The first partially transplanted human heart

Owen Monroe, the 5-pound newborn from Leland, N.C., was born with  Trunk Arteriosus (TA), a rare congenital heart defect. In particular, a normal heart, in order to operate, requires the transport of blood. Blood is transported by blood vessels – arteries, veins, capillaries – to and from the heart. There are normally two arteries that carry blood away from the heart. In this anomaly, during fetal development, a normal separation has not taken place, so there is only one large artery. This large artery is called the common arterial trunk. As a result, there is no proper exit of oxygenated and deoxygenated blood from the heart. In most cases, surgery is required. In Owen’s case surviving the wait for a full heart transplant was almost impossible. During the live donation surgery – from a freshly cut heart – the arteries and valves were fused to Owen’s existing heart. The muscle tissue used, however, was weak for a complete transplant, but had very strong valves suitable for implantation.

In general, due to growth, the physiology and anatomy of the heart are constantly changing. Therefore, after initial implantation with a standard valve, there is a chance that the need for open heart surgery will arise again in order to change the valve tissue. Often, when implanting, doctors use a human graft for a valve. These valves are frozen in freezers and do not grow, as the tissue is not alive. This results in the need to undergo surgery again to “preserve heart function” or to replace the valve. This is quite ordinary actually, as in most similar medical cases, paediatric patients typically receive cryopreserved human tissue.

Experts explain    

Duke’s chief of paediatric cardiac surgery, Joseph W. Turek, M.D., Ph.D., who led the surgery, said, “This approach potentially solves the problem of a growing valve. If we can even eliminate the need for multiple open-heart surgeries every time a child outgrows an old valve, we will be able to extend that child’s life.”

Owen has seen remarkable growth and improvement since undergoing the surgery and his future seems optimistic. Therefore, the Duke team’s efforts—including fellow paediatric heart surgeon Nicholas Andersen, M.D. and a large team of anaesthesiologists, nurses, technicians and support staff – to implant valves that will grow with the patient appears to be more than successful.

Also the contribution of Owen’s pediatric transplant cardiologist, Michael Carboni, M.D., associate professor in the Department of Paediatrics at Duke University School of Medicine is noteworthy. He states that: “Not only can this innovation extend children’s lives, but it also uses a donated heart that otherwise could not be transplanted. In fact, it gives impetus to the ways in which we can use the incredible gift of organ donation to save more lives.”

Hope for the future    

Owen’s family, visibly moved by the outcome, trusted from the beginning that their son was in the best medical hands. Hopefully, in the near future this scientific advancement, will change the way in which organ donation and transplants are carried out for all patients.