.

Main Methods:

• The first human PHT was performed on a 17-day-old infant with truncus arteriosus and severe truncal valve regurgitation.
• The transplanted PHT conduit was monitored for adaptive valve growth and assessed for immunogenicity.
• Regulatory status of PHT as human cells, tissues, or cellular or tissue-based products (HCT/Ps) was established.

Main Results:

• The PHT procedure was successful, with the transplanted conduit demonstrating appropriate adaptive valve growth.
• PHT grafts exhibit low immunogenicity and promote recipient endothelialization, leading to reduced immunosuppression needs.
• PHT utilizes organs unsuitable for traditional orthotopic heart transplantation, enhancing organ stewardship.

Conclusions:

• Partial heart transplantation is a promising innovation for pediatric cardiac surgery, offering growth potential and reduced immunosuppression.
• The successful first human PHT case validates the procedure's efficacy and the potential for adaptive valve growth.
• PHT expands treatment options and improves organ utilization, with distinct regulatory pathways from traditional organ transplantation.