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The first baby to receive a partial heart transplant is expected to avoid repeated heart surgeries as the transplanted tissue will grow with the baby. This is a result never before seen in humans.
In 2022, surgeons made history when they sewed heart valves and blood vessels taken from an infant donor into the heart of 18-day-old transplant recipient Owen Monroe.
This technique, which harvests natural heart tissue and uses only living donor tissue to replace the defective part, has never been tried in humans before.
Lead surgeon Joseph Turek of Duke University had previously performed the procedure on only five piglets.
More than a year later, baby Owen’s heart has grown from the size of a strawberry to the size of an apricot, and the donor tissue has grown with it.
Researchers reported that Owen’s heart function was “very good” and he was meeting normal one-year-old developmental milestones, including playing, crawling and standing. Japan Automobile Manufacturers Association.
“This publication proves that this technology works, that this idea works, and that it can be used to help other children,” Turek says.
Owen’s parents, Nick and Taylor Monroe, agreed to the surgery after learning their baby had a serious heart defect known as truncus arteriosus. Trunk arteriosus is a disease in which the tubes exiting the heart fail to separate during development, resulting in fusion of the two major blood vessels. This will starve your baby of oxygen.
Approximately 250 babies in the United States are affected by this disease each year. Infants with truncus arteriosus are usually treated with a complete heart transplant or with frozen tissue taken from a cadaver’s heart.
Donor hearts transplanted into infants grow as the child grows, but often malfunction over time. As a result, about half of children who receive a heart transplant will die by age 20.
To prevent the transplanted heart from being rejected by the immune system, the recipient is given drugs to suppress the immune system. This leaves the body unable to fight not only heart tissue, but also cancer and infections.
It is the donor heart muscle, not the valves or blood vessels, that the body tends to reject as foreign. Because baby Owen only had a partial blood vessel and valve graft, he only needed to be given a half dose of one of these immunosuppressants.
Infants treated with frozen cadaveric tissue for truncus arteriosus require surgery every few years to replace overgrown grafts. As a result of these dangerous surgeries, this treatment carries a 50% risk of death during infancy.
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Baby Owen was listed as a candidate for a heart transplant, but his parents knew he was unlikely to survive six months before being matched with a donor.
Owen was already suffering from heart failure when he was just a few days old, and his heart was too weak to undergo emergency treatment such as cardiopulmonary bypass surgery, known as ECMO.
Taylor-Monroe said: “When they explained the situation and informed me that they didn’t have time to wait for heart tests and that I was basically in heart failure right after I got out of the hospital, I didn’t really have many options.”
“If something were to happen, we’d just try to resuscitate him and hope for the best, but it’s really hard and scary to hear that.”
Fortunately, Owen’s patched heart is now pumping normally and is “expected to last a lifetime,” researchers report.
The paper is Japan Automobile Manufacturers Association.
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